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• W3089214909 abstract "ICI have demonstrated clinical benefit and improved survival in mUC. However, outcomes remain poor and predictive markers are not available. Derived neutrophil-to-lymphocyte ratio (dNLR) and immune-related adverse events (irAEs) have been associated with response to ICI in other tumor types. Our aim was to assess the role of these factors in mUC patients treated with ICI. Retrospective analysis of a cohort of patients (p) with mUC treated with ICI in our institution between 2016 and 2019. Clinical characteristics were collected. dNLR, defined as neutrophils/(leukocytes-neutrophils), at baseline and at week 3 from first dose was calculated. IrAEs were assessed with CTCAE v.4.0. Survival analysis was made using Kaplan-Meier method. Correlation of clinical factors and outcomes was studied using Chi-squared test and Cox regression. 71 p were included. Median age was 68 years, 54 p (76%) were male, 59 p (83%) had PS-ECOG 0-1, 15 p (21%) were treatment-naïve, 15 p (24%) had elevated LDH 11 p (15.5%) had liver metastases (LM). Patients were treated with pembrolizumab (27 p, 38%), atezolizumab (37p, 52%), nivolumab (5p, 7%), Durvalumab – Tremelimumab (2 p, 3%). Median nº cycles were 4 (1 - 50). Response rate was 31% (95% CI, 21-43). Median overall survival (OS) was 9 months (m) (95% CI 6,5 – 11,5). Median progression-free survival was 3 m. (95% CI, 2 – 4). Incidence of irAE was 32% (grade 3/4, 17%). IrAE-related discontinuation rate was 13%. Ocurrence of irAE (OR 6.42, 95% CI 2.1 – 19.5, p < 0.002) and decrease in dNLR (vs. increase) at week 3 (OR 3.65, 95% CI 1.14 - 11.69, p=0.034) were associated with response. Hemoglobin (Hb) < 10 mg/dL, LM, decrease in dNLR and ocurrence of irAE were independently associated to OS (Table).Table 777PVariableUnivariateMultivariateLiver M1HR 2.002 (95%CI 0.964 – 4.157) p = 0.062HR 2.417 (95%CI 1.062 – 5.499) p = 0.035Baseline LDHHR 1.747 (95%CI 0.923 – 3.305) p = 0.086HR 1.607 (95%CI 0.816 – 3.167) p = 0.170Hemoglobin < 10 mg/dLHR 1.839 (95%CI 1.129 – 2.994) p = 0.014HR 1.851 (95% CI 1.165 – 2.941) p = 0.009Decrease in dNLR at week 3HR 0.414 (95% 0.229 – 0.748) p = 0.003HR 0.385 (95%CI 0.204 – 0.725) p = 0.003IrAE YesHR 0.401 (95%CI 0.207 – 0.776) p = 0.007HR 0.384 (95CI% 0.189 – 0.782) p = 0.008 Open table in a new tab Decrease in dNLR may be an early indicator of therapeutic effect and long-term improved survival in mUC. IrAE and classical factors, as hemoglobin and LM, remained prognostic in our cohort." @default.
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• W3089214909 date "2020-09-01" @default.
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• W3089214909 title "777P Decrease in derived neutrophil-to-lymphocyte ratio (dNLR) related to immune checkpoint inhibitors (ICI) benefit in patients with metastatic urothelial carcinoma (mUC)" @default.
• W3089214909 doi "https://doi.org/10.1016/j.annonc.2020.08.849" @default.
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