Author of

• 17398

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  P2.01 - Poster Session with Presenters Present (ID 461)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Biology/Pathology
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17468

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    P2.01-070 - Circulating Biomarkers of Frailty Are Associated with a Poor Prognosis in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC) (ID 4234)

    14:30 - 14:30  |  Author(s): C. Hutton
    • Abstract

    Background:
    Patients with borderline performance status (PS), multiple co-morbidities or who are frail have increased chemotherapy toxicity. With an ageing population, more NSCLC patients are presenting with these characteristics. Improved assessment is required to distinguish those patients likely to benefit from therapy from those where treatment precipitates significant functional decline. The Newcastle 85+ study identified circulating biomarkers associated with frailty in a cross-section of adults aged 85 years (n=845). Their utility in NSCLC is not known.
    
    Methods:
    Samples from 161 patients (median age 65; range 33 to 81) with advanced NSCLC (stage 3B/4) and PS adequate to consider systemic therapy (34% PS0; 53% PS1; 13% PS2) were analysed for biomarkers of frailty at Northern Institute for Cancer Research and Newcastle Institute for Ageing , Newcastle UK. Biomarkers included telomere length, adiponectin, high-sensitivity CRP (hsCRP), IGFBP1, TGF-β, Alpha-1 acid Glycoprotein (AAG) and FLT3 ligand. Full blood count, liver function tests, serum creatinine, CR-51 EDTA glomerular filtration rate and survival were extracted from patients’ clinical notes.
    
    Results:
    Age and line of therapy were not predictive of survival. As expected PS 2 was associated with significantly worse survival (70 days vs 315 days (PS 0-1), p<0.0001) and was associated with significantly higher biomarkers of inflammation (high hsCRP, AAG, TGF- β and neutrophils, low albumin and haemoglobin). In PS 0-1 patient’s high hsCRP, shorter telomere length and low adiponectin were associated with poor survival. An exploratory risk score combining PS and biomarkers was a stronger predictor of prognosis than PS alone (Figure 1); HR 3.2 (95%CI, 2.0 to 5.2), p<0.0001, and seemed to be particularly useful in patients >65years; HR 4.1 (95%CI, 2.0 to 8.4), p<0.0001.Figure 1
    
    
    
    Conclusion:
    Circulating biomarkers of frailty are associated with a poor prognosis in NSCLC patients and may give additional information over PS. Prospective validation and assessment of the utility in guiding therapy choices is now needed.