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856 Routine baseline blood tests predicting pembrolizumab sensitivity in advanced high-grade serous ovarian cancer (AHGSOC) 1st line therapy: substudy from the NEOPEMBROV/GINECO (NCT03275506) randomized trial
  1. Stanislas Quesada1,2,
  2. Isabelle Ray-Coquard2,3,
  3. Camille Schiffler2,
  4. Aude-Marie Savoye4,
  5. Marie-Ange Mouret-Reynier5,
  6. Florence Joly6,
  7. Olfa Derbel Miled7,
  8. Elsa Kalbacher8,
  9. Alejandra Martinez9,
  10. Marianne Leheurteur10,
  11. Jérôme Meunier11,
  12. MAthilde Martinez12,
  13. Nicolas Cloarec13,
  14. Laurence Venat-Bouvet14,
  15. Dominique Berton15,
  16. Frédéric Selle16,
  17. Pierre-Alexandre Just17,
  18. Guillaume Bataillon18,
  19. Isabelle Treilleux2,3 and
  20. Olivia Le Saux2,3
  1. 1Department of Medical Oncology, GINECO and Institut Régional du Cancer de Montpellier, Montpellier, France
  2. 2Department of Medical Oncology, Centre Léon Bérard, Lyon, France
  3. 3Cancer Research Center of Lyon (CRCL), UMR INSERM 1052 CNRS 5286, Centre Léon Bérard, Lyon, France
  4. 4Medical Oncology, GINECO and Institut Jean Godinot, Reims, France
  5. 5Medical Oncology, GINECO and Centre Jean Perrin, Clermont-Ferrand,, France
  6. 6Department of Medical Oncology, Centre François Baclesse, University Caen Normandie, Caen, France
  7. 7Department of Medical Oncology, Hôpital Privé Jean Mermoz, Lyon, France
  8. 8Medical Oncology, GINECO and Hôpital Jean Minjoz, Besançon, France
  9. 9Medical Oncology, GINECO and Institut Claudius Regaud, Toulouse, France
  10. 10Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
  11. 11Department of Medical Oncology, CHR Orléans, Orléans, France
  12. 12Department of Medical Oncology, Clinique Pasteur, Toulouse, France
  13. 13Medical Oncology, GINECO and CH Henri Duffaut, Avignon, France
  14. 14Medical Oncology, GINECO and CHU Dupuytren, Limoges, France
  15. 15Medical Oncology, GINECO and Institut de Cancérologie de l’Ouest, Saint-Herblain, France
  16. 16Department of Medical Oncology, Groupe Hospitalier Diaconesses – Croix Saint-Simon, Paris, France
  17. 17Department of Pathological Anatomy and Cytology, APHM, Marseille, France
  18. 18Anatomopathology Department, University hospital of Toulouse, Toulouse, France


Introduction/Background Clinical benefit to immunotherapy (ICPI) has been limited to date in high-grade serous ovarian carcinoma (HGSOC), underpinning the necessity of better patient’s selection. Conversely, peripheral blood parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) have been correlated to ICPI benefit in various malignancies. As such, the present ancillary study from the NEOPEMBROV/GINECO phase II trial (NCT03275506) assessed these parameters as predictive biomarkers of pembrolizumab (P) adjunction to standard chemotherapy (CT) and interval debulking surgery for advanced HGSOC.

Methodology 91 patients were enrolled in the trial (P+CT arm: 61; CT arm: 30). Optimal cut-off values for baseline NLR, PLR, and LMR regarding progression-free survival (PFS) in the P+CT arm were determined by ROC curves. Subsequently, a composite blood score (CBS) integrating these three biomarkers was evaluated.

Results Using ROC-based optimal cutoff values, we observed in P+CT arm a positive predictive impact of NLR ≤4 vs >4 (median PFS: 26.2 vs 17.0 months; hazard ratio (HR) 0.48 ; 95% confidence-interval (95CI) 0.25–0.89; p<0.05), PLR ≤250 vs >250 (median PFS: 26.0 vs 17.2 months; HR 0.49 ; 95CI 0.26–0.91; p<0.05) and LMR ≥2 vs <2 (median PFS: 25.8 versus 17.0 months; HR 0.47 ; 95CI 0.23–0.93; p<0.05). CBS, defined as the combination of NLR ≤4 + PLR ≤250 + LMR ≥2 in a given patient led to the following median PFS: 30.7 vs 15.1 months (HR 0.31; 0.16–0.60; CBS positive (n=33) and negative (n=28), respectively; p<0.0001). Interestingly, none of these biomarkers were associated with enhanced PFS in the CT arm.

Conclusion Our study reports that baseline NLR, PLR, LMR and CBS are promising predictive biomarkers of P+CT treatment efficacy in newly diagnosed HGSOC. These exploratory results will require to be further assessed and validated in larger cohorts of patients with HGSOC and treated with ICPI.

Disclosures Stanislas Quesada: no COI

Isabelle Ray-Coquard: GINECO President

Camille Schiffler: no COI

Aude-Marie Savoye: no COI

Marie-Ange Mouret-Reynier

Florence Joly: honoraria or consultations fees for AstraZeneca, GSK, Janssen, Ipsen, Clovis, Amgen, Astellas, MSD, BMS, Bayer

Olfa Derbel Miled: no COI

Elsa Kalbacher: honoraria or consultations fees for Astrazeneca, GSK, Sanofi, Roche, Seagen

Alejandra Martinez: honoraria or consultations fees for GSK

Marianne Leheurteur: travel grants from MSD

Jérôme Meunier: no COI

Mathilde Martinez: no COI

Nicolas Cloarec: no COI

Laurence Venat-Bouvet: no COI

Dominique Berton: no COI

Frédéric Selle: honoraria or consultations fees for GSK, AstraZeneca, MSD, Eisai

Pierre-Alexandre Just: honoraria or consultations fees for GSK and Roche

Guillaume Bataillon: Consulting/Advisory Board for GSK

Isabelle Treilleux: no COI

Olivia Le Saux: honoraria or consultations fees for GSK, Clovis, MSD

Abstract 856 Table 1

median OS and PFS according to baseline biomarkers and CBS

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