Neutropenia a Factor for OS in NSCLC After Gem-Carbo Therapy

In patients with non-small-cell lung cancer (NSCLC) being treated with gemcitabine-carboplatin chemotherapy, neutropenia may predict OS, according to long-term follow-up data presented at the ESMO 2020 Virtual Congress

“This retrospective study examines the prognostic significance of relative versus absolute neutropaenia in patients receiving GemCarbo chemotherapy, proposing neutropaenia as a surrogate biomarker of appropriate drug dose to the individual patient,” wrote Y.F. Clark, MD, North Wales Cancer Treatment Centre-Glan Clwyd Hospital, Rhyk, United Kingdom, and co-investigators.

Researchers explained the prognostic relevance of relative neutropenia in this cohort had not been previously examined.

A total of 248 patients undergoing at least one cycle of GemCarbo chemotherapy for NSCLC from 2007 to 2016 at the North Wales Cancer Treatment Center were included in this retrospective analysis.

Absolute neutropenia was classified as none (grade 0), moderate (grade 1-2), or severe (grade 3-4), using Common Terminology for Adverse Events grading. Relative neutropenia was calculated as (neutrophils on Day 21-neutrophils on Day 1)neutrophils on Day 1, and categorized.

In this cohort, 42.8% of patients had grade 0 neutropenia, 54.3% had grade 1-2 neutropenia, and 2.9% had grade 3-4 neutropenia. Measured on Day 21 of chemotherapy, 43.4% of patients exhibited absolute neutropenia and 94% had relative neutropenia. After adjusting for other prognostic factors with multivariate analysis, researchers found moderate relative neutropenia was associated with improved OS.

Median OS according to relative neutropenia grade was 12.3 months, 22.1 months, and 12.6 months, respectively. Absolute neutropenia was not statistically significant.

“Our results indicate that a moderate level of neutropaenia predicts for prolonged overall survival in this cohort, suggesting that appropriate drug dosage could be tailored to obtain moderate neutropaenia in order to maximize patient benefit,” Dr Clark et al concluded. —Kaitlyn Manasterski

Clark YF, Vangara J, Wreglesworth N, Innominato P. Chemotherapy-induced neutropaenia as a marker for overall survival (OS) in non-small cell lung cancer (NSCLC) patients undergoing gemcitabine/carboplatin (GemCarbo) chemotherapy: A 9-year real-life data. Presented at: the ESMO Virtual Congress 2020; September 19-21, 2020; virtual. Abstract 103P.