P2.01-57 New Prognostic Markers in Patients with Lung Cancer Treated with Immunoterapy: NLR and PLR

Immunotherapy has become standard therapy in metastatic lung cancer. The problem for these agents is lack of prognostic and predictive markers which is feasible in clinical practice. On the otherhand up to 30% of patients accelerated progression of tumor early after immune checkpoint blockade (Hyperprogression). Predictive biomarkers of Hyperprogression(HP) have not been emerged. NLR and PLR are established strong prognostic markers associated with worse OS in several tumor types. The aim of our study was to analyse the prognostic impact of NLR and PLR in lung cancer patients treated with immunotherapy. And is there any relationship between these biomarkers and HP. NLR was calculated by division of absolute neutrophil and lymphocyte counts measured in peripheral blood before start of immunotherapy. PLR was calculated by division of thrombocytes and lymphocytes accordingly. The study included 63 patients who were treated with immunotherapy on metastatic setting. Most of patients (63.4%) had been given at least two line chemotherapy. The after-immunotherapy radiological response; three patients (4.8%) had a complete response, 13 patients (20.6%) had a partial response. Hyperprogression was detected 7(11.1%) patients. Median PFS was 3.2 months (95% CI 2.78 to 3.72), and median OS was 6.5 months (95%CI 4.04 to 9.04) with immunotherapy. Median OS was 9.4 vs 2.7 months in patients with NLR<5.4 vs NLR≥5.4(Log rank p= 0.001). Median OS was 7.6 vs 2.99 months in patients with PLR<320 vs NLR≥320(Log rank p= 0.02). Grade 1-2 hypothroidi was detected in six patients, Grade 3 pneumonia in two patients. No other complications are observed in any other patients.View Large Image Figure ViewerDownload Hi-res image Download (PPT) NLR and PLR are standardized tests and easily used in daily routine. Elevated pre-treatment NLR and PLR are associated with shorter OS in patients with metastatic lung cancer. During the treatment of immunotherapy might be correlated with treatment response and we need larger studies.