P3.01-97 Which is Better Prognostic Factor, PS, Inflammatory Marker, or PD-L1 Expression in Treating NSCLC with Nivolmab; A Retrospective Analysis

Although nivolumab showed the significantly longer overall survival (OS) compared with standard second-line therapy using docetaxel for both squamous and non-squamous non-small cell lung cancer (NSCLC) based on two phase III randomized controlled trials, PD-L1 expression alone is not yet an adequate biomarker in treating NSCLC patients with nivolmab. This single institute retrospective study aimed to analyze which biomarker or pretreatment patients’ status were more associated with outcomes in NSCLC patients treated with nivolumab. We retrospectively reviewed the medical records of all patients with previously treated advanced NSCLC who received nivolumab between December 2015 and May 2016 in our institute. And we confirmed PD-L1 expression in the patients who were able to examine PD-L1 status. Multivariable logistic regression and Cox proportional hazards models were used to assess the impact of pretreatment PD-L1 expression, performance status (PS), and inflammation parameter (neutrophil-to-lymphocyte ratio (NLR)) on progression-free survival (PFS) and OS. The data cut off was on 31th October 2017. A total of 66 patients were included in this analysis. Median age was 66 (range, 46–85) years old, 48 patients were men, 54 patients were non-squamous cell carcinoma, 57 patients had a smoking history, 15 patients had a PS of 2 or higher, 23 patients were NLR ≥4, and 10 patients were PD-L1 expression ≥50 and 19 patients were PD-L1 expression 1-49. As for pretreatment prognostic factors, multivariate analyses revealed that never smoker (hazard ratio (HR): 4.22, 95% confidence interval (CI): 1.23 - 15.90), PS ≥2 (HR: 3.72, 95% CI: 1.80 - 7.52), and no PD-L1 expression (HR: 2.03, 95% CI: 1.10 – 3.84) were significantly associated with poor PFS, and furthermore PS ≥2 (HR: 6.27, 95% CI: 2.72 - 14.65) was independently associated with poor OS. PS is the better prognostic factor than NLR and PD-L1 expression in NSCLC patients treated with nivolumab.