The association of nutritional and inflammatory biomarkers with overall survival in patients with non-small-cell lung cancer treated with immune checkpoint inhibitors.
immune checkpoint inhibitors
immunotherapy
non‐small‐cell lung cancer
nutritional and inflammatory biomarkers
prognostic markers
Journal
Thoracic cancer
ISSN: 1759-7714
Titre abrégé: Thorac Cancer
Pays: Singapore
ID NLM: 101531441
Informations de publication
Date de publication:
19 Jul 2024
19 Jul 2024
Historique:
revised:
18
06
2024
received:
15
02
2024
accepted:
21
06
2024
medline:
20
7
2024
pubmed:
20
7
2024
entrez:
20
7
2024
Statut:
aheadofprint
Résumé
Pretreatment biomarkers are needed to identify patients with non-small-cell lung cancer (NSCLC) likely to have worse survival. This ensures that only patients with a real chance of benefit receive immune checkpoint inhibitor (ICI) treatment. In this study, we examined the associations of baseline nutritional and inflammatory biomarkers with overall survival in a real-world cohort of NSCLC patients who received ICIs. We used prospectively collected data from the OncoLifeS data biobank. The cohort included 500 advanced-stage NSCLC patients treated with ICIs from May 2015 to June 2021. Biomarkers were evaluated within 2 weeks before ICI treatment: neutrophil-to-lymphocyte ratio, C-reactive protein (CRP), Glasgow prognostic score, CRP/albumin ratio (CAR), prognostic nutritional index (PNI), and advanced lung cancer inflammation index. For each biomarker, low- and high-risk groups were defined using literature-based cut-offs. Adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs) were estimated using adjusted survival analysis. Most patients were male (60.8%), the mean baseline age was 65 ± 9 years, and 88% had stage IV disease. For each biomarker, low-risk patients had better overall survival (all, p < 0.001), with CAR and PNI showing the strongest associations. In multivariable analyses a combined CAR/PNI risk score had a stronger association with overall survival (aHR 3.09, 95% CI 2.36-4.06) than CAR alone (aHR 2.22, 95% CI 1.79-2.76) or PNI alone (aHR 2.09, 95% CI 1.66-2.61). These results highlight the potential value of nutritional and inflammatory biomarkers, in particular CAR and PNI, in identifying NSCLC patients with highest mortality risk before starting ICI treatment.
Identifiants
pubmed: 39030876
doi: 10.1111/1759-7714.15401
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Horizon 2020 Framework Programme
ID : 875171
Informations de copyright
© 2024 The Author(s). Thoracic Cancer published by John Wiley & Sons Australia, Ltd.
Références
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. https://doi.org/10.3322/caac.21660
Ganti AK, Klein AB, Cotarla I, Seal B, Chou E. Update of incidence, prevalence, survival, and initial treatment in patients with non‐small cell lung cancer in the US. JAMA Oncol. 2021;7(12):1824–1832. https://doi.org/10.1001/jamaoncol.2021.4932
Alexander M, Kim SY, Cheng H. Update 2020: Management of non‐small cell lung cancer. Lung. 2020;198(6):897–907. https://doi.org/10.1007/s00408-020-00407-5
Zhang C, Leighl NB, Wu YL, Zhong WZ. Emerging therapies for non‐small cell lung cancer. J Hematol Oncol. 2019;12(1):45. https://doi.org/10.1186/s13045-019-0731-8
Toschi L, Rossi S, Finocchiaro G, Santoro A. Non‐small cell lung cancer treatment (r)evolution: ten years of advances and more to come. Ecancermedicalscience. 2017;30(11):787. https://doi.org/10.3332/ecancer.2017.787
Duma N, Santana‐Davila R, Molina JR. Non‐small cell lung cancer: epidemiology, screening, diagnosis, and treatment. Mayo Clin Proc. 2019;94(8):1623–1640. https://doi.org/10.1016/j.mayocp.2019.01.013
Reck M, Rodríguez‐Abreu D, Robinson AG, Hui R, Csőszi T, et al. Updated analysis of KEYNOTE‐024: Pembrolizumab versus platinum‐based chemotherapy for advanced non‐small‐cell lung cancer with PD‐L1 tumor proportion score of 50% or greater. J Clin Oncol. 2019;37(7):537–546. https://doi.org/10.1200/JCO.18.00149
Herbst RS, Baas P, Kim DW, Felip E, Pérez‐Gracia JL, Han JY, et al. Pembrolizumab versus docetaxel for previously treated, PD‐L1‐positive, advanced non‐small‐cell lung cancer (KEYNOTE‐010): a randomized controlled trial. Lancet. 2016;387(10027):1540–1550. https://doi.org/10.1016/S0140-6736(15)01281-7
Patel SA, Weiss J. Advances in the treatment of non‐small cell lung cancer: immunotherapy. Clin Chest Med. 2020;41(2):237–247. https://doi.org/10.1016/j.ccm.2020.02.010
