ESTRO 2024 - Abstract Book

S1594

Clinical - Lung

ESTRO 2024

higher risk of neurocognitive decline. We conducted a prospective clinical trial to explore potential serum biomarkers that are associated with neurocognitive decline in patients with SCLC who received PCI.

Material/Methods:

This exploratory study was pre-specified in the phase III randomized clinical trial (NCT01780675)1, which primarily evaluated whether hippocampal-avoidance (HA) PCI reduced the risk of neurocognitive decline compared with PCI in patients with SCLC. This study included paticipants whose blood samples were collected in the NCT01780675 trial. Blood samples for biomarker tests (serum neurofilament light chain [NFL] and 38 cytokines) were collected before PCI (baseline) and 3-days after initiating PCI. The sample group included patients from Flanders and the Netherlands Cancer Institute, because no funding was available for the Dutch centres. Neurocognitive decline was defined as a decrease of ≥5 points from baseline on total recall using the Hopkins Verbal Learning Test— Revised (HVLT-R) from baseline to 4-months after completing PCI. Potential biomarkers for neurocognitive decline were screened using univariate logistic regression analysis. P≤0.1 was defined to determine statistical significance.

Results:

In total, 48 of the 168 enrolled patients from Flanders (n=42) and of the Netherlands Cancer Institute with available blood samples were included, of which 60.4% were males, 39.6% were current smokers, and 29.2% of the patients had stage IV disease. The median age was 63.5 years (Table 1). All patients completed neurocognitive testing before PCI, 27 patients underwent neurocognitive testing at 4-months, of which 10 patients showed neurocognitive decline. A blood sample was collected from all patients before PCI (T1), and from 43 patients at 3-days after initiating PCI (T2). The univariate logistic analysis showed that the concentration level (pg/mL) of Tie-2, MIP-1b, CCL-17, and IL 1a detected before PCI might predict neurocognitive decline at 4-months (Tie-2: OR=0.999, 95%CI 0.998 1.000, P=0.062; MIP-1b: OR=1.022, 95%CI 0.996-1.048, P=0.093; CCL-17: OR=1.004, 95%CI 1.000-1.007, P=0.029; IL 1a: OR=1.597, 95%CI 0.999-2.552, P=0.05). Changes in levels (pg/mL) of circulating VEGF-C, CCL-17, IL-1a,and VEGF 3 days after initiating PCI might be associated with neurocognitive decline at 4-months (delta.VEGF-C: OR=0.972, 95%CI 0.944-1.001, P=0.055; delta.CCL-17: OR=0.993, 95%CI 0.987-1.000, P=0.036; delta.IL-1a: OR = 0.788, 95%CI 0.608-1.021, P=0.071; delta.VEGF: OR=0.981, 95%CI 0.962-1.000, P=0.051) (Table 2). The other biomarkers were not significant (P>0.1).