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S.Y. Moorcraft
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P2.07 - Immunology and Immunotherapy (ID 708)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.07-049 - Early Clinical Predictors of Progressive Disease or Non-Response to PD-1/PD-L1 Inhibitors in Advanced Non-Small Cell Lung Cancer (ID 10256)
09:30 - 09:30 | Author(s): S.Y. Moorcraft
- Abstract
Background:
Treatment with PD-1/PD-L1 inhibitors are now the standard of care for patients with advanced non-small cell lung cancer. PD-L1 expression, in addition to interferon score and tumour mutational burden, are predictive biomarkers, however early clinical predictive biomarkers are lacking.
Method:
Patients with NSCLC who received treatment with PD-1/PD-L1 inhibitors between 1 Jan 2014 – 31 Dec 2016 were retrospectively identified from electronic health records. Data was collected on patient, treatment and tumour characteristics. Discrete variables were compared using Fisher’s exact test. Odds ratios (OR) were calculated with 95% confidence intervals (CI) for significant associations, using contingency tables.
Result:
We identified 91 patients, with a mean age of 65 years, of whom 52% were male. The majority were ex-smokers (69.2%), followed by never smokers (23.1%). Non-squamous histology was seen in 59.3% of patients and 86.8% of the patients had ECOG performance status 0-1. The lactate dehydrogenase (LDH) at baseline, cycle 2, and the change-in LDH≥10% at cycle 2 and 6 weeks, did NOT predict for disease control rate (DCR) at the first tumour response evaluation (TRE). A LDH ≥ upper limit of normal at 6 weeks DID predict disease progression at the first TRE (P-value=0.04), with an OR of 3.58 (95% CI 1.11 – 11.52). The neutrophil-lymphocyte ratio (NLR) at baseline and 6 weeks, and the change-in NLR>10% at cycle 2 and 6 weeks did NOT predict for DCR at the first TRE. A NLR ≥5 at cycle 2 DID predict for disease progression at the first TRE (P-value=0.008), with an OR of 3.92 (95% CI 1.48 – 10.39). Receiver operator curve analysis of the early LDH/NLR score (1 point each for 6 week LDH ≥ upper limit of normal and cycle 2 NLR ≥5) predicted for disease progression at the first TRE (C-index 0.77, P-value <0.0001).
Conclusion:
The LDH greater than upper limit of normal at cycle 2 and NLR ≥5 at 6 weeks predicts for disease progression at the first TRE. These routine early predictive biomarkers could be used to identify non-responders when treating with PD-1/PD-L1 inhibitors prior to a CT scan. This data needs validation in a larger cohort.
