129P Predicting response to immunotherapy in advanced non-small cell lung cancer

Abstract

Background: The advanced Non-Small Cell Lung Cancer's (aNSCLC) response to immunotherapy (IO) is heterogenous, thus biomarkers to predict response are needed. EPSILoN and NLCIPS (Non-Small Cell Lung Cancer Immunotherapy Prognosis Score) are two predictive models which help to identify aNSCLC patients who will benefit from IO. Methods: We conducted a retrospective, single-center study of aNSCLC patients who had received IO, between January 2016 and December 2020. The primary endpoint was progression-free survival (PFS) and its correlation with each score. EPSILoN combines five baseline clinical/blood parameters: ECOG/PS, smoking, liver metastases, LDH and neutrophil-to-lymphocyte ratio (NLR). EPSILoN stratified patients in good, intermediate or poor responders to IO. NLCIPS is a response predictive model based in smoking index and NLR, which stratifies patients in 4 groups on 1-year-PFS: very poor, poor, intermediate and good. Descriptive statistical analysis, survival analyses with Kaplan-Meier curves and multivariate analyses with cox regression model were made using SPSS®. Results: We analyzed 70 patients, 68,6% male, median age 62,5 years (38–81 years), 57,1% smokers, 57,1% stage IV and 27% expressed PD-L1350%. Using EPSILoN score patients were stratified in good 25,7%; intermediate 67,14%; and poor 7,1%. Using NLCIPS predictive model patients were stratified in 4 groups according to predicted 1-year-PFS: very poor (1-year PFS <0,1) in 18,57%; poor (1-year PFS 0,18) in 27,14%; intermediate (1-year PFS 0,28) in 25,7%; and good (1-year PFS >0,6) in 28,6%. The median follow-up was 8,5 months. Median PFS was 4 months (0–56 months), with statistical significance differences in PFS between groups either applying EPSILoN (p = 0,003) or NLCIPS score (p = 0,008). The multivariate analysis with cox regression, showed a statistically significant difference in PFS using EPSILON score (HR 3,05 [CI 95% 1,24–7,46], p = 0,015), NLCIPS (HR 0,595 [CI 95% 0,4–0,89], p = 0,010) and PD-L1350% (HR 0,247 [CI 95% 0,09–0,68], p = 0,007). Conclusions: Our study shows that stratifying aNSCLC patients using either EPSILON or NLCIPS score can help to identify who will most likely benefit from IO. Further studies are warranted. Legal entity responsible for the study: Portuguese Institute for Oncology of Coimbra. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.