A nomogram to predict survival in non-small cell lung cancer patients treated with nivolumab

Journal of Translational Medicine

Marco Mazzotta¹  Francesca Romana Di Pietro¹  Michela Roberto¹  Federica Mazzuca¹  Andrea Botticelli¹  Raffaele Giusti¹  Paolo Marchetti¹  Ilaria Grazia Zizzari²  Marianna Nuti²  Massimiliano Salati³  Bruna Cerbelli⁴  Laura Pizzuti⁵  Patrizia Vici⁵  Lidia Strigari⁶ 

[1] Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University of Rome;Department of Experimental Medicine, Sapienza University of Rome;Department of Oncology, University Hospital of Modena and Reggio Emilia;Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome;Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute;Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute;

关键词: Immunotherapy;    Lung cancer;    Prognostic factors;    Nivolumab;    Nomogram;   

DOI  :  10.1186/s12967-019-1847-x

来源: DOAJ

【 摘 要 】

Abstract Background The advent of immune checkpoint inhibitors (ICIs) has considerably expanded the armamentarium against non-small cell lung cancer (NSCLC) contributing to reshaping treatment paradigms in the advanced disease setting. While promising tissue- and plasma-based biomarkers are under investigation, no reliable predictive factor is currently available to aid in treatment selection. Methods Patients with stage IIIB–IV NSCLC receiving nivolumab at Sant’Andrea Hospital and Regina Elena National Cancer Institute from June 2016 to July 2017 were enrolled onto this study. Major clinicopathological parameters were retrieved and correlated with patients’ survival outcomes in order to assess their prognostic value and build a useful tool to assist in the decision making process. Results A total of 102 patients were included in this study. The median age was 69 years (range 44–85 years), 69 (68%) were male and 52% had ECOG PS 0. Loco-regional/distant lymph nodes were the most commonly involved site of metastasis (71%), followed by lung parenchyma (67%) and bone (26%). Overall survival (OS) in the whole patients’ population was 83.6%, 63.2% and 46.9% at 3, 6 and 12 months, respectively; while progression-free survival (PFS) was 66.5%, 44.4% and 26.4% at 3, 6 and 12 months, respectively. At univariate analysis, age ≥ 69 years (P = 0.057), ECOG PS (P < 0.001), the presence of liver (P < 0.001), lung (P = 0.017) metastases, lymph nodes only involvement (P = 0.0145) were significantly associated with OS and ECOG PS (P < 0.001) and liver metastases (P < 0.001), retained statistical significance at multivariate analysis. A prognostic nomogram based on three variables (liver and lung metastases and ECOG PS) was built to assign survival probability at 3, 6, and 12 months after nivolumab treatment commencement. Conclusion We developed a nomogram based on easily available and inexpensive clinical factors showing a good performance in predicting individual OS probability among NSCLC patients treated with nivolumab. This prognostic device could be valuable to clinicians in more accurately driving treatment decision in daily practice as well as enrollment onto clinical trials.

【 授权许可】

Unknown