Dr Murray on the Investigation of Prognostic Markers in Cemiplimab-treated NSCLC

Joseph Christopher Murray, MD, PhD, co-director, Lung Cancer Precision Medicine Center of Excellence, Instructor of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, discusses the investigation of peripheral myeloid cells as prognostic markers in patients with non–small cell lung cancer (NSCLC) treated with cemiplimab (Libtayo).

In a post-hoc analysis presented in a poster at the 2023 ASCO Annual Meeting, investigators conducted a pooled analysis of patients with NSCLC treated with cemiplimab in the phase 3 EMPOWER-Lung 1 (NCT03088540) and EMPOWER-Lung 3 (NCT03409614) trials. Similar to other treatment patterns in advanced NSCLC, these studies utilized chemotherapy plus immunotherapy across a broad and inclusive patient population, independent of known biomarkers such as PD-L1 status, Murray explains. The goal of the analysis was to better understand the prognostic importance of neutrophil/lymphocyte ratio and other peripheral myeloid cells in this patient population, Murray says.

Therefore, investigators looked at the relevant relationship between these different cell subsets obtained at baseline. Along with the neutrophil/lymphocyte ratio, they examined other immune cells known as monocytes and eosinophils, Murray expands. Investigators showed that a higher neutrophil plus monocyte/lymphocyte ratio was associated with lower overall survival in this patient population, he says. Although this conclusion has been drawn from previous retrospective studies, this post-hoc analysis drew the conclusion from findings in a prospective clinical trial, he says.

These findings have important implications for patients and clinicians, who should continue to evaluate blood counts that could affect responses to immunotherapy, Murray concludes.