Host immune‐inflammatory markers to unravel the heterogeneous outcome and assessment of patients with PD‐L1 ≥50% metastatic non‐small cell lung cancer and poor performance status receiving first‐line immunotherapy

Thoracic Cancer

Francesca Mazzoni¹  Giuseppe L. Banna²  Emilio Bria³  David J. Pinato⁴  Giampiero Porzio⁴  Alex Friedlaender⁵  Maria Vittoria Pensieri⁶  Marcello Tiseo⁷  Alain Gelibter⁸  Rita Chiari⁹  Joachim G. J. V. Aerts^1,10  Erika Rijavec^1,10  Alfredo Addeo^1,11  Alessio Cortellini^1,11  Cinzia Baldessari^1,12  Federico Cappuzzo^1,12  Alessandro De Toma^1,13  Francesco Grossi^1,14  Carlo Genova^1,15  Raffaele Giusti^1,16  Francesca Rastelli^1,17  Luca Cantini^1,18  Fabrizio Citarella^1,19  Stefania Gori^2,20  Corrado Ficorella^2,21  Diego L. Cortinovis^2,22  Federica Bertolini^2,23  Rossana Berardi^2,24  Giulio Metro^2,25  Giovanni Mansueto^2,26  Alessandro Morabito^2,27  Annamaria Catino^2,28  Marianna Macerelli^2,29  Francesco Facchinetti^3,30 

[1] IRCCS Ospedale Policlinico San Martino Genoa Italy;Candiolo Cancer Institute, FPO‐IRCCS Candiolo, Turin Italy;Comprehensive Cancer Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy;Department of Biotechnology and Applied Clinical Sciences University of L'Aquila L'Aquila Italy;Department of Medical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy;Department of Medical Oncology Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia Perugia Italy;Department of Medicine and Surgery University of Parma Parma Italy;Department of Oncology Careggi University Hospital Florence Italy;Department of Oncology University Hospital Santa Maria Della Misericordia Udine Italy;Department of Pulmonary Diseases Erasmus Medical Center Rotterdam the Netherlands;Department of Surgery and Cancer Imperial College London, Hammersmith Hospital London UK;Dipartimento di Oncologia ed Ematologia Azienda Ospedaliero‐Universitaria di Modena Modena Italy;Division of Medical Oncology 2 IRCCS Regina Elena National Cancer Institute Rome Italy;Division of Medical Oncology University of Insubria Varese Italy;Lung Cancer Unit;Medical Oncolgy St. Andrea Hospital Rome Italy;Medical Oncology (B) Policlinico Umberto I, "Sapienza" University of Rome Rome Italy;Medical Oncology Campus Bio‐Medico University Rome Italy;Medical Oncology F. Spaziani Hospital Frosinone Italy;Medical Oncology Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Monselice Italy;Medical Oncology St. Salvatore Hospital L'Aquila Italy;Medical Oncology Unit ASST San Gerardo Hospital Monza Monza Italy;Medical Oncology Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy;Oncology Clinic Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona Ancona Italy;Oncology Department University Hospital of Geneva Geneva Switzerland;Oncology Unit IRCCS Ospedale Sacro Cuore Don Calabria Negrar Italy;Thoracic Medical Oncology Istituto Nazionale Tumori ‘Fondazione G Pascale’, IRCCS Naples Italy;Thoracic Oncology Unit Clinical Cancer Center IRCCS Istituto Tumori "Giovanni Paolo II" Bari Italy;UOC Oncologia Ascoli Piceno – San Benedetto del Tronto Ancona Italy;Université Paris‐Saclay, Institut Gustave Roussy, Inserm, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie Villejuif France;

关键词: immunotherapy;    inflammation;    neutrophil‐to‐lymphocyte ratio (NLR);    non‐small cell lung cancer;    performance status;   

DOI  :  10.1111/1759-7714.14256

来源: DOAJ

【 摘 要 】

Abstract Background Patients with programmed cell death‐ligand 1 (PD‐L1) ≥50% metastatic non‐small cell lung cancer (mNSCLC) and ECOG performance status (PS) of 2 treated with first‐line immunotherapy have heterogeneous clinical assessment and outcomes. Methods To explore the role