Lu Y, Zhang X, Ning J, Zhang M. Immune checkpoint inhibitors as first‐line therapy for non‐small cell lung cancer: a systematic evaluation and meta‐analysis. Hum Vaccin Immunother. 2023;19(1):2169531. https://doi.org/10.1080/21645515.2023.2169531
Magee DE, Hird AE, Klaassen Z, Sridhar SS, Nam RK, Wallis CJD, et al. Adverse event profile for immunotherapy agents compared with chemotherapy in solid organ tumors: a systematic review and meta‐analysis of randomized clinical trials. Ann Oncol. 2020;31(1):50–60. https://doi.org/10.1016/j.annonc.2019.10.008
Reck M, Rodríguez‐Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, et al. Five‐year outcomes with pembrolizumab versus chemotherapy for metastatic non‐small‐cell lung cancer with PD‐L1 tumor proportion score ≥ 50. J Clin Oncol. 2021;39(21):2339–2349. https://doi.org/10.1200/JCO.21.00174
Cao D, Xu H, Xu X, Guo T, Ge W. A reliable and feasible way to predict the benefits of nivolumab in patients with non‐small cell lung cancer: a pooled analysis of 14 retrospective studies. Onco Targets Ther. 2018;7(11):e1507262. https://doi.org/10.1080/2162402X.2018.1507262
Riedl JM, Barth DA, Brueckl WM, Zeitler G, Foris V. C‐reactive protein (CRP) levels in immune checkpoint inhibitor response and progression in advanced non‐small cell lung cancer: a Bi‐center study. Cancers (Basel). 2020;12(8):2319. https://doi.org/10.3390/cancers12082319
Takamori S, Takada K, Shimokawa M, Matsubara T, Fujishita T, Ito K, et al. Clinical utility of pretreatment Glasgow prognostic score in non‐small‐cell lung cancer patients treated with immune checkpoint inhibitors. Lung Cancer. 2021;152:27–33. https://doi.org/10.1016/j.lungcan.2020.11.026
Araki T, Tateishi K, Sonehara K, Hirota S, Komatsu M, Yamamoto M, et al. Clinical utility of the C‐reactive protein:albumin ratio in non‐small cell lung cancer patients treated with nivolumab. Thorac Cancer. 2021;12(5):603–612. https://doi.org/10.1111/1759-7714.13788
Johannet P, Sawyers A, Qian Y, Kozloff S, Gulati N, Donnelly D, et al. Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer. J Immunother Cancer. 2020;8(2):e001674. https://doi.org/10.1136/jitc-2020-001674
Mountzios G, Samantas E, Senghas K, Zervas E, Krisam J, Samitas K, et al. Association of the advanced lung cancer inflammation index (ALI) with immune checkpoint inhibitor efficacy in patients with advanced non‐small‐cell lung cancer. ESMO Open. 2021;6(5):100254. https://doi.org/10.1016/j.esmoop.2021.100254
Peng L, Wang Y, Liu F, Qiu X, Zhang X, Fang C, et al. Peripheral blood markers predictive of outcome and immune‐related adverse events in advanced non‐small cell lung cancer treated with PD‐1 inhibitors. Cancer Immunol Immunother. 2020;69(9):1813–1822. https://doi.org/10.1007/s00262-020-02585-w
Sidorenkov G, Nagel J, Meijer C, Duker JJ, Groen HJM, Halmos GB, et al. The OncoLifeS data‐biobank for oncology: a comprehensive repository of clinical data, biological samples, and the patient's perspective. J Transl Med. 2019;17(1):374. https://doi.org/10.1186/s12967-019-2122-x
Zhang N, Jiang J, Tang S, Sun G. Predictive value of neutrophil‐lymphocyte ratio and platelet‐lymphocyte ratio in non‐small cell lung cancer patients treated with immune checkpoint inhibitors: a meta‐analysis. Int Immunopharmacol. 2020;85:106677. https://doi.org/10.1016/j.intimp.2020.106677
Kang HS, Shin AY, Yeo CD, Kim SK, Park CK, et al. Significance of Glasgow prognostic scores in NSCLC patients treated with immunotherapy after platinum‐based cytotoxic chemotherapy. In Vivo. 2021;35(6):3423–3430. https://doi.org/10.21873/invivo.12642
Pan M, Zhao Y, He J, Wu H, Pan Y, Yu Q, et al. Prognostic value of the Glasgow prognostic score on overall survival in patients with advanced non‐small cell lung cancer. J Cancer. 2021;12(8):2395–2402. https://doi.org/10.7150/jca.52215
Liu N, Jiang A, Zheng X, Fu X, Zheng H, Gao H, et al. Prognostic nutritional index identifies risk of early progression and survival outcomes in advanced non‐small cell lung cancer patients treated with PD‐1 inhibitors. J Cancer. 2021;12(10):2960–2967. https://doi.org/10.7150/jca.55936
Matsubara T, Takamori S, Haratake N, Toyozawa R, Miura N, Shimokawa M, et al. The impact of immune‐inflammation‐nutritional parameters on the prognosis of non‐small cell lung cancer patients treated with atezolizumab. J Thorac Dis. 2020;12(4):1520–1528. https://doi.org/10.21037/jtd.2020.02.27