Virtual Library

Start Your Search

Adela Rodriguez



Author of

  • +

    FP07 - Pathology (ID 109)

    • Event: WCLC 2020
    • Type: Posters (Featured)
    • Track: Pathology, Molecular Pathology and Diagnostic Biomarkers
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
    • +

      FP07.06 - Lung Immune Prognostic Index (LIPI) in Advanced NSCLC Patients Treated with Immunotherapy, Chemotherapy and both Combined Upfront. (ID 823)

      00:00 - 00:00  |  Author(s): Adela Rodriguez

      • Abstract
      • Slides

      Introduction

      The Lung Immune Prognostic Index (LIPI) that combines the neutrophils/[leucocytes minus neutrophils] ratio (dNLR) and lactate dehydrogenase (LDH), is associated with outcomes in pretreated advanced NSCLC patients receiving single agent immune checkpoint inhibitors (ICI). However, its role in first line treatment of advanced NSCLC patients has not been explored yet. We assessed the value of baseline LIPI in the first line setting, for ICI-monotherapy, ICI-combination or platinum-based chemotherapy alone (CT).

      Methods

      We retrospectively collected data of patients treated with first-line ICI between 2016 and 2019 as single agent if PD-L1 ≥50% (ICI-cohort), or in combination with a CTLA4-inhibitor (ICI+ICI cohort), or with chemotherapy (ICI+CT cohort), from 18 centers worldwide. A control cohort of patients treated with platinum-based CT (CT-cohort) was also collected between 2011 and 2019 from 2 centers. Baseline LIPI was calculated as previously reported and correlated with overall survival (OS) and progression-free survival (PFS) in each treatment cohort.

      Results

      Overall, 930 patients were enrolled, 561 in the ICI-cohort, 186 in the combo ICI+CT, 55 in the ICI+ICI and 128 in the CT-cohort. Median (m) follow-up was 12.5 months. In the whole cohort, median age was 66 years, 70% male, 80% had non-squamous histology, and 84% had PS ≤1. Based on LIPI (available for 792 patients): 305 (38%) were considered good, 331 (42%) intermediate and 156 (20%) poor group.

      Treatment outcomes according to LIPI scores are depicted in Table 1. The LIPI poor population had significantly worse OS compared with other LIPI groups, in the whole cohort (P<0.001) as well as in the ICI monotherapy and combo ICI+CT cohorts (both P<0.0001); and in the CT cohort (P=0.004). In term of PFS, we observed correlation between LIPI groups and outcomes in the whole cohort (P<0.001) and in the ICI- monotherapy cohort (P=0.008); however, no differences were observed in the cohorts of patients receiving chemotherapy regimens, alone (P=0.08) or combined with ICI (P=0.08). The analysis by PD-L1 expression in 756 patients with available data will be presented in the Congress.

      Table 1: Median OS and PFS according to LIPI subgroups. NR = non reached.

      Outcomes

      LIPI

      subgroups

      Overall cohort

      N= 925

      ICI-cohort

      N=558

      ICI + CT-cohort

      N= 185

      ICI + ICI cohort

      N= 55

      CT-cohort

      N=127

      Median OS

      (95% CI)

      All

      16.3 (14.7-18.8)

      21.0 (17.1-NR)

      24.7 (16.9-27.1)

      20.5 (14.1-NR)

      9.79 (8.3-14.4)

      LIPI good, 38.5%

      19.8 (17.2-25.7)

      NR (NR-NR)

      25.7 (25.6-NR)

      33.6 (14.7-NR)

      14.42 (8.9-17.9)

      LIPI interm, 41.8%

      15.8 (14.3-20.3)

      21.2 (17.1-NR)

      20.3 (12.8-NR)

      14.6 (5.5-NR)

      9.30 (7.0-14.5)

      LIPI poor, 19.7%

      6.96 (5.6-12.5)

      8.5 (3.4-13.7)

      6.1 (4.9-NR)

      14.1 (10.3-NR)

      6.1 (5.0-NR)

      Global LogRank P value

      <0.0001

      <0.0001

      <0.0001

      0.4

      0.004

      Overall cohort

      N= 909

      ICI-cohort

      N=543

      ICI + CT-cohort

      N= 185

      ICI + ICI cohort

      N= 54

      CT-cohort

      N=127

      Median PFS

      (95% CI)

      All

      6.5 (5.9-7.1)

      6.3 (5.0-7.6)

      8.9 (6.80-10.9)

      7.2 (5.7-30.6)

      5.7 (5.3-6.4)

      LIPI good, 38.7%

      7.0 (5.9-8.5)

      6.4 (4.5-10.8)

      9.8 (7.8-13.0)

      9.2 (5.7-NR)

      6.0 (5.3-7.8)

      LIPI interm, 41.6%

      6.6 (6.1-7.6)

      6.6 (5.6-8.1)

      10.4 (6.4-12.4)

      5.5 (2.5-NR)

      6.1 (4.3-7.6)

      LIPI poor, 19.7%

      3.6 (3.1-5.6)

      3.3 (1.9-6.7)

      4.5 (2.8-8.2)

      7.1 (2.56- NR)

      3.7 (3.4-NR)

      Global LogRank P value

      <0.0001

      0.008

      0.08

      0.4

      0.08

      Conclusion

      Pretreatment LIPI was prognostic in untreated advanced NSCLC patients regardless of the type of therapy. However, LIPI was associated with PFS only in patients receiving ICI-monotherapy, with no statistically significant differences in CT-containing cohorts (alone or combined with ICI). This value of LIPI to guide treatment selection should be further explored in prospective studies.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    MA03 - New and Revisited Prognostic Factors in Early Stage Lung Cancer (ID 119)

    • Event: WCLC 2020
    • Type: Mini Oral
    • Track: Early Stage/Localized Disease
    • Presentations: 1
    • +

      MA03.08 - Impact of COVID-19 Pandemic in the Diagnosis and Prognosis of Lung Cancer (ID 3700)

      15:30 - 16:30  |  Author(s): Adela Rodriguez

      • Abstract
      • Presentation
      • Slides

      Introduction

      COVID-19 pandemic has drastically changed the management of patients with cancer. The prioritization of the healthcare towards COVID-19 patients could interfere with the initial diagnosis, resulting in delayed treatment and worse outcome. We aimed to study the incidence of lung cancer new diagnosis, severity and clinical outcomes during Covid-19-period (during-COVID) compared to the same period in 2019 (before-COVID).

      Methods

      Bicenter retrospective cohort study of newly diagnosed non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) patients before (Jan-Jun/19) and during COVID-19 (Jan-Jun/20) in Spain. Clinical data were collected. We primarily assessed the difference on new lung cancer cases between both periods, and the disease severity considering: Performance status (PS), stage and any significant complication at diagnosis. Secondarily, we assessed the 30 days-mortality rate, progression-free survival (PFS) and overall survival (OS) by period.

      Results

      162 newly diagnosed lung cancer patients (68% NSCLC and 32% SCLC) were enrolled, with median age of 66 years, 70% were male, 33% smokers, 25% with PS ≥2. Advanced disease was diagnosed in 50% of NSCLC and 61% SCLC; 13% of NSCLC harbored driver alterations.

      During-COVID, the number of new cases diagnosed decreased by 38% (43 NSCLC; 19 SCLC), compared to before-COVID period (67 NSCLC; 33 SCLC). More symptomatic cases were new diagnosed during vs. before-COVID. The Table 1 summarized clinical data and complications of new lung cancer cases by period and histology.

      In NSCLC population diagnosed during-COVID, we observed more respiratory symptoms at diagnosis (30% vs. 23% before-COVID) with mainly locally-advanced/advanced disease (82% vs. 76% before-COVID). Among the cases hospitalized, the mortality during-hospitalization was 44% (2/9) vs. 17% before-COVID.

      In SCLC population diagnosed during-COVID, respiratory symptoms were more common (32% vs. 24% before-COVID), but no more aggressive disease observed in terms of stage, complications and hospitalizations. Among the 4 cases hospitalized at diagnosis, none died during-hospitalization vs. 18% before-COVID (2/11).

      Overall, during-Covid the mOS was 6.7 months [95% CI, 5.4-not reached] vs. 7.9 months [95% CI, 4.7-12] before-COVID. In NSCLC, the 30-days mortality was 49% vs. 25% before-COVID; in SCLC, it was 32% vs. 18% before-COVID. Updated data and treatment outcomes will be presented in the meeting.

      table 1.png

      Conclusion

      Lung cancer diagnosis has been affected during the COVID-19 pandemic with fewer cases diagnosed and more symptomatic disease compared to 2019, which seems to be associated with worse outcomes. This study is still ongoing.

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.