Prognostic role of immunosenscence associated with index in elderly non-small cell lung cancer patients treated with an anti-PD-1 antibody.

Journal of global oncology Pub Date : 2019-10-07 DOI:10.1200/jgo.2019.5.suppl.100

Tomohiro Tanaka, T. Yoshida, K. Masuda, Y. Takeyasu, Y. Shinno, Y. Matsumoto, Y. Okuma, Y. Goto, H. Horinouchi, N. Yamamoto, Y. Ohe

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Abstract

100 Background: Immunosenescence, an age-related impairment of the immune system, dampens acquired immunity and promotes inflammation. Therefore, it could also influence the degree of effectiveness of immune checkpoint inhibitors. Methods: We retrospectively reviewed the data of 52 NSCLC patients aged ≧75 years old treated with nivolumab or pembrolizumab from December 2015 to April 2019. Immunosenescence was assessed by the modified Glasgow Prognostic Scale (mGPS), Neutrophil-to-lymphocyte ratio (NLR), and Charlson Comorbidity Index (CCI), which are related to nutrition, inflammation and comorbidity, respectively. The Cox proportional hazard model and Kaplan-Meier curves were used to identify factors associated with survival. Results: The median follow-up duration was 19.5M (IQR:1-41). The patient characteristics were as follows: median age 79.7 years; male/female ratio, 41/11; PS0/1/2/3, 10/32/8/2; adeno/squamous histology/others, 33/15/4;stage III/IV/recurrence, 2/26/24; PD-L1 (22C3) (%)unknown/0/1-49/50-100, 18/2/8/24; driver mutation status positive/negative, 11/41; nivolumab/pembrolizumab, 29/23; treatment line 1/2/3/4 or more, 28/15/3/6; median number of treatment cycles 7.0 (1-53). The overall response rate (ORR) and disease control rate (DCR) were29.1% and 56.2%, respectively. The median progression-free survival (PFS) was 4.2 months (95% CI 1.8-7.5). The mGPS was significantly associated with the DCR (High/Low = 37.5/68.8%, p = 0.02) and the PFS (score 0-1/2 = 4.1/0.6 months) (HR: 0.37, 95% CI 0.18-0.74, p <0.01). However, neither the CCI nor the NLR wasassociated with the PFS (CCI: High/Low = 3.8/1.8 months, p = 0.64, and NLR: High (>3.5)/Low (≦3.5) = 3.8/5.6 months, p = 0.89). Multivariate regression analysis identified the mGPS as a significant predictor of the PFS(HR: 0.40, p = 0.008). Conclusions: A high mGPS score was significantly associated with a lower DCR and shorter PFS in elderly NSCLC patients treated with anti-PD-1 antibody.

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免疫衰老与指数在接受抗pd -1抗体治疗的老年非小细胞肺癌患者中的预后作用

100背景:免疫衰老是一种与年龄相关的免疫系统损伤，它会抑制获得性免疫并促进炎症。因此，它也可能影响免疫检查点抑制剂的有效程度。方法:回顾性分析2015年12月至2019年4月接受纳武单抗或派姆单抗治疗的52例年龄≥75岁的非小细胞肺癌患者的资料。免疫衰老采用改良的格拉斯哥预后量表(mGPS)、中性粒细胞与淋巴细胞比值(NLR)和Charlson共病指数(CCI)进行评估，这三个指标分别与营养、炎症和共病有关。采用Cox比例风险模型和Kaplan-Meier曲线确定与生存率相关的因素。结果:中位随访时间为195m (IQR:1-41)。患者特征如下:中位年龄79.7岁;男女比例41/11;PS0/1/2/3 10/32/8/2;腺/鳞状组织/其他，33/15/4;III/IV期/复发，2/26/24;未知PD-L1 (c3) 22日(%)/ 0/1 - 49/50 - 100,18/2/8/24;驱动突变状态为阳性/阴性，11/41;nivolumab / pembrolizumab, 29/23;处理线1/2/3/4以上，28/15/3/6;治疗周期中位数为7.0(1-53)。总有效率(ORR)和疾病控制率(DCR)分别为29.1%和56.2%。中位无进展生存期(PFS)为4.2个月(95% CI 1.8-7.5)。mGPS与DCR(高/低= 37.5/68.8%，p = 0.02)和PFS(评分0-1/2 = 4.1/0.6个月)(HR: 0.37, 95% CI 0.18-0.74, p = 3.5)/低(≦3.5)= 3.8/5.6个月，p = 0.89)有显著相关性。多因素回归分析发现mGPS是PFS的显著预测因子(HR: 0.40, p = 0.008)。结论:在抗pd -1抗体治疗的老年NSCLC患者中，高mGPS评分与较低的DCR和较短的PFS显著相关。

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来源期刊

Journal of global oncology ONCOLOGY-

自引率

0.00%

发文量

审稿时长

20 weeks

期刊介绍： The Journal of Global Oncology (JGO) is an online only, open access journal focused on cancer care, research and care delivery issues unique to countries and settings with limited healthcare resources. JGO aims to provide a home for high-quality literature that fulfills a growing need for content describing the array of challenges health care professionals in resource-constrained settings face. Article types include original reports, review articles, commentaries, correspondence/replies, special articles and editorials.