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J. Macklis
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P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.04-093 - Neutrophil/Lymphocyte Ratios Inversely Related to Weight Change, Overall Survival; ALI Inversely Related to OS in NSCLC Pts (ID 3078)
09:30 - 09:30 | Author(s): J. Macklis
- Abstract
Background:
A high neutrophil/lymphocyte ratio (NLR) at baseline and at follow-up is associated with shorter survival in cancer patients and may be a surrogate for ongoing inflammation which is implicated in promoting cancer cachexia and tumor progression. The objective of this study is to explore potential relationships between OS, serial weights, and serial NLRs and ALI (Advanced Lung cancer Inflammatory) index in advanced NSCLC patients receiving chemotherapy.
Methods:
139 stage III/IV NSCLC pts were treated with first-line platinum doublets from June, 2011 to August, 2012. NLR and body weight were recorded at baseline, 6, and 12 weeks from initiation of therapy and correlated with OS. The association between NLR and OS was assessed using Cox PH analysis, and the association between NLR and weight change was assessed using a simple regression analysis. ALI index was defined as BMI (Body Mass Index) x (Albumin)/NLR. ALI was calculated at baseline, 6, and 12 weeks from initiation of therapy and correlated with OS for some pts.
Results:
139 pts with median age 68, PS 0-1/2 = 83/17%, male/ female = 48%/52%. NLR at baseline median 3.6, range 0.1898 to 30.910; at 6wks median 3.11, range 0.2703 to 42.11; at 12wks median 3.52 range 0.2147 to 42.93. Increase in the NLR at baseline, 6, and 12 weeks were associated with a decrease in OS (baseline HR 1.06, p < 0.001; 6 wks HR 1.07, p = 0.001; 12wks HR 1.05, p < 0.001). The effect of NLR on hazard is multiplicative (i.e. a change of 5 in baseline NLR results in a HR of 1.065). Initial weight and NLR were negatively correlated (cor = -0.267, p = 0.001), and weight change and NLR were also negatively correlated at 12wks (cor = -0.371, p < 0.001; weight change -13.17kg to +16.61kg, median -0.5kg, mean -0.89kg). 96, 93 and 84 pts had ALI score available at baseline, 6wks, and 12 wks respectively. 38 pts with baseline ALI score <= 18 had significantly lower OS (median OS=9.63 mos) compared to 58 pts with ALI > 18 (median not reached, p = 0.001). 41 pts with 6 week ALI <= 18 had significantly lower OS (median OS=11.4 mos) compared to 52 pts with ALI > 18 (median not reached, p = 0.03). 30 pts with 12 week ALI <= 18 had significantly lower OS (median OS=9 mos) compared to 54 pts with ALI > 18 (median not reached, p < 0.001).
Conclusion:
High baseline and progressive increase in NLRs are associated with inferior OS and weight loss in advanced NSCLC patients. In addition to having prognostic significance, these observations suggest that studying molecular mediators of cachexia/inflammation and their relationships to tumor progression may identify new therapeutic targets in the large subset of NSCLC patients who have cancer cachexia. We also confirmed findings by Jafri at all 2013, that ALI score <=18 is associated with lower OS at any time before or during treatment.
