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Peripheral Blood Biomarkers Associated with Clinical Outcome in NSCLC

Targeting of the immune system has been found to confer clinical benefit for patients with some types of advanced solid tumour. Given that only a limited number of patients experience a durable response, whereas all those treated are at risk for specific immune side effects, the identification of individuals who are most likely to benefit from nivolumab and similar agents is an important clinical goal.
Tanizaki J et al. (ID 8547) showed that a baseline signature of a low absolute neutrophil count (ANC), high absolute lymphocyte count (ALC), and high absolute eosinophil count (AEC) was associated with a better outcome of nivolumab treatment, with the number of favourable factors identifying subgroups of patients differing in survival and response rate.

Method

A total of 134 patients with advanced or recurrent NSCLC treated with nivolumab was analysed retrospectively. Univariable and multivariable analyses were performed to evaluate the relation between survival and peripheral blood parameters measured before treatment initiation, including ANC, ALC, absolute monocyte count (AMC), and AEC as well as serum C-reactive protein and lactate dehydrogenase levels. Progression-free survival (PFS), overall survival (OS), and response rate were determined. We further evaluated the association of these factors and the expression level of PD-L1 of tumor tissue.

Results

Among variables selected by univariable analysis, a low ANC, high ALC, and high AEC were significantly and independently associated with both better PFS (p = 0.001, p = 0.04, and p = 0.02, respectively) and better OS (p = 0.02, p = 0.04, and p = 0.003, respectively) in multivariable analysis. Categorization of patients according to the number of favourable factors revealed that those with only one factor had a significantly worse outcome compared with those with two or three factors. Median PFS was 209, 87, and 42 days and the response rate was 43.5%, 27.1%, and 5.9% in patients with three, two, or one of the three favourable factors, respectively. The association between survival factors and the expression of PD-L1 in tumour tissue will be presented at the conference (October 16, 2017; Poster Session).

References:
Tanizaki J et al., abstract P1.07-010: Peripheral Blood Biomarkers Associated with Clinical Outcome in Non–Small Cell Lung Cancer Patients Treated with Nivolumab (ID 8547)

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