Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
(n=78) with squamous histological subtype, 43.5% (n=60) were ex-smoker and
50.3% (n=74) had Stage I disease. PD-L1 positivity vs negativity among nonsmoker,
ex-smoker and current smoker were 13.0% vs 20.9%, 47.8% vs 43.3%
and 39.1% vs 35.8% respectively, (p=0.708). PD-L1 expression by IHC was
significantly higher in squamous NSCLC compared to non-squamous NSCLC
(34.7% vs 14.6%, p=0.030). We also noted increased PD-L1 positivity with
rising tumor T stage (T1 vs T2 vs T3 vs T4: 7.1% vs 30.6% vs 0% vs 60%, p=0.023)
and grade of differentiation (G1 vs G2 vs G3: 11.1% vs 19.6% vs 44%, p=0.039).
There was no correlation between nodal status and PD-L1 expression (N0 vs
N1 vs N2: 25.5% vs 25% vs 26.3%, p=0.995). PD-L1 expression appears to be
independent of overall disease stage (I vs II vs III: 27.3% vs 22.7% vs 25.0%,
p=0.921). The median overall survival for PD-L1 positive vs negative pts was
22.1 vs 20.8 months with HR of 0.64 (95% CI: 0.34-1.12, p=0.123). Overall
survival rates of pts with PD-L1 positive vs negative tumors at 2 years were
47.8% vs 44.8% and at 5 years were 43.5% vs 26.9%. Conclusion: In our cohort,
PD-L1 expression was not associated with poorer survival among resected
NSCLC pts. Tumour size and grade of differentiation appear to correlate with
PD-L1 expression which warrants further validation in future studies.
POSTER SESSION 2 – P2.01: BIOLOGY/PATHOLOGY
IMMUNE MECHANISMS IN THORACIC CANCER AND TARGETED THERAPY –
TUESDAY, DECEMBER 6, 2016
P2.01-067 THE RELEVANCE OF CEA AND CYFRA21-1 AS PREDICTIVE
FACTORS IN NIVOLUMAB TREATED ADVANCED NON-SMALL CELL
LUNG CANCER (NSCLC) PATIENTS
Maria Giovanna Dal Bello 1 , Rosangela Filiberti 2 , Erka Rijavec 1 , Carlo Genova 1 ,
Giulia Barletta 1 , Giovanni Rossi 1 , Federica Biello 1 , Roberta Distefano 1 , Anna
Maria Orengo 1 , Angela Alama 1 , Simona Coco 1 , Irene Vanni 2 , Michele Mussap 1 ,
Francesco Grossi 1
1 Lung Cancer Unit, San Martino Hospital - National Institute for Cancer Research,
Genova/Italy, 2 Clinical Epidemiology, San Martino Hospital - National Institute for
Cancer Research, Genova/Italy
Background: CEA, CYFRA21-1 and NSE are tumor markers acknowledged as
useful predictors of response to chemotherapy for advanced adenocarcinoma,
squamous and small-cell lung cancer, respectively. However, their role in
cancer immunotherapy needs to be investigated. Methods: We analyzed 56
patients with advanced NSCLC treated with nivolumab (3 mg/kg) every 14
days within a single-institutional translational research study. Blood samples
were collected at baseline and at each cycle up to 5 cycles, and then every two
cycles. All patients underwent a CT-scan every 4 cycles and responses were
classified according to RECIST and Immune-Related Response Criteria (irRC).
The serum level of CEA was measured with a Chemiluminescent Microparticle
Immunoassay while CYFRA21-1 and NSE with an Immuno Radiometric Assay.
The markers levels at baseline and after 4 cycles were used to analyze the
relationship between their median variation and the objective response rate
(ORR). The performance of tumor markers in predicting ORR was analyzed by
ROC analysis and a reduction of 20% was used as cut-off level. Results: Fortyeight
patients were evaluated: median age: 71 years (44-85); male/female:
73%/27%; current or former smokers: 87.5%; non-squamous/squamous
histology: 79%/21%. Baseline median levels were 4.8 ng/ml for CEA, 3.47 ng/
ml for CYFRA21-1 and 7.51 ng/ml for NSE. At baseline, values over the upper
normal limit of CEA, CYFRA21-1 and NSE were detected in 23 (48%), 26 (54%),
and 7 (14%) patients respectively. Significant differences were observed
between responders and non-responders and CEA variation (-9% vs.+41%,
p=0.003 for RECIST; -10% vs.+31%, p=0.015 for irRC), CYFRA21-1variation
(-39% vs.+92%, p