Inflammatory Biomarkers In Hiv-Infected Veterans With Non-Small Cell Lung Cancer Receiving Anti-Pd-1 Immunotherapy.

e21110 Background: Anti-programmed cell death (anti–PD-1) response in patients with advanced non-small cell lung cancer (NSCLC) varies greatly. Higher neutrophil/lymphocyte ratio (NLR) or lower advanced lung cancer inflammation index (ALI) predicted lower nivolumab response rates and survival in studies of immunocompetent patients with NSCLC. The distribution of these markers in people living with HIV (PLWH) is unknown. This is the first report describing inflammatory biomarkers among HIV-infected and -uninfected veterans. Methods: We searched the Corporate Data Warehouse (CDW) to identify all 46,916 PLWH who used the Veterans Health Administration 2000-2016 and a 4:1 age-matched HIV-negative control cohort. Within these 2 cohorts, we defined the anti–PD-1 NSCLC cohorts by the following inclusion criteria: 1) VA Cancer Registry NSCLC diagnosis; and 2) receipt of ≥ 3 doses of nivolumab or pembrolizumab monotherapy. We calculated ALI using BMI*albumin/NLR at anti–PD-1 initiation, as previously described. Overall survival (OS) was measured from first anti–PD-1 dose. We used Fisher’s exact, independent t-test, and log-rank to compare cohorts. Results: Nine PLWH and 62 HIV-negative controls met inclusion criteria. Baseline age was similar between the two groups (67 [PLWH] vs. 66 [controls], p = 0.83), as was albumin, NLR and ALI (p > 0.05). Mean BMI of PLWH was lower than BMI of controls (21.6 vs. 25.9, p = 0.02). Months of treatment (mean 10.1 vs. 13.8, p = 0.37) and median OS (12.3 vs. 13.9 months, p = 0.76) were similar among PLWH and controls. Clinical benefit rate (CBR, defined as complete/partial response or stable disease) was higher in PLWH with ALI < 18 vs. PLWH with ALI > 18 (CBRALI < 18 = 2/2 [100%], CBRALI > 18 = 2/7 [29%], p > 0.05); median OSALI < 18 was not reached among PLWH. OS among controls with ALI > 18 was significantly greater than controls with ALI < 18 (18.9 vs. 11.2 months, p = 0.048). Conclusion: Baseline NLR and ALI, and anti–PD-1–treated NSCLC survival, were comparable in HIV-infected and uninfected veterans.. There was an unexpected trend of improved CBR among PLWH with lower ALI. OS was significantly prolonged in HIV-negative patients with higher ALI.