Virtual Library
Start Your Search
Y.K. Chae
Author of
-
+
P1.07 - Immunology and Immunotherapy (ID 693)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
-
+
P1.07-034 - Pretreatment Neutrophil & Platelet Count as a Predictor for Unfavorable Clinical Outcome in Non-Small Cell Lung Cancer (NSCLC)Â (ID 10250)
09:30 - 09:30 | Author(s): Y.K. Chae
- Abstract
Background:
The importance of tumor immune microenvironment in disease outcomes has already been established. We can speculate that markers present in patients’ complete blood count (CBC) such as absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and absolute monocyte count (AMC) could potentially help predict clinical benefit. In addition, given the recently discovered T cell inhibitory role of platelets, we hypothesized that increased platelet counts may lower the efficacy of T cell mediated immune checkpoint inhibitors. Here, we explored how well the information obtained from the simple non-invasive peripheral blood CBC can predict clinical outcome to immunotherapy in NSCLC.
Method:
ANC, ALC, AMC, neutrophil lymphocyte ratio (NLR) and platelet values were collected for twenty NSCLC patients at two times points; pretreatment (t1) & approximately 2-3 weeks after first treatment (t2). Response to immune checkpoint inhibitors based on RECIST criteria (response rate (RR) and clinical benefit rate (CBR)), progression-free survival (PFS) and overall survival (OS) were examined. Cox regression analyses were performed for baseline and delta (t2-t1) CBC values while controlling for various other clinical variables.
Result:
Baseline ANC and AMC were significantly associated with both worse PFS and OS, respectively (ANC; HR= 1.30, p=0.004 & HR= 1.31, p=0.020, AMC; HR= 13.75, p=0.030 & HR= 38.14, p=0.042). Platelets showed significance for only worse OS (HR= 4.45, p=0.036). Delta hematological profiles did not show any significant differences in clinical outcome. In multivariate analyses adjusting for clinical variables, ANC remained as an independent predictor of unfavorable PFS. None of the above variables examined were predictive of RR or CBR. Figure 1
Conclusion:
Elevated pretreatment ANC appears to strongly predict shorter PFS and OS in patients with NSCLC treated with immunotherapy. Pretreatment platelets greater than 400K was linked with poor survival outcome. Further studies with a larger cohort and serial CBC collection during treatment are warranted to validate this study.
