337PNeutrophil-to-Lymphocyte ratio as a predictive factor for hyperprogressive disease in NSCLC patients treated with immune checkpoint inhibitor. (24th November 2019)

• Record Type: Journal Article
• Authors: Takahashi, R; Shibata, E; Higashiyama, T; Kamei, T; Tada, A; Ishigaki, H; Nakajima, Y; Negi, Y; Niki, M; Mikami, K; Minami, T; Yokoi, T; Kuribayashi, K; Kijima, T
• Is Part Of: Annals of oncology. Volume 30(2019)Supplement 9
• Publication Date: 2019-11-24
• Subjects: Oncology -- Periodicals; 616.992
• DOI: 10.1093/annonc/mdz438.019
• Languages: English
• ISSNs: 0923-7534

Abstract

Abstract: Background: Hyperprogressive disease (HPD) has been reported as one of unfavorable responses during treatment with immunecheck point inhibitors for advanced non-small cell lung cancer (NSCLC) patients. However its mechanism remains unclear and the phenomenon itself remains controversial. Methods: Medical records from consecutive NSCLC patients treated by monotherapy with anti-PD-1/PD-L1 antibodies at Hyogo College of Medicine Hospital between Jun 2016 and May 2018 were analyzed retrospectively. HPD criteria was defined as 1) time to treatment failure < 1 month and 2) tumor growth kinetics rate > 2. To explore the predictive factor for HPD, we examined the association between clinical parameters and responses. Results: Ninety-four patients were treated with nivolumab. The median patient age was 70 (range 4188) years and 72 patients (73%) were male. Patients number of ECOG PS 0/1/2/3/4 were 15(16%)/59(60%)/18(19%)/2 (3%)/0 respectively. Fifty-two patients (55%) were diagnosed with adenocarcinoma, 38 (40%) were squamous cell carcinoma, and 4 (5%) were other types. We examined Neutrophil-to-lymphocyte ratio (NLR) at base line and relative change in the course of treatment, and the NLR of 48 (56%) patients were ≥ 3.0 and the other 46 (44%) were < 3.0. Among 94 patients, the best all over response were complete response 3 (3.2%), partial response 27 (28.7%), stable disease 35 (37.2%), progressive disease 25 (26.6%); non-HPD 21 (22.3%), HPD 4 (4.3%), and not evaluated 3 (3.2%). All of the 4 HPD patients were male with ECOG PS 1/2/2/3, and treated in 2nd-line therapy for adenocarcinoma. NLR for HPD patients at baseline were 1.62, 4.84, 9.31, 14.75 (median=2.80, range 0.62-19.9) and ΔNLR (relative change of NLR in the course) were 1.51, 3.44, 3.29, 4.26 (median=1.10, range 0.27-4.26). Conclusions: Our study suggests that HPD exists in a fraction of patients treated immune checkpoint inhibitor and could be associated with high neutrophil-to-lymphocyte ratio. We will update and publish the data containing patients treated with other anti-PD-1/PD-L1 antibodies. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: T. Minami: Honoraria (institution): Taiho. T. Yokoi: Honoraria (institution): Ono; Honoraria (institution): Chugai; Honoraria (institution): MSD; Honoraria (institution): Bristol-Myeres; Honoraria (institution): AstraZeneca; Honoraria (institution): Taiho. K. Kuribayashi: Honoraria (institution): Ono; Honoraria (institution): Bristol-Myers Squibb. T. Kijima: Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (self): Ono; Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (institution): Bristol-Myeres; Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (institution): Chugai; Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (institution): MSD; Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (institution): Taiho. All other authors have declared no conflicts of interest.