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L. Yang



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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
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      P1.07-039 - Blood Biomarkers Correlate with Outcome in Advanced Non-Small Cell Lung Cancer Patients Treated with Anti PD-1 Antibodies (ID 9050)

      09:30 - 09:30  |  Author(s): L. Yang

      • Abstract

      Background:
      Anti-PD-1 antibodies have demonstrated improved overall survival (OS) and progression free survival (PFS) in a subset of patients with metastatic or locally advanced non-small cell lung cancer (NSCLC). Currently, no blood biomarkers in NSCLC predict clinical outcome to anti-PD-1 antibodies.

      Method:
      A retrospective analysis of locally advanced or metastatic NSCLC patients treated with anti-PD-1 antibodies at Mayo Clinic was performed. White blood cell count (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute neutrophil to lymphocyte count ratio (ANC/ALC), absolute eosinophil count (AEC), platelet counts and myeloid to lymphoid ratio (M:L) at baseline and throughout treatment were assessed. Kaplan–Meier and Cox regression analysis were performed.

      Result:
      157 patients were treated with nivolumab or pembrolizumab between 1/2015 and 4/2017. At median follow-up of 20 months, median OS and PFS were 13.4 and 2.6 months respectively. Higher baseline ANC, AMC, ANC/ALC ratio and M:L ratio significantly correlated with worse clinical outcomes. A baseline ANC/ALC ratio ≥ 5.9 had a significantly increased risk of death [hazard ratio (HR) = 1.65; 95% CI 1.06–2.56, p 0.027] and disease progression [HR = 1.65; 95% CI 1.17–2.34, p 0.005] compared with patients with ANC/ALC ratio <5.9. A baseline M:L ratio ≥ 11.3 had significantly increased risk of death [HR = 2.13; 95% CI 1.32–3.44, p 0.002] even after a multivariate analysis [HR = 1.89, p 0.015] compared to those with lower ratio. An increase from baseline values at 8 weeks for ANC [HR 1.10, p 0.006] and WBC [HR 1.11, p 0.004] was significantly associated with worse OS. Figure 1



      Conclusion:
      Increased baseline ANC/ALC ratio and M:L ratio were associated with poor PFS and OS in NSCLC patients treated with anti-PD-1 antibodies. The potential predictive value of these biomarkers might help with risk stratification, treatment strategies and warrant further investigation in a larger, prospective study.