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140P New inflammatory biomarkers in uresectable stage III NSCLC treated with radio-chemotherapy (RCT) followed by durvalumab: Preliminary results of the Neutrality trial

2024; Elsevier BV; Volume: 9; Linguagem: Inglês

10.1016/j.esmoop.2024.102727

2059-7029

Emanuela Olmetto, Carlos A. Mattioli, Saverio Caini, Marco Del Riccio, Marco Banini, A. Sbrana, Cristina Zannori, Giovanna Finocchiaro, Elisa Roca, Giulio Metro, Marianna Macerelli, Alessandro Russo, Angelo Delmonte, Carlo Genova, Diego Cortinovis, M. D’Arcangelo, Marco Perna, Alessio Bruni, Lorenzo Livi, Vieri Scotti,

Cancer Diagnosis and Treatment

Different blood markers have been investigated as prognostic indexes in NSCLC. Neutrality trial wants to analyze how NLR (Neutrophil to Lymphocytes ratio) and SII (Systemic Inflammatory Index - NLR x platelets) impact on outcomes of patients treated in accordance with Pacific regimen. In the last years new indexes such as the dNLR (neutrophil to leukocytes - neutrophil ratio) and the LIPI (Lung Immune Prognostic Index) have been validated in advanced NSCLC and are considered in the present analysis. Patients were enrolled in two cohorts: those who received Durvalumab within the Italian EAP, and those treated with RCT alone. This analysis will focus on Durvalumab group. Blood count tests were recorded at established time points from the start of Durvalumab. Different cut-offs of NLR, dNLR and SII were considered, based on the median values observed in our population at baseline. We divided patients in 3 LIPI index prognostic groups: good (dNLR 3 or LDH ≥ UNL) and poor (dNLR > 3 and LDH ≥ UNL). We performed a Cox-Regression analysis on the different parameters modeled as time-variables. Data about 96 patients from 34 Italian Oncology Centers were evaluable. Details of patients are shown in the table. The baseline NLR significantly correlates with PFS: for a cut-off of 5, the HR was 1.93 CI (1.12-3.30) p: 0.017, and for each increase of 1 point of NLR, the HR was 1.07 CI (1-1.14) p: 0.04. The baseline SII and dNLR values significantly correlate with PFS too, p: 0.08, and p: 0.018, respectively. The PFS of the good prognostic LIPI index group was significantly better than the intermediate group (p: 0.004), and the poor group (p: 0.039), as expected. Table: 140PPatients (%)96SexM62 (64.5%)F34 (35.5%)SmokeYes85 (88%)No9 (12%)Age yearsMedian68 yRange44-83HistologyAdenocarcinoma54 (56%)Squamocellular39 (41%)Others3 (3%)PD-L1 Expression012 (12.5%)1-4941 (43%))≥ 5030 (31%)Not tested13 (13.5%)Stage DiseaseIIIA35 (36.5%)IIIB48 (50%)IIIC13 (13.5%)ECOG PS059 (61.5%)135 (37.5%)21 (1%)RadiotherapyConcomitant49 (51%)Sequential47 (49%)DTF60 Gy73 (76%)66 Gy5 (5%)60-66 Gy4 (4%)< 60 Gy14 (15%)Time to Durvalumab< 40 days16 (17%)40-90 days58 (60%)> 90 days22 (23%) Open table in a new tab Our study confirms the prognostic role of blood inflammatory indexes in unresectable stage III NSCLC. These could be possible biomarkers to guide intensification or de-escalation of treatments. Further analysis are still ongoing.