Assessing the accuracy of multiple prognostic scores for immune checkpoint inhibitors (ICI) in patients with advanced solid tumors

ABSTRACT

Background: Many patients fail to achieve a clinical benefit from ICI. Several scores have been developed to improve ICI candidates selection but it is uncertain which one better predicts patients’ outcome. Here, we performed a direct comparison of the most successful scores. Methods: This is a sub-analysis of the immunoblood prospective observational study that enrolled patients diagnosed with advanced solid tumors treated with ICI. Main clinicopathological data were retrieved from medical records and responses assessed according to RECIST 1.1 criteria. LIPI, RMH, PMH, dNLR, NLR, PIPO and GRIm scores were calculated. Receiving operator characteristics (ROC) curves and their area under curve (AUC) were used to predict PFS and durable clinical benefit (DCB;stable disease≥6 months or better). Associations with PFS, OS and DCB, where assessed with Cox and logistic regressions. Scores’ correlation was assessed with Spearman rho. Significance was set at p<0.05. Results: We recruited 155 patients (65% male, mean age 63). NSCLC (28%), colorectal (20%) breast (9%) H&N (6%) cancer and melanoma (6%) were the most frequent tumor types. Frequency of the high risk/bad outcome group of each score were LIPI 13%, RMH 36%, PMH 54%, GRIm 14%, PIPO 6%, NLR 32% and dNRL 27%. Fair accuracy in identifying patients at higher risk of progression or mild accuracy in predicting DCB were observed for the RMH (AUC PFS 0.7, 95%CI 0.6-0.8;AUC DCB 0.6, 0.5-0.8) and LIPI (AUC PFS 0.7, 95%CI 0.6-0.8;AUC 0.6, 0.5-0.7) scores. All other scores provided poor/no accuracy. No significant difference was observed between RMH and LIPI AUC for PFS and DCB (both p>0.05). Additionally, only LIPI and RMH were associated with PFS (p=0.001;p<0.001), OS (p<0.001;p=0.001) and DCB (p=0.034;p=0.010) at univariate analyses. At multivariate analyses RMH and LIPI remained significantly associated with PFS (p=0.030;p=0.021) and OS (p=0.012;p<0.001). A strong correlation between both scores (rho=0.72, p<0.001) was observed. Conclusions: RMH and LIPI scores were sufficiently reliable in assessing the prognosis of patients with advanced solid tumors treated with ICI. They were superior to other analyzed scores in our population and highly correlated. Legal entity responsible for the study Hospital Clinic y Provincial de Barcelona, Medical Oncology Department. Funding: Has not received any funding. Disclosure J. Garcia-Corbacho Financial Interests, Personal, Advisory Board, FGFR inhibitors implementation in clinical practice Johnson & Johnson Pharmaceutical;Financial Interests, Institutional, Invited Speaker, Participation in clinical trials of the company as PI Johnson and Johnson Pharmaceutical, Boehringer Ingelheim, Astellas, Cytomx, Incyte, Lilly, Menarini, Merck, Bayer, AstraZeneca, Amgen, Daiichi Sankyo. L. Mezquita Financial Interests, Personal, Advisory Board Takeda, AstraZeneca, Roche;Financial Interests, Personal, Invited Speaker Roche, BMS, AstraZeneca, Takeda;Financial Interests, Personal, Research Grant, SEOM Beca Retorno 2019 BI;Financial Interests, Personal, Research Grant, ESMO TR Research Fellowship 2019 BMS;Financial Interests, Institutional, Research Grant, COVID research Grant Amgen;Financial Interests, Institutional, Invited Speaker Inivata, Stilla. N. Baste Rotllan Non-Financial Interests, Advisory Role Eisai, MSD, Merck Serono, BioNTech, Roche, BMS, Exelixis. A. Prat Financial Interests, Personal, Invited Speaker Roche;Financial Interests, Personal, Invited Speaker, Lecture fees Novartis, Daiichi Sankyo;Financial Interests, Personal, Advisory Board, Advisory role/consultancy Novartis, Pfizer, BMS, Puma, Oncolytics Biotech, MSD, Guardant Health, Peptomyc;Financial Interests, Institutional, Invited Speaker, Clinical trials Daiichi Sankyo;Financial Interests, Institutional, Other, Contracted research Boehringer, Medica Scientia Inno. Research;Financial Interests, Personal, Advisory Board AstraZeneca;Financial Interests, Personal, Invited Speaker, Leadership role Reveal Genomics, SL.;Financial I terests, Personal, Stocks/Shares Reveal Genomics, Oncolytics Biotech;Financial Interests, Personal, Royalties Reveal Genomics;Financial Interests, Institutional, Invited Speaker Roche, AstraZeneca, Novartis;Financial Interests, Personal and Institutional, Invited Speaker Daiichi Sankyo;Non-Financial Interests, Institutional, Other, Leadership roles Patronage committee SOLTI Foundation, Actitud Frente al Cáncer Foundation. All other authors have declared no conflicts of interest.