Mini Oral session - Sarcoma Mini Oral session

405O - Neutrophil-lymphocyte and platelet-lymphocyte ratios as robust prognostic markers in sarcomas: A population-based analysis of 3746 sarcoma patients from Hong Kong

Presentation Number
405O
Lecture Time
12:00 PM - 12:05 PM
Speakers
  • Sui Chun Sampson Kwan
Location
Room 311, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:40 AM - 12:20 PM
Authors
  • Sui Chun Sampson Kwan
  • Carlos K. Wong
  • CW Ho
  • Ying Zhun Zhang
  • Teresa Tse
  • Yat-ming Lau
  • Linda K. Leung
  • Teresa Tan
  • Herbert Loong

Abstract

Background

Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been shown to be prognostic in various cancers. Prior reports of this in sarcomas have predominantly been made through smaller cohorts from single institutions. We investigated the prognostic implications of these indices in patients with soft-tissue (STS) and bone sarcomas using a large population-based database.

Methods

A population-based retrospective database was assembled to extract pts with sarcoma, as defined as ICD-9-CM codes of bone (170.x) or/and soft tissue (171.x) who have attended clinics or hospitals of the Hong Kong Hospital Authority between Jan 2004 and Mar 2018. Eligible patients (pts) with index presentation of bone sarcoma or/and STS on or after Jan 2005 were analysed to allow 1-year window. The most recent documented lymphocyte, neutrophil, and platelet counts from the index date of sarcoma diagnosis were retrieved, and the neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were correlated with survival. Abnormal (abn) NLR and abn PLR are defined as NLR≥2.5 and PLR≥182 respectively. Restricted cubic spline plots were used to explore the shape of association between baseline NLR and PLR and all-cause mortality, fitting a restricted cubic spline function with four knots (5th, 35th, 65th, and 95th centiles).

Results

Of 3746 pts identified, 3358 pts satisfied eligibility: bone n = 661, STS n = 2576, both n = 121. NLR and PLR is available for 89.93% (n = 3020) of eligible pts, amongst which 65.9% (n = 1989) had abn NLR while 47.6% (n = 1438) had abn PLR., Abn NLR and abn PLR are each associated with higher all-cause mortality (abn NLR: HR 1.698, p < 0.001, 95% CI 1.424-2.025; abn PLR: HR 1.346, p < 0.001, 95%CI 1.164-1.555) and cancer-related mortality (abn NLR: HR 1.648, p < 0.001, 95% CI 1.341-2.024; abn PLR: HR 1.430, p < 0.001, 95% CI 1.205-1.697).

Conclusions

This is the largest assembled population-based sarcoma cohort in Asia. We show that NLR and PLR are robust prognostic factors, and abn NLR and PLR have negative effects on survival. More importantly, the relationship between NLR and PLR and mortality is shown to be non-linear.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Collapse
Mini Oral session - Sarcoma Mini Oral session

406O - VEGFR2 Polymorphisms as Novel Biomarker of Anti-angiogenic Therapy for Pediatric and Young Adult Sarcoma

Presentation Number
406O
Lecture Time
12:05 PM - 12:10 PM
Speakers
  • Qiyuan Bao
Location
Room 311, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:40 AM - 12:20 PM
Authors
  • Qiyuan Bao
  • Yuehao Hu
  • Junxiang Wen
  • Yuhui Shen
  • Weibin Zhang

Abstract

Background

The impact of germline mutations of the angiogenesis pathways on the therapeutic response has been extensively studied for the carcinoma population. However, such information is almost unknown for pediatric and young adult’s sarcoma, for which the field has seen the rapid growing popularity of the use of the anti-angiogenic therapy.

Methods

In this study, we retrospectively analyzed 79 tissue sarcoma patients less than 45 yrs receiving anti-angiogenic therapy (apatinib). In 67 (84%) of these patients, twenty previously reported single nuclear polymorphism (SNPs) in angiogenesis pathway were genotyped to screen for potential toxicity and predictive biomarkers.

