P2.01-43 Pre-Therapeutic Markers and Scores Predict Response and Survival in Stage IV Lung Cancer Patients Independent of Histology

Abstract

Lung cancer is the leading cause of death among all cancer entities. Identification of reliable and validated predictive and prognostic markers is important to estimate patients’ prognosis. By doing this, planning of treatment and adequate patient guidance would improve. Many studies investigated several predictive and prognostic markers in lung cancer patients. Never the less, most of them describe very selective cohorts. This study aims at investigating histology independent predictive and prognostic markers in stage IV lung cancer patients. We retrospectively analyzed 129 stage IV lung cancer patients who had been diagnosed and treated at a German tertiary care lung cancer center between 2015 and 2016. Patients’ characteristics in terms of age, gender, performance status, histology, smoking status, treatment modalities and molecular pathological findings were collected from patients’ charts. We extracted data sets from electronic patient records and compared anthropometric data, pre-therapeutic blood values as well as clinical scores and performed tests for prediction analysis Eight markers and scores could be identified to significantly alter prognosis in univariate analysis. Over the normal cut off elevated values of CRP (p <0.001), LDH (p <0.001), Neutrophil to Lymphocyte ratio (NLR) (p = 0.018) and Systemic Inflammation Index (SII) (p = 0.036) as well as decreased levels of MCV (p = 0.025) and total protein (p = 0.049) were significantly associated with reduced overall survival (OS). Furthermore, the higher the Glasgow Prognostic Score (GPS) (p <0.001) or the Lung Prognostic Index (PI-lung) (p <0.001) were the worse was the OS. Failure of first line treatment was significantly predicted by low albumin (p=0.006), lymphocytes (p = 0.032) and PNI (p = 0.001) levels, whereas low values of CRP (p <0.001), LDH (p = 0.042) and Thrombocyte to Lymphocyte ration (TLR) (p = 0.017) predict response to first line therapy. Multivariate analysis revealed CRP, PI-lung and GPS as independent prognostic factors regardless histology. Simply to obtain blood values and clinical scores provide histology independent markers for response to fist line treatment and survival in stage IV lung cancer patients.