Baseline Absolute Lymphocyte Count and ECOG Performance Score Are Associated with Survival in Advanced Non-Small Cell Lung Cancer Undergoing PD-1/PD-L1 Blockade

Journal of Clinical Medicine

Theresa Westphal¹  SimonPeter Gampenrieder¹  Florian Huemer¹  Richard Greil¹  Lukas Weiss¹  Gabriel Rinnerthaler¹  Bernd Lamprecht²  David Lang²  Hubert Hackl³  Georg Hutarew⁴ 

[1] Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria;Department of Pulmonology, Kepler University Hospital, Med Campus III, 4020 Linz, Austria;Division of Bioinformatics, Biocenter, Medical University of Innsbruck, 6020 Innsbruck, Austria;Institute of Pathology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria;

关键词: absolute lymphocyte count;    ECOG performance status;    immune-checkpoint inhibitor;    antibiotics;    PD-1/PD-L1;    immune-checkpoint blockade;    RANK;    VEGF;    denosumab;   

DOI  :  10.3390/jcm8071014

来源: DOAJ

【 摘 要 】

Immune-checkpoint blockade in front-line or second-line treatment improves survival in advanced non-small cell lung cancer (aNSCLC) when compared with chemotherapy alone. However, easily applicable predictive parameters are necessary to guide immune-checkpoint inhibition in clinical practice. In this retrospective bi-centric analysis, we investigated the impact of baseline patient and tumor characteristics on clinical outcome in aNSCLC patients treated with programmed cell death protein 1(PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors. Between May 2015 and January 2018, 142 unselected consecutive NSCLC patients received PD-1/PD-L1 inhibitors during the course of disease. In multivariate analysis, we identified the Eastern Cooperative Oncology Group (ECOG) performance status (ECOG > 1 versus ECOG ≤ 1, HR: 3.23, 95%CI: 1.58−6.60, P = 0.001), baseline absolute lymphocyte count (ALC; high: >0.93 × 10⁹/L versus low: ≤ 0.93 × 10⁹/L, HR: 0.38, 95%CI: 0.23−0.62, P < 0.001), prior or concomitant anti-vascular endothelial growth factor (VEGF) targeting therapy (yes versus no, HR: 2.18, 95%CI: 1.15−4.14, P = 0.017) and TNM stage (IV versus III, HR: 4.18, 95%CI: 1.01−17.36, P = 0.049) as the most relevant parameters for survival. Neither antibiotic exposure (antibiotic-positive versus antibiotic-negative, HR: 0.90, 95%CI: 0.56−1.45, P = 0.675), nor PD-L1 expression on tumor cells (≥1% versus <1%, HR: 0.68, 95%CI: 0.41−1.13, P = 0.140) was associated with survival. Baseline ECOG performance status and ALC were associated with survival in aNSCLC patients treated with PD-1/PD-L1 inhibitors and assessment of these parameters could be suitable in clinical practice.

【 授权许可】

Unknown