Results

The mean 6 mo PFS rate was 64%, with the duration of response varying from no response to more than 26 months. Multivariate analysis indicated that hand-foot reactions, hair depigmentation and spontaneously pneumothorax (SP) remain independent toxicity biomarker for greater PFS. Interestingly, we observed a strong correlation of ITGA2 rs1126643 polymorphism vs surgical wound complications (C/C 4% vs C/T 24% vs T/T 33%, p = 0.008) as well as SP (C/C 13.8% vs C/T 36.4% vs T/T 66%), suggesting that Integrin mechanism might underline both toxicities. Moreover, VEGFR2 rs2071559 polymorphism remains the only sensitivity biomarker for mPFS (mutation vs WT, 12 mo vs 5 mo), regardless of the sarcoma subtypes. Surprisingly, such mutations were to be associated with the incidence of hair depigmentation (R = 0.398, p = 0.026), further supporting that hair discoloration is a mechanism-based toxicity biomarker. Moreover, a significant higher frequecies of such two mutations (0.53 for ITGA polymorphism, 0.59 for VEGFR2 polymorphism) in our cohort than general Han Chinese (1000G project database) suggest a theoretical impact on the sarcomagenesis.

Conclusions

Our study is the first one examining the angiogenesis germline polymorphism for the younger population in bone and soft tissue cancer. VEGFR2 (rs2071559) as well as ITGA (rs1126643) might serve as pan-sarcoma biomarkers for VEGFR2 targeted therapy and warrant further validation for its biological and clinical implications.

Legal entity responsible for the study

Ruijin Hospital.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Collapse
Immunotherapy in GU cancers: Focus on kidney and bladder cancers Challenge Your Expert session

Discussion

Lecture Time
12:05 PM - 12:30 PM
Location
Summit 2, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Surgical management of ovarian cancer Challenge Your Expert session

Surgical Management of Ovarian Cancer

Lecture Time
11:45 AM - 12:00 PM
Speakers
  • Christian Marth
Location
Hall 407, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Authors
  • Christian Marth
Optimal sequence and treatment choice in osimertinib failure Challenge Your Expert session

Discussion

Lecture Time
12:00 PM - 12:30 PM
Location
Hall 404, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Immunotherapy in GU cancers: Focus on kidney and bladder cancers Challenge Your Expert session

Kidney

Lecture Time
11:45 AM - 11:55 AM
Speakers
  • Yu Li Su
Location
Summit 2, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Authors
  • Yu Li Su
Locally advanced nasopharyngeal carcinoma (LA NPC): Asian and European perspectives Challenge Your Expert session

Discussion

Lecture Time
12:15 PM - 12:30 PM
Location
Room 324, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Surgical management of ovarian cancer Challenge Your Expert session

Discussion

Lecture Time
12:00 PM - 12:30 PM
Speakers
  • Amita Maheshwari
Location
Hall 407, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Authors
  • Amita Maheshwari
Immunotherapy in GU cancers: Focus on kidney and bladder cancers Challenge Your Expert session

Bladder

Lecture Time
11:55 AM - 12:05 PM
Speakers
  • Ravindran Kanesvaran
Location
Summit 2, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Authors
  • Ravindran Kanesvaran
Optimal sequence and treatment choice in osimertinib failure Challenge Your Expert session

Optimal sequence and treatment choice in osimertinib failure

Lecture Time
11:45 AM - 12:00 PM
Speakers
  • Tony S.K. Mok
Location
Hall 404, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Authors
  • Tony S.K. Mok
Locally advanced nasopharyngeal carcinoma (LA NPC): Asian and European perspectives Challenge Your Expert session

Locally advanced nasopharyngeal carcinoma (LA NPC): Asian and European perspectives

Lecture Time
11:45 AM - 12:15 PM
Speakers
  • Anthony T. Chan
  • Pierre Blanchard
Location
Room 324, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Authors
  • Anthony T. Chan
  • Pierre Blanchard

Q&A (ID 1804)