Association of severe lymphopenia and disease progression in unresectable locally advanced non-small cell lung cancer treated with definitive chemoradiation and immunotherapy.


Journal

Lung cancer (Amsterdam, Netherlands)
ISSN: 1872-8332
Titre abrégé: Lung Cancer
Pays: Ireland
ID NLM: 8800805

Informations de publication

Date de publication:
04 2021
Historique:
received: 15 11 2020
revised: 22 12 2020
accepted: 21 01 2021
pubmed: 22 2 2021
medline: 22 6 2021
entrez: 21 2 2021
Statut: ppublish

Résumé

Definitive chemoradiation with consolidative immunotherapy offers the best chance for cure in patients with unresectable, locally advanced non-small cell lung cancer (NSCLC). However, treatment-related lymphopenia (TRL) may negatively impact outcomes. Patients definitively treated with chemoradiation and immunotherapy from 2015 to 2019 at a single tertiary academic center were identified. Severe lymphopenia was defined as <0.5 × 10 Seventy-eight patients were included in the final cohort. The median age was 66 years (IQR: 58-73), 55 % were males, and 88 % had a KPS of >70. At baseline, 90 % (n = 70/78) of patients had a normal ALC and one patient had severe lymphopenia. After chemoradiation, the median ALC decreased from 1.52 × 10 This is the first report to associate severe TRL with disease progression in patients with locally advanced NSCLC receiving consolidative immunotherapy. Factors associated with development of lymphopenia and strategies to mitigate lymphopenic effects should be considered.

Sections du résumé

BACKGROUND
Definitive chemoradiation with consolidative immunotherapy offers the best chance for cure in patients with unresectable, locally advanced non-small cell lung cancer (NSCLC). However, treatment-related lymphopenia (TRL) may negatively impact outcomes.
METHODS
Patients definitively treated with chemoradiation and immunotherapy from 2015 to 2019 at a single tertiary academic center were identified. Severe lymphopenia was defined as <0.5 × 10
RESULTS
Seventy-eight patients were included in the final cohort. The median age was 66 years (IQR: 58-73), 55 % were males, and 88 % had a KPS of >70. At baseline, 90 % (n = 70/78) of patients had a normal ALC and one patient had severe lymphopenia. After chemoradiation, the median ALC decreased from 1.52 × 10
CONCLUSIONS
This is the first report to associate severe TRL with disease progression in patients with locally advanced NSCLC receiving consolidative immunotherapy. Factors associated with development of lymphopenia and strategies to mitigate lymphopenic effects should be considered.

Identifiants

pubmed: 33611224
pii: S0169-5002(21)00040-4
doi: 10.1016/j.lungcan.2021.01.022
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

36-43

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

Auteurs

Cole Friedes (C)

Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Turja Chakrabarti (T)

Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.

Sarah Olson (S)

Biostatistics, Epidemiology, and Data Management Core (BEAD), Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.

Laura Prichett (L)

Biostatistics, Epidemiology, and Data Management Core (BEAD), Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.

Julie R Brahmer (JR)

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Patrick M Forde (PM)

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Ranh K Voong (RK)

Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Kristen A Marrone (KA)

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Vincent K Lam (VK)

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Christine L Hann (CL)

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Stephen R Broderick (SR)

Department of Thoracic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Richard J Battafarano (RJ)

Department of Thoracic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Jinny S Ha (JS)

Department of Thoracic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Errol L Bush (EL)

Department of Thoracic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Stephen C Yang (SC)

Department of Thoracic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Russel K Hales (RK)

Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Josephine L Feliciano (JL)

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: jfelici4@jhmi.edu.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH