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Linda Willén
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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.01-15 - Systemic Hyperinflammation Is a Strong Independent Predictor of Early Mortality in Advanced NSCLC (Now Available) (ID 1143)
08:00 - 18:00 | Author(s): Linda Willén
- Abstract
Background
Prognostic tools in NSCLC are important for treatment decisions and evaluation of new treatment options. Ample evidence support inflammation as a marker of outcome in NSCLC. Our study explores outcome for a population-based real-life cohort of patients in the highest stratum of inflammatory activity.
Method
The source cohort comprised all patients diagnosed with NSCLC between January 2016 – May 2017 at Gävle County Hospital, Sweden (n=155, inclusion rate 95%). Following exclusion of patients with active infection, the subgroup (n=77) in stage IIIB-IV with complete available laboratory parameters were studied further. Blood parameters were examined individually, and cut-offs (ESR>60 mm, CRP>20 mg/L, WBC>10 x10e9/L, PLT>400 x10e9/L) for high inflammation were set with an aim to pin-point the top echelon of hyperinflamed patients. A prognostic score was developed by assigning one point for each parameter above cut-off (0-4 points).
Result
One year survival of patients with an inflammation score of ≥2 (n=23) was 0% compared to 50% and 33% among patients with a score of 0 (n=36) and 1 (n=18), respectively (figure 1). The effect of a high inflammation score on overall survival remained significant in multi-variate analysis adjusted for confounding factors (stage, gender, age, smoking status, ECOG PS). The hazard ratio of an inflammation score ≥2 in multi-variate analysis (HR 3.45, CI 1.62-7.34) was on par with a change of ECOG PS from 0 to 2 (HR 3.67, CI 1.44-9.4).
Conclusion
Inflammation is a well established marker for treatment outcome in solid tumours. Our results show that high level inflammation is a strong independent marker for poor survival in patients with advanced stage NSCLC. This observation may indicate a need to stratify and subgroup patients in clinical studies with regard to systemic hyperinflammation and warrants further research on underlying mechanisms linked to tumour progression.