2419 - Prognostic Value and Immunological Correlation of Spleen Volume Change in Extensive-Stage Small-Cell Lung Cancer Treated with Chemo-Immunotherapy
Presenter(s)
X. Liu; Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China, Jinan, Shandong, China
Purpose/Objective(s): The changes in spleen volume may, to some extent, mirror shifts in the body's anti-tumor immune function, potentially influencing the efficacy of immunotherapy. This study explores the prognosis predictive value of spleen volume change in extensive-stage small-cell lung cancer (ES-SCLC) treated with immunotherapy combined with chemotherapy (ICT) and differences in tumor-infiltrating lymphocyte (TIL) and peripheral blood immune-related parameters with varying spleen volume changes.
Materials/Methods: A total of 216 ES-SCLC patients who received first-line ICT were retrospectively included. The impact of baseline and post-treatment change of spleen volume, peripheral blood immune-related parameters and other clinicopathologic characteristics on overall survival (OS) and progression-free survival (PFS) was analyzed using the Cox proportional hazards model. The potential influencing factors, such as TIL and blood immune-related parameters were compared using Wilcoxon rank-sum test.
Results: Multivariate Cox analysis identified increased spleen volume as an independent poor prognostic factor for OS and PFS. Kaplan-Meier analysis also showed reduced OS (p=0.0031) and PFS (p=0.0057) in patients with increased spleen volume. These patients had a lower objective response rate (ORR) (p<0.01). The Wilcoxon rank sum test revealed significantly lower levels of total TIL, CD4+ TIL, CD8+ TIL, and absolute lymphocyte count (ALC) (all p<0.01), but a higher neutrophil-to-lymphocyte ratio (NLR) (p<0.01).
Conclusion: Spleen volume change may be served as a predictive biomarker of efficacy in ES-SCLC treated with ICT and showed potential relationship with TIL, peripheral ALC and NLR, reflecting the local and systemic immune status to a certain extent, which need further exploration.