S187
Clinical - Biomarkers of clinical response
ESTRO 2026
Groups also differed in metastasis location, most frequently lung (31%), lymph node (22%) and spine (21%) in the NLR high group vs spine (43%), lung (34%), and non-spine bone in the NLR low group (p=0.008). Groups were otherwise similar in baseline patient and tumor characteristics. The NLR high group had shorter PPFS (median 11.4 vs 17.6 months; p=0.004) and shorter OS (median 22.8 vs 44.2 months; p<0.001) compared to the NLR low group (Figure 1). NLR high remained a significant predictor of both PPFS (HR 1.54, p=0.010) and OS (HR 1.93, p<0.001) on multivariable regression analyses (Table 1).
myocardial infarction. Circulation 2002;106:2961–6. [4] Januzzi JL et al. ST2 and prognosis in acutely decompensated heart failure: the International ST2 Consensus Panel. Am J Cardiol 2015;115:26B-31B. Keywords: breast radiotherapy, cardiotoxicity, ST2 Digital Poster Highlight 1937 neutrophil-to-lymphocyte ratio as a biomarker in oligoprogressive malignancy Alexandra Leigh Winkel 1 , Hamza Nadeem 1 , Eshawn Johal 1 , Benjamin Mou 2 , Islam Mohamed 2 , Mitchell Liu 3 , Tina Zhang 3 , Matthew Chan 3 , Howard Pai 4 , Devin Schellenberg 5 , Jaime Kwok 5 , Haley Clark 5 , Scott Tyldesley 3 , Robert Olson 6 , Sarah Baker 5 1 Medicine, University of British Columbia, Vancouver, Canada. 2 Radiation Oncology, BC Cancer, Kelowna, Canada. 3 Radiation Oncology, BC Cancer, Vancouver, Canada. 4 Radiation Oncology, BC Cancer, Victoria, Canada. 5 Radiation Oncology, BC Cancer, Surrey, Canada. 6 Radiation Oncology, BC Cancer, Prince George, Canada Purpose/Objective: Biomarkers for oligoprogressive cancer are lacking. Systemic inflammation and immune suppression, measured by an elevated neutrophil-to-lymphocyte ratio (NLR), may indicate a permissive state for cancer progression. We evaluated NLR as a prognostic marker for polymetastatic progression-free survival (PPFS) and overall survival (OS) in patients treated with SABR for oligoprogressive malignancy. Material/Methods: The study included all patients with up to 5 oligoprogressing lesions treated on the single-arm phase II SABR-5 trial (November 2016 - July 2020) and on the retrospective British Columbia Oligometastases Registry (August 2020 - April 2024) who had an available complete blood count prior to SABR treatment. The optimal threshold for NLR was determined by receiver operating characteristic curve with Youden Index. PPFS was calculated as the time from SABR until disease progression with 6 or more metastases or death from any cause. Results: A total of 253 patients (88 on SABR-5 and 165 on the Registry) were included. Median follow-up time was 23.6 months (IQR 14.3 – 40.1). The optimal cutoff value of the NLR was 3.90. Patients were stratified into NLR low (NLR ≤ 3.90; n=171) and high (NLR > 3.90; n=82) groups. Groups differed in primary tumor histology, with predominantly renal (24%), lung (23%), prostate (17%), melanoma (6%), breast (6%) and colorectal cancer (1%) in the NLR high group, vs prostate (20%), lung (17%), renal (15%), breast (12%), colorectal (23%) and melanoma (10%) in the NLR low group (p=0.007).
Figure 1. Polymetastatic progression-free survival (A) and overall survival (B) in patients with high vs low neutrophil lymphocyte ratio.Table 1. Multivariable regression analyses for polymetastatic progression- free survival and overall survival.
Conclusion: Elevated NLR (>3.90) was independently associated with shorter PPFS and OS and may be a practical biomarker for identifying high-risk patients and stratification for future clinical trials. Keywords: Oligoprogression, Neutrophil-to- Lymphocyte Ratio
Proffered Paper 2190
Impact of circulating T-cell subsets in advanced squamous cell carcinoma treated with SBRT and durvalumab ± tremelimumab in the ABIMMUNE trial Antonin Levy 1,2 , Lisa Bouarroudj 2 , Nicolas Hardy 2 , Jerome Durand-Labrunie 1 , Nathalie Chaput 3 , Chrsitophe Massard 4 , Charlotte Robert 2 , Daphné Morel 2 , Eric Deutsch 1,2 1 Radiation Oncology, Gustave Roussy, Villejuif, France. 2 Inserm U1030, Gustave Roussy, Villejuif, France.
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