Tumori Journal Abstract Book - October 2020 - 16

16	
Background: Eosinophilia (EO) is defined as an absolute
eosinophil count (EC) of more than 500 cells/µL.
The prognostic role of eosinophils in cancer is controversial: in some cancers such as Hodgkin's lymphoma, EO is
associated with a worse prognosis, while in gastrointestinal tumors it is associated with a better survival.
About EO and immunotherapy there are few scientific evidence: EO has been associated with better responses in
some patients with melanoma, but this has not been investigated in NSCLC.
In our study, we aimed to investigate the prognostic value
and safety of EO in NSCLC treated with Nivolumab.
Patients and methods: We enrolled 69 patients (pts) (44
men and 25 women) with advanced NSCLC treated with
Nivolumab.
Mean age was 70 years (range 48-82).
Squamous and non squamous histologies were diagnosed
in 33 and 36 pts, respectively.
We defined EO as an absolute EC of more than 500 cells/µL.
Pts were divided into two groups based on EC (< 500
cells/ µL or > 500 cells/ µL).
We evaluated response to treatment and safety in relation
to EC.
Results: 44/69 pts (63.7%) had low EC while 25/69
(36.3%) had high EC.
At the first instrumental evaluation, 18 pts with low EC
had progression disease (PD) (41%), 13 pts stable disease
(SD) (29.5%), 11 showed partial response (RP) (25%) and
2 complete response (RC) (4.5%) with a clinical benefit
(CB) (RC+RP+SD) of 59%.
Pts with high EC, 18 had PD (72%), 6 SD (24%) and 1 RP
(4%) with a CB of 28%.
We examined several immune-related toxicities and for
some of these we found differences between the groups
examined:
Low EC versus (VS) high EC: Diarrhea/Colitis(18%VS32
%);Rash(15.9%VS48%); Itching(25%VS36%),
Conclusions: Our results suggest that high pre-treatment
EC is associated with lower response rate and greater incidence of immune-related toxicities such as Diarrhea/
Colitis, rash and itching in NSCLC treated with Nivolumab.

A22
Identification of predictive
biomarkers of clinical benefit
to immunotherapy in pretreated
advanced non-small cell
lung cancer: a prospective
observational study

Tumori Journal 106(2S)
Background: The anti-programmed death 1 (anti-PD-1)
agent, nivolumab, has demonstrated remarkable clinical
activity in patients with advanced non-small cell lung cancer (NSCLC). Thus far, few clinically-available biomarkers of response to immune checkpoint inhibitors (ICIs)
have been identified.
Methods: The aim of the present monocentric prospective
observational study was to identify predictive biomarkers
in peripheral blood (PB) that correlate with clinical
responses to nivolumab in NSCLC patients. PB samples
from 30 patients who received nivolumab in second-line
setting, from February 2016 to May 2018 at Clinical
Oncology Unit, Careggi University Hospital, were subjected to immunological assessments. The following
parameters were evaluated and compared with healthy
donors cohort: lymphocyte subpopulations, inhibitory and
cytotoxic molecules on lymphocyte subpopulations and
cytokines production profile after in vitro polyclonal stimulation. The Cox model was used to correlate biomarkers
values and patients' survival outcomes.
Results: The expression of PD-1 in circulating immune
cells of the study population was higher in CD4+ cells and
CD16+ cells when compared to healthy donors
(22.86±2.31 vs 17.07±1.36 (p=0.038) and 4.74±1.00 vs
2.33±0.51 (p=0.039), respectively). The cytotoxic molecules granzyme A and perforine have a lower expression in
CD16+ cells from PB of NSCLC patients compared to
controls (77.13±3.28 vs 89.55±1.03 (p<0.001) and
72.03±4.01 vs 86.84±1.30 (p=0.001), respectively),
while they are higher expressed in CD8+ cells of patients
than CD8+ cells of healthy donors (65.13±4.19 vs
56.19±2.66 (p=0.076) and 58.43±4.64 vs 37.93±3.01
(p<0.001), respectively). The cytokines IL-2 and TNFalfa are significantly higher in CD4+ from patients' samples than in control group (63.39±2.68 vs 40.64±1.99
(p<0.001) and 32.67±3.31 vs 24.10±2.36 (p=0.039),
respectively). Finally, PD-L1 expression on CD4+ cells
negatively correlated with PFS (p=0.0379) and OS
(p=0.0152) and PD-L1 expression on CD16+ cells negatively correlated with OS (p=0.0302).
Conclusions: NSCLC patients have a peculiar subpopulation of lymphocytes and express molecules and cytokines
other than healthy controls. A better understanding of this
immunological profile can lead to the identification of predictive biomarkers of response to ICIs.

A23

Mazzoni F.1, Caliman E.1, Liotta F.2, Maggi L.2, Pillozzi S.1, Lavacchi
D.1, Cosmi L.2, Annunziato F.2, Antonuzzo L.1

Overall survival prediction in
non-small cell lung cancer: a
radiomic approach with a multiVOI analysis

1
Oncology Department, Careggi University Hospital, Firenze; 2Department of
Experimental and Clinical Medicine, University of Florence, Firenze

Ippolito E.1, Fiore M.2, Greco C.2, D'Amico N.C.3, Sicilia R.4, Cordelli
E.4, Gentile S.2, Miele M.2, Iannello G.5, Soda P.6, Ramella S.7
Tumori Journal Abstract Book - October 2020

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