Author of

• 30943

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  P2.04 - Immuno-oncology (ID 167)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Immuno-oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 30964

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    P2.04-21 - Serum CRP Decrease Has Predictive Value for Long-Term Disease Control by PD-1/ PD-L1 Inhibitors in Patients with NSCLC (ID 305)

    10:15 - 18:15  |  Author(s): Naozumi Hashimoto
    • Abstract

    Background
    

    Several studies showed the predictive or prognostic value of systemic inflammatory markers such as C-reactive protein (CRP) in patients with non-small cell lung cancer (NSCLC) treated with PD-1/PD-L1 inhibitors. In OAK study, serum CRP decrease at 6 weeks from baseline was associated with the favorable clinical efficacy of atezolizumab, a PD-L1 inhibitor. However, the result is not validated in the clinical practice setting including patients treated with anti PD-1 antibodies. The aim of this study is to investigate the significance of serum CRP change from baseline as a biomarker in NSCLC patients treated with PD-1/PD-L1 inhibitors.

    Method
    

    The current study is a retrospective cohort study. NSCLC patients treated with anti-PD-1/PD-L1 inhibitors in 2nd or later line setting were reviewed at Nagoya University Hospital and Tosei General Hospital. Patients were divided into two groups by serum CRP change (Group 1; patients with serum CRP decrease at 6 weeks by >= 33% compared to the baseline, and Group 2; the others except Group 1).

    Result
    

    From January 2016 to September 2018, 124 advanced or recurrent NSCLC patients were enrolled. 34 (27.4%) patients were divided into Group 1 and 90 (72.6%) were into group 2, respectively. Group 1 showed statistically significant higher objective response rate compared with Group 2 (38.2% vs 7.0%, p< 0.01), and longer progression-free survival (PFS) (1-year PFS rate: 34.2% vs. 11.7%, HR of group 1 to group 2: 0.63 (95%CI: 0.39-0.98), p=0.04). Multivariate analysis also identified the CRP decrease as an independent favorable factor of PFS (adjusted HR of group 1 to group 2: 0.45 (95%CI: 0.26-0.77), p< 0.01). In contrast, PFS and OS were similar between the patients treated with PD-1 and PD-L1 inhibitors.

    Conclusion
    

    Serum CRP decrease at 6 weeks from baseline would have predictive value for long-term disease control by PD-1/PD-L1 inhibitors for NSCLC in the clinical practice setting.

• 31865

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  P2.18 - Treatment of Locoregional Disease - NSCLC (ID 191)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Treatment of Locoregional Disease - NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31887

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    P2.18-18 - Impact of Combined Evaluation Using Tumor Volume and Metastatic Nodal Extent in Stage III NSCLC Treated with CRT (ID 310)

    10:15 - 18:15  |  Author(s): Naozumi Hashimoto
    • Abstract
    • Slides

    Background
    

    Chemoradiotherapy (CRT) is the standard treatment for patients with unresectable stage III non-small cell lung cancer (NSCLC). In those, gross tumor volume (GTV) and number of metastatic nodal stations were proposed as possible prognostic factors, while TNM stage classification (stage IIIA vs. stage IIIB/IIIC) did not show significant prognostic impact. However, these evidences remain controversial. The aim of this study was to investigate the prognostic impact of GTV and metastatic nodal extent.

    Method
    

    We retrospectively reviewed stage III NSCLC patients treated with CRT at our institution between October 2005 and December 2018. Simplified GTV (sGTV) was calculated by oval volume formula. We confirmed statistically significant association between sGTV and standard GTV as previous preparation. Metastatic nodal extent was divided into limited nodal extent (≤ND2a) (defined as "LN") or extensive nodal extent (>ND2a)(defined as "EN"). Prognostic impact of sGTV and metastatic nodal extent was evaluated by univariate and multivariate analysis.

    Result
    

    58 patients were enrolled in this study. Median progression-free survival (PFS) of all patients were 9.0 months. In univariate analysis, patients with sGTV>90cm³ had shorter PFS compared to those with sGTV≤90cm³ (median PFS: 6.7 vs. 11.7, p=0.03). Further, patients with sGTV>90cm³ and EN showed poorer PFS (HR 3.3; 95% CI,1.40-7.87; p<0.01) and OS (HR 3.3, 95% CI: 1.18-9.32, p<0.01) in univariate analysis. Multivariate analysis also showed an independent poor prognosis in patients with sGTV>90cm³ and EN (adjusted HR of PFS: 3.6, 95% CI: 1.49-8.71, p<0.01, adjusted HR of OS 4.1, 95% CI: 1.37-12.6, p=0.01).

    Conclusion
    

    Combined evaluation using sGTV and metastatic nodal extent can be a useful stratified factor for clinical trial in patients with stage III NSCLC.

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