Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Clinical haematological biomarkers: Derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) and their relationship to survival outcomes in non small cell lung cancer (NSCLC) treated with immunotherapy: A multicenter review.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr e20704)
Author(s): Colum Dennehy, Eileen McMahon, Derek Gerard Power, Seamus O'Reilly, Dearbhaile Catherine Collins, Deirdre O'Mahony, Anne M. Horgan, Miriam O'Connor, Emmet Jordan, Paula Calvert, Richard Martin Bambury; Cork University Hospital, Cork, Ireland; Mater Misericordiae University Hospital, Dublin, Ireland; Mercy University Hospital, Cork, Ireland; Drug Development Unit-The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom; Princess Margaret Cancer Centre, Toronto, ON, Canada; University Hospital Waterford, Waterford, Ireland; Memorial Sloan Kettering Cancer Center, New York, NY; Cork University Hospital, Wilton, Ireland
Background: Efficient use of immunotherapy in non-small-cell lung cancer (NSCLC) has been limited by the lack of a definitive predictive biomarker. Recently considerable efforts have been invested to develop biomarkers to predict which patients should receive immune checkpoint inhibitors. This retrospective cohort study aimed to determine whether clinical factors and inflammation-based biological markers such as pre-treatment derived neutrophils to lymphocytes (dNLR) ratio, platelets to lymphocytes (PLR) ratio and prognostic nutritional index (PNI) were associated with outcomes in NSCLC patients treated with immunotherapy. Methods: This study was a multicentered, retrospective systematic review. Clinical and electronic records were retrospectively examined from metastatic NSCLC patients treated with immunotherapy from August of 2015 to September 2018 in 2 regional cancer centers and a total of 69 patients were enrolled. NLR ≥5 and PLR ≥260 were defined as elevated and PNI ≤35 was defined as reduced. Results: Approximately, 57% of patients had NLR ≤ 5 and 51% had PLR ≤260. We found utilising univariant analysis, that pretreatment NLR ≤ 5 was independently associated with superior OS (median 12.4 vs. 6.8 months; HR 2.13, 95% CI 1.66-2.6; p = 0.007) and PFS (median 3.55 vs. 2.6 months; HR 1.75, 95% CI 1.18-2.32; p = 0.024). Results were similar when examining PLR ≤260 median OS 13.64 vs. 7.36 months; HR 1.92, 95% CI 1.1-3.5; p = 0.028) The optimal cutoff for PNI was designated to be 35. The majority (87%) had PNI > 35. NSCLC patients with PNI > 35 were found to have significantly higher median OS compared to patients with PNI ≤35 (11.11 vs. 2.4 months; HR 5.36, 95% CI ; p = 0.001). Conclusions: Immunotherapy is considered as an effective new method to treat advanced NSCLC. In this cohort of patients pretreatment NLR < 5,PLR < 260 and PNI > 35 were associated with superior outcomes. It is unclear whether these markers are predictive or prognostic or both.