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M.Á. García Del Barrio
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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)
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P1.07-035 - Lymphocytes and Neutrophils Count After Two Cycles and TTF1 Expression as Early Outcome Predictors During Immunotherapy (ID 10308)
09:30 - 09:30 | Author(s): M.Á. García Del Barrio
- Abstract
Background:
Non-small cell lung cancer (NSCLC) therapeutic paradigm has dramatically changed with immune checkpoint blockers. The unconventional response patterns seen in patients treated with immunotherapy (IT) make it difficult to differentiate patients who respond from non-responders early on in treatment; and biomarkers predicting clinical benefit are still lacking. As previously shown in melanoma, changes in absolute lymphocytes and neutrophils count (ALC and ANC) during IT (PD-1/PD-L1 inhibitors) may be related to response in NSCLC (Nakamuta et al, Oncotarget 2016). TTF1 expression has been associated with PD-L1 expression (Vieira et al, Lung Cancer 2016). We aimed to investigate TTF1 expression and changes in ALC and ANC after 2 cycles and their potential association with clinical outcomes to IT.
Method:
We enrolled 32 consecutive patients with advanced NSCLC treated with IT at Clínica Universidad de Navarra (Spain) since 2015. Radiological response was evaluated according to RECIST v1.1. The potential correlation between ALC and ANC changes during the first two cycles and response to treatment [disease control rate (DCR) vs progression] was evaluated using Student’s T-test. Fisher’s exact test was used to study the association between changes in ALC (<1,000 vs >1,000) and ANC (<4,000 vs >4,000) after 2 cycles and response to IT. TTF1 expression was correlated with IT response. Overall survival (OS) was assessed with Kaplan-Meier analysis and Log-rank test according to ALC and ANC.
Result:
TTF1 tumor expression in adenocarcinoma histology (n= 18) was significantly associated with response to IT (88% vs 45%, p= 0.03). Patients with ANC <4,000 after two cycles showed a longer median OS (NR vs 4.9 months; p=0.02). An ALC increase after 2 cycles was associated with DCR compared to progression (147 vs -155; p=0.05). ALC >1,000 after 2 cycles seemed to be more frequent among patients with TTF1+ tumors (82% vs 45%; p= 0.05) and among those experiencing DCR compared to progression (73% vs 58%; p=0.30).
Conclusion:
Our results show that ALC and ANC changes during IT and TTF1 expression may act as early predictors of clinical benefit in stage IV NSCLC patients treated with PD1/PD-L1 blockers. Our results warrant further investigation in larger series.
