Author of

• 15382

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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)

  • 15497

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    P3.04-115 - A New Prognostic Index in Chinese Patients With Metastatic Non-Small Cell Lung Cancer Receiving First-Line Chemotherapy (ID 1485)

    09:30 - 09:30  |  Author(s): H. Yu
    • Abstract

    Background:
    Non-small cell lung cancer (NSCLC) is the leading cause of cancer deaths worldwide. Platinum-based duplet therapy is current standard first-line therapy for metastatic NSCLC although its influence on overall survival is modest. The response to chemotherapy and prognosis of patients with metastatic NSCLC is variable due to the heterogeneity. The purpose of the present study was to develop a new prognostic index to predict the clinical outcome of patients with metastatic NSCLC and then improve the clinical management for these patients.
    
    Methods:
    This prospective single-institutional study included 70 patients with metastatic NSCLC receiving platinum-based first-line chemotherapy. Plasma levels of 27 cytokines before chemotherapy were measured using multiplex immune assays. Receiver operating characteristics (ROC) curves were adopted to select the cut-off values for survival and chemotherapy response analyses. The Kaplan–Meier method, univariate and multivariate Cox regression analyses were used to evaluate the associations between each cytokine, ratio or clinical variable and progression-free survival (PFS) and overall survival (OS). Prognostic index (PI) was calculated by parameters estimates and PI subgroups were created using tertiles. The performance of the PI was calculated using PSEP method and validated by a bootstrap approach.
    
    Results:
    Five variables were identified as statistical significant independent prognostic factors by multivariate Cox model: three cytokines/cytokine ratios including IP-10/Eotaxin (HR, 1.578; P=0.018), MCP-1 (HR, 1.138; P=0.032) and MIP-1a (HR, 0.464; P=0.007) as well as CRP (HR, 5.948; P<0.001) and histology (HR, 5.372; P<0.001). Using these five variables, a new PI was developed to distinguish the patients into high-risk group and low-risk group according to the outcome (P<0.001). Internal validation showed that the mean optimism over 1000 iterations was 0.17 and an unbiased estimate of PSEP was 0.40.
    
    Conclusion:
    The new PI including cytokine and clinical variables can efficiently predict the survival outcome of patients with metastatic NSCLC. This finding may serve as the basis for further development of biomarkers for the prognosis and treatment of metastatic NSCLC.