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5PSQ-037 Peripheral blood biomarkers dynamics predict clinical response to pembrolizumab plus chemotherapy in patients with non-squamous metastatic non-small-cell lung cancer
  1. S Lora,
  2. R Jiménez-Galán,
  3. E Prado-Mel,
  4. MD Vega-Coca,
  5. MA Pérez-Moreno,
  6. L Abdel-Kader Martín
  1. Hospital Universitario Virgen del Rocío, Pharmacy Department, Seville, Spain


Background and Importance Heterogeneity in response to immunotherapy in patients with advanced non-small-cell lung cancer (NSCLC) highlights the need to identify predictive biomarkers. Peripheral blood biomarkers have been associated with the prognosis in advanced NSCLC treated with immunotherapy.

Aim and Objectives To analyse the correlation between the response to pembrolizumab plus chemotherapy and peripheral blood biomarker dynamics in patients with non-squamous metastatic NSCLC.

Material and Methods Retrospective and observational study including all patients treated with pembrolizumab plus pemetrexed plus platinum-based chemotherapy from January 2020 to December 2021. Variables collected: sex, age, baseline Eastern Cooperative Oncology Group (ECOG) scale, and lymphocyte, neutrophil and eosinophil absolute counts (ALC, ANC and AEC, respectively) at three timepoints: baseline (before treatment), week 4 of treatment and first computerised tomography (CT) scan. Neutrophil-to-lymphocyte ratio (NLR) was calculated for each timepoint. Patients were classified as responders (partial response or stable disease) or non-responders (progression at first CT scan). Statistical analysis was performed with software SPSS 24.0.

Sixty patients were included 76.7% were male with a median age of 62 years. 88.3% presented baseline ECOG <2 and 76.7% of patients were categorised as responders (23.3% non-responders). Baseline NLR was similar between responders and non-responders. Median NLR at week 4 was significantly higher in non-responders (3.3 vs 1.99; p=0.04). Median NLR at first CT scan was also significantly higher in non-responders (3.5 vs 1.9; p=0.01). Among responders, there was a significant decrease (p<0.01) between baseline NRL and at time of first CT, while non-significant changes were found in the non-responder group. ANC was similar at baseline and first CT among responders and non-responders. However, there were significant differences at week 4 (p=0.036). Regarding ALC, significant differences were only found between both groups at first CT (p=0.015). Finally, for AEC, we did not find significant differences at any of the measured timepoints.

Conclusion and Relevance Our results suggest that NLR behaves as a predictive biomarker of response to immunotherapy. ANC showed significant differences among responders and non-responders at week 4, and ALC at the first evaluation. AEC did not show correlation with response.

Conflict of Interest No conflict of interest.

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