Tumori Journal Abstract Book - October 2020 - 140

140	

H06
Prognostic role of systemic
inflammatory indexes in germ cell
tumors treated with high dose
chemotherapy
Cursano M.C.1, Kopf B.2, Scarpi E.2, Menna C.2, Casadei C.2, Schepisi
G.2, Lolli C.2, Altavilla A.2, Gallà V.2, Santini D.1, Tonini G.1, Chovanec
M.3, Mego M.3, De Giorgi U.4
1

Università Campus Biomedico di Roma, Roma; 2Istituto Scientifico
Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014,
Meldola, Italy; 3Second Department of Oncology, Faculty of Medicine,
Comenius University, Klenova, Bratislava; 4Istituto Scientifico Romagnolo per
lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy

Background: Conventional dose chemotherapy (CDCT)
and high dose chemotherapy (HDCT) with support of
peripheral blood progenitor cells (PBPC) are the two salvage curative approaches in relapsed/refractory germ cell
tumors (GCT). Since the complexity of this population and
the toxicity of HDCT, this study evaluated the association
between blood-based systemic inflammatory indexes and
outcome of GCT patients undergoing salvage treatment
with HDCT in order to define additional prognostic factors
able to orient clinical decision.
Methods: Between August 2009 and April 2018 we retrospectively collected baseline characteristics, neutrophilto-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio
(PLR) and the systemic immune-inflammation index (SII)
of 62 patients undergoing HDCT for GCT. The aim is to
evaluate the correlation between each inflammatory
marker (NLR, PLR and SII) and response to HDCT, overall survival (OS) and progression free survival (PFS).
Results: Patients with GCT with NLR ⩾3.3 and SII
⩾844000 had shorter PFS and inferior OS. In the multivariable analysis including inflammatory markers, IPFSG
risk group, age and previous line of treatment, NLR ⩾3.3
and SII ⩾844000 were identified to be independently
associated with shorter PFS and OS. Moreover, NLR,
PLR and SII significantly correlate with overall response
to HDCT.
Conclusions: Inflammation markers may improve prediction of oncologic outcome in the heterogeneous population
of patients with relapsed/refractory GCT. Associating the
International Prognostic Factor Study Group (IPFSG)
prognostic score to inflammation markers at baseline of
HDCT adds prognostic information and might help physicians to make more personalized treatment decisions.

H07
Primary Resistance (PrR) versus
Acquired Resistance (AcR) to
Immune Checkpoint Inhibitors (ICI)
in first-line metastatic renal cell
carcinoma (mRCC)

Tumori Journal 106(2S)
Guida A.1, Alves Costa Silva C.2, Colomba E.2, Flippot R.2, Salviat F.2,
Bracarda S.2, Escudier B.2, Albiges L.2
1

Ospedale Santa Maria Terni, Terni; 2Institute Gustave Roussy, Villejuif

Backgound: ICI have revolutionized first-line treatment
paradigm of mRCC, achieving durable responses and
longer survival. However, a subset of patients (pts) developed resistance immediately (PrR) or after an initial clinical benefit (AcR). The aim of the study is to identify key
differences between these two subgroups.
Methods: Retrospective analysis was performed from
IGReCC (Institut Gustave Roussy Renal Cell Carcinoma)
database on pts treated with first line (1L) ICI. PrR was
defined as progression disease (PD) or stable disease (SD)
lasting <6 months (mo) as best response; AcR was defined
as complete, partial or SD=6 mo. Statistical tests as appropriate were used to describe differences between groups
and investigated established prognostic markers (IMDC,
metastatic sites). The Kaplan-Meier and Cox regression
methods were used to estimate overall survival (OS)
Results: A total of 50 pts received 1L ICI and were evaluated for best response. The majority of pts (86%) received
Nivo+Ipi and 8 pts (6%) received ICI monotherapy (6
nivo, 2 atezo). PrR and ArR were 21 (42%) and 29 (58%)
respectively. PrR and ArR groups were compared for
main clinical features and only significant differences are
reported in the table and considered for multiple regression. From multivariate analysis time to treatment start
(TTT) (odds ratio [OR] 19.4; 95%CI 1.7-224, p=0.016)
and number of metastatic sites =3 (OR 10.2; 95%CI 1.856.1, p=0.005) seems associated with PrR. With a median
follow-up of 19 mo (range 1-55), 12mo-OS rate was 96%
(95%CI 72-99) vs 53% (95%CI 25-75) and 24mo-OS rate
was 81% (95%CI 48-94) vs 35% (95%CI 12-62) for AcR
and PrR, respectively HR 5.8 (95%CI 1.8-18.9), p 0.0009
Conclusions: Deciphering first-line PrR and AR subsets
of pts may become a key challenge for decision-making in
mRCC. This is the first report to describe different patterns of resistance potentially related to different clinical
outcomes

TTT <= 1 year
Metastatic sites >= 3
Haemoglobin < LNL

PrR N/%

AcR N/%

P

20/95
12/60
12/52

19/66
4/17
7/25

0.016
0.005
0.049

H08
Finding the right biomarker in
metastatic renal cell carcinoma
(mRCC): soluble PD-1, PD-L1, pan-BTN3As,
BTN3A1, BTN2A1 and plasma dynamic
changes as predictive biomarkers of
immunotherapy response
Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020
