Author of

• 18502

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  P3.02c - Poster Session with Presenters Present (ID 472)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18581

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    P3.02c-079 - Immunotherapy in Non Small Cell Lung Cancer (NSCLC): Biomarkers Associated with Early Death (ID 5979)

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

    Background:
    Inmune checkpoint blockade monoclonal antibodies have demonstrated an improvement in the overall survival (OS) of patients with NSCLC. The aim of our research was to explore biomarkers of early death among the routinely used biological parameters in the population diagnosed with advanced lung cancer treated with immunotherapy.
    
    Methods:
    In this retrospective study, we collected blood levels of lymphocytes, eosinophils and lactate dehydrogenase (LDH) before inmunotherapy infusion. Inclusion criteria were a diagnosis of stage IV NSCLC, at least one previous line of chemotherapy.
    
    Results:
    44 patients (p) were treated between April 2014 and December 2015. Thirteen p received atezolizumab,27 p nivolumab and 4 p pembrolizumab. 70.5% males with a median age of 63 (range 42-82), 29.5% squamous and 2.3% never-smoker patients. Eighteen p had PS 0 (41%), 22p PS1 (50%) and 4p PS 2 (9%). Thirty-one p had ≥ 2 metastatic sites. Immunotherapy was the second-line treatment in 27p. The median number of doses received was 4.5 (range 1-27). Median OS was 12 months (95% CI 3–21) from the start of checkpoints inhibitors. Median PFS was 4 months (95% CI 0.7–7) from the start of checkpoints inhibitors. At 1 year, the overall survival rate was 40%. Eighteen p (41%) died within the first 3 months. The risk of early death based in terms of PS (15p PS0-1), smoking status (1p never-smoker), histology (14p non-squamous), molecular status (5p KRAS), metastases (3p brain metastases), response of previous line and line of treatment (second line in 8/14 p (55 %), was not statistically significant. The risk of early death was higher in 14/18p (78%) had basal LDH levels above the normal range with a difference statistically significant, p 0.036; OR =4.6. However, 11/18 p (62%) had baseline eosinophils <100 mm3, the risk of early death was higher compared to the patients with eosinophils >100 mm3, p 0.04; OR 0.28. The risk of early death based on basal lymphocytes level ≥1000 mm3 or lymphocytes level ≥1500 was not statistically significant. In the multivariate analysis, baseline LDH levels remained as an independent predictor of overall survival but not of early death, p 0.055; HR 4.3 (95% IC 0.9-19).
    
    Conclusion:
    Our study suggests that baseline serum determination of LDH and eosinophils might help us to identify patients with NSCLC who achieve more benefit from immunotherapy. Futher studies are guaranteed.