Clinical and immunologic variables associated with outcomes following combination ipilimumab and nivolumab immunotherapy in melanoma

Autor: Michael A. Postow, Erica Kwong, Katherine S. Panageas, Samuel Rosner
Rok vydání: 2017
Předmět:
Zdroj: Journal of Clinical Oncology. 35:55-55
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2017.35.7_suppl.55
Popis: 55 Background: Prior studies have shown routine laboratory parameters such as lymphocytes (lymphs) and eosinophils (eos) are associated with outcome in patients (pts) treated with ipilimumab (ipi) or programmed death-1 (PD-1) agents as single drugs. Less is known about these parameters as potential biomarkers for pts treated with ipi + nivolumab (nivo) in combination. Methods: After IRB approval, a single institution, retrospective review was performed of pts with melanoma who received ipi + nivo on phase I-III clinical trials (n=122) as well as via commercial use (n=87). Prior to treatment initiation, routine laboratory parameters were investigated and correlated with overall survival (OS) and disease response by RECIST 1.1 (partial or complete response vs. stable/progressive disease). Absolute as well as relative frequencies of cell counts were examined. Kaplan-Meier estimators and Cox regression were performed. Results: 209 pts, 85 (41%) women and 124 (59%) men, with a median age of 60.5 years were analyzed. Median OS was 44.4 months, 95% CI (32.9, not reached). 23 pts had a complete response (CR) and 87 pts had a partial response (PR), while 39 pts had stable disease (SD) and 49 pts had progressive disease (PD). By univariate analysis, significant favorable factors for OS included: low absolute monocytes, low absolute/relative neutrophils, high relative eos, and high relative lymphs. Low LDH and the neutrophil to lymph ratio were also associated with better OS. None of these factors were significantly associated with response by RECIST 1.1. Conclusions: Routinely assessed laboratory parameters were associated with OS but not disease response among pts receiving ipi + nivo. Some of these factors were similar to those which previously correlated with OS after ipi or nivo as single-agents, suggesting they may be prognostic. Given the ongoing randomized phase III study of ipi + nivo and nivo vs. ipi, there is an opportunity to examine whether these factors are relevant in refining which pts obtain the greatest benefit from ipi + nivo vs. single agent therapy.
Databáze: OpenAIRE
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