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A.A.B. Da Costa
Author of
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P2.03b - Poster Session with Presenters Present (ID 465)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03b-058 - Blood Cell Count Ratios at Diagnosis as Prognostic Markers in Patients with Metastatic Non-Small Cell Lung Cancer (mNSCLC) (ID 4645)
14:30 - 14:30 | Author(s): A.A.B. Da Costa
- Abstract
Background:
Systemic inflammation has been linked with cancer development and outcome. Several biomarkers reflect this inflammatory response, notably, the neutrophil (NLR), monocyte (MLR) or platelet (PLR) to lymphocyte blood count ratio. It has also been shown that inflammatory/immune cells (IC) in tumor microenvironment have an importantrole in tumor development and behavior. The aim of this study is to investigate the clinical significance of NLR,MLR, PLR and IC infiltration as prognostic factors in mNSCLC.
Methods:
We retrospectively collected clinical, pathological and demographical data from the medical charts of mNSCLCpatients, diagnosed between Jan 1st 2011 and July 30th 2014, from a single Brazilian institution. When available,archival tissue samples were evaluated for tumor IC intensity and pattern (hematoxylin-eosin stain)and CD8 and FOXP3 positive cell counts by immunohistochemistry (IHC).NLR, MLR and PLR were defined as the ratio between the absolute neutrophil, monocyte or platelet to lymphocyte blood counts. Overall survival (OS) was calculated from the time of CT start for metastatic disease till death by any cause. Association between clinical variables and NLR/MLR/PLR was tested with Chi-square or Fisher´s exact test. OS curves were generated by Kaplan–Meier method and compared using log-rank test. Multivariate analysis was performed using Cox regression (backward stepwise method) to assess variables independently associated with OS. P values <0.05 were considered statistically significant.
Results:
A total of 170 patients were included in the study.Median age was 63.4 years, 54.1% were male, 80.6% had adenocarcinoma, 17.1% had mutated EGFR, 73.3% were current/former smokers, and 78.2% had ECOG≤1. Median values for NLR, MLR and PLR were 4.6, 0.419 and 215, respectively. 114 (67.1%) patients had samples available for IC analysis and 88 for IHC, 39% had moderate to strong IC(IC2/3) infiltrate and 91.2% had a monuclear predominant infiltration pattern. Median follow-up time was 19.64 months (mo) and median overall survival was 13.6 mo. NLR>4.6 (6.89 vs. 19.05 mo, p<0.001) and PLR>215 (6.89 vs. 8.7 mo, p<0.014) were associated with poor OS. IC2/3 was associated with shorter OS (IC1 13.63mo vs. 4.6mo IC2/3, p=0.006), while mononuclear IC pattern was associated with improved survival (13.6 vs. 4.6 mo, p=0.023). CD8 and FOXP3 positive cells were not associated with OS. In multivariate analysis, the NLR remained as an independent prognostic factor for worse OS (HR 2.71 IC95% 1.39-5.25, p=0.003).
Conclusion:
Elevated NLR is an independent predictor of poor OS in patients with advanced NSCLC.
