Tumori Journal Abstract Book - October 2020 - 22

22	
Borrelli A.1, Di Lisa F.S.1, Cristofani L.1, Sorace C.1, Arcuri T.1,
Speranza I.2, Bianco V.2, Fuccillo F.1, Santamaria F.1, Resuli B.1,
Vivona L.1, Fusco F.1, Astorino V.1, Verrico M.1, Tomao S.1
1

Università Sapienza, Roma; 2Oncologia Policlinico Umberto 1, Roma

Background: Immunotherapy has demonstrated to
improve overall survival (OS) and progression-free survival (PFS) in a subset of patients with metastatic or
locally advanced non-small cell lung cancer (NSCLC).
Recently, there has been an increasing interest in the prognostic role of systemic inflammation. According to many
studies an increase of neutrophil-to-lymphocyte ratio
(NLR), monocyte to lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) is associated with poor
prognosis. In this study, we evaluated the prediction role
of all these systemic inflammation scores at baseline in
NSCLC patients treated for at least six months with
immunotherapy.
Material and methods: We retrospectively reviewed 85
patients with advanced NSCLC treated with anti-PD-1
antibodies at Policlinico Umberto I between 2015 and
2020. Propensity score, based on age, sex and BMI as clinical features, selected 50 patients for matching. Mean
value of NLR, MLR, PLR at baseline was used to determine the cut-off values, 5.26, 5.8 and 213.6 respectively.
Patients with high NLR (⩾ 5,26), MLR (⩾ 5,8) and PLR
(⩾ 213,6) were given a score of 3. Patients with two of
three high values were given a score of 2. Patients without either abnormality were scored 0. Based on the total
score that patient received, we divided them in two main
groups; GROUP A including patients with total score
between 0-1 and GROUP B including patients with total
score between 2-3.
Results: We analyzed the response to immunotherapy in
the Group A and B with Kruskal-Wallis test: GROUP B
with higher inflammatory score at baseline correlated with
worse clinical outcomes. A baseline high inflammatory
score had a significantly increased risk of progression disease and lower response to treatment (4/25; 16%) (p<0,05)
compared with patients of the GROUP A with lower
inflammatory ratio in which a significative number of
patients had stability or partial remission of disease 17/25
(68%) (p<0,05).
Conclusions: Increased baseline of inflammatory score
before initiation of anti-PD1 antibodies is associated with
lower response to treatment in advanced NSCLC patients.
The potential predictive value of these representative
index might help with risk stratification. We acknowledge
to this study obvious limitations including the relatively
small sample size, the retrospective and not-randomized
nature of the analysis, and the short observational period.
These findings should be investigated in a larger and prospective study.

Tumori Journal 106(2S)

A33
The role of Distress Thermometer
on clinical outcomes in lung
cancer patients: a monoinstitutional experience
Lauro S.1, Mazzotta M.2, Rossi A.1, Marinelli D.1, Argentieri F.3, De
Meo S.3, Krasniqi E.2, Marchetti P.1, Rendina E.A.4, Costantini A.3
1
Department of Molecular and Clinical Medicine, "Sapienza" University,
Oncology Unit, Sant'Andrea Hospital, Rome, Italy, Roma; 2Division of Medical
Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy,
Roma; 3Psychoncology Unit, Faculty of Medicine and Psychology, Sant'Andrea
Hospital, Sapienza University, Rome, Italy, Roma; 4Department of Thoracic
Surgery, Sapienza University, Sant'Andrea Hospital, Rome, Italy, Roma

Background: In lung cancer (LC) patients, psychological
and emotional aspects deserve a primary attention in clinical management, as depression and anxiety are strictly
linked to survival. Emotional distress can be assessed with
the Distress Thermometer (DT). Our study aims to evaluate whether the DT score can be useful to predict clinical
outcomes in a cohort of LC patients.
Patients and methods: Patients with histological diagnosis of LC admitted at Sant'Andrea Hospital of Rome that
completed the DT were retrospectively investigated. The
DT is a visual analogue scale that ranges from 0 (no distress) to 10 (extreme distress). Furthermore, patients are
invited to complete a problem list that comprises 47 items
(addressing practical, social, emotional, spiritual, and
physical problems).
Results: From Jan 2018 to Jul 2019, 243 patients were
enrolled. The clinical characteristics of population are
summarized in Table 1. At the end of the follow-up
period (13 months, median), 214 patients were still alive
(88.0%). DT was completed by all patients: the median
score was 4.25 (range 0-10). High DT score was correlated with Sex (female vs male, p=0.011) and stage at
diagnosis (IV vs other, p=0.023). In whole population,
the DT score as continuous variable and the Performance
Status (PS) were prognostic for overall survival (OS) in
univariate analysis. DT score confirms significantly for
OS in multivariate analysis. Furthermore, in metastatic
patients, DT score was correlated with the type of treatment received at the time of the test (anova test,
p=0.037): patients receiving target-therapy have the
lower median DT score (3.21), followed by immunotherapy (4.30) and chemotherapy (4.77). In Kaplan-Meier
analysis, OS was significantly lower in subjects that
declared issues in the emotional (p=0.040) and physical
(p=0.007) items.
Conclusions: These results suggest that the DT score can
be linked to clinical outcomes of LC patients and confirm
the usefulness of this tool in oncology practice.



Tumori Journal Abstract Book - October 2020

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

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
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