Author of

• 35377

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  P14 - Immuno-biology and Novel Immunotherapeutics (Phase I and Translational) - Immuno-Biology (ID 153)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Immuno-biology and Novel Immunotherapeutics (Phase I and Translational)
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35420

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    P14.32 - Predictive Value of Neutrophil-Lymphocyte Ratio on the Outcome of Patients with Advance NSCLC Treated with PD-1 Inhibition and Radiotherapy (ID 3735)

    00:00 - 00:00  |  Presenting Author(s): Fen Wang
    • Abstract
    • Slides

    Introduction
    

    Pre-treatment neutrophil-lymphocyte ratio (NLR), an indicator of systemic inflammation, is correlated with survival in patients with NSCLC and other solid malignancies. This study sought to evaluate the time-dependent impact of NLR on overall survival for advanced NSCLC patients treated with radiotherapy (RT) and immune checkpoint inhibition (ICI).

    Methods
    

    We retrospectively studied patients from a single institution diagnosed with metastatic NSCLC and treated with ICI +RT. NLR values were recorded at the start of ICI, before radiotherapy, and after the completion of radiotherapy. Cox regression models were used to determine the association between NLRs and other factors including biologically equivalent dose of RT(BED10), sites of RT, ICI-RT sequence and patient’s sex with OS. Raw NLR values were log transformed for univariate and multivariate analyses. Maximally selected rank statistics were used to determine an optimal cut-off NLR value to dichotomize patients, and OS was compared based on NLR.

    Results
    

    A total of 85 patients received ICI+RT with median follow-up of 15 months from diagnosis and median survival of 18.6 months. In univariable analysis, pre-ICI log (NLR), post-RT log (NLR), dose of RT (BED10), sites of RT, ICI-RT sequence and patient’s sex were all associated with OS. Multivariate analysis found pre-ICI log (NLR) (HR 3.37; P = 0.007) and RT dose BED10 > 45 Gy (HR 0.37; P = 0.0056) to be independent predictors of OS. Because Pre-ICI and post-RT log(NLR) variables were found to be strongly correlated (r =.68; P <.0001), in multivariate models to adjusted without pre-ICI log (NLR) showed post-RT log(NLR) (HR 2.78; P = 0.012) and RT dose BED10 > 45 Gy (HR 0.37; P = 0.0056) to be independent predictors of OS. The post-RT NLR cut-off value of 5.36 was then used to dichotomize patients and compare OS. Patients with NLR ≥ 5.36 post-RT exhibited particularly poor OS compared to those with NLR < 5.36 (median 11.5 months vs. 23.7 months; P = 0.001).

    Conclusion
    

    Both of Pre-ICI NLR and RT dose BED10 > 45 Gy are prognostic of survival in advanced NSCLC patients receiving ICI and RT. Post-RT NLR is correlated well with pre-ICI NLR and becomes independent predictor for survival after adjusted with pre-ICI NLR.

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