P2.24 Lung Immune Prognostic Index in Patients with Non-small Cell Lung Cancer Treated with Either Chemo or Immunotherapy

Abstract

Background: To characterize and identify factors associated with the presentation of hyperporgression after initiation of immunotherapy in patients with advanced non-small cell lung cancer (NSCLC). Method: A multicenter international retrospective study on 110 patients was conducted. Clinical variables as well as routine blood studies were recorded before initiation of treatment. Regression analysis was used to find associations. A random forest tree analysis (RFTA) based on continuous and discrete variables was used to subcategorize patients based on occurrence of hyperprogression. Results: Median age was 64 years (Range 34-90) and 59.8 % were male patients. ECOG performance status was >1 on 8.8% of patients. Median overall survival was 12.7 months (95% CI 9.67-14 months) and progression-free survival of 4.27 months (95% CI 3.97-5.0). 44 hyperprogressors were documented (19.8%, [95%CI 14.5-25.1%]). Median time to progression was approximately 5 weeks after initiation of treatment. Factors associated included albumin and hemoglobin levels (p ¼ 0.046 and 0.037 respectively), presence of CNS (p¼ 0.0009) and bone metastasis (p ¼ 0.004) and weight loss (p¼ 0.004). RFTA revealed that a leucocyte count over 5.300 cells/dl was present in all hyperprogressors. Conclusion: Hyperprogression is a phenomenon after initiation of immunotherapy which is associated with clinical and paraclinical variables. These associations could be used to withhold certain agents and prevent its occurrence in NSCLC treatment.

The Lung Immune Prognostic Index May Predict the Efficacy of Different Treatments in Patients with Advanced NSCLC: A Meta-Analysis

“…The numbers of patients treated with ICI, TT, and CT were 3,651, 1,241, and 2,481, respectively. We also provided the information of the median OS and 95% CI of 2,048 patients who did not meet the inclusion criteria under different treatment methods [5,6,10,[16][17][18][19][20]. Characteristics of the included studies are shown in Table 1, and characteristics of patients in other literature that did not meet the inclusion criteria are given in Table 2.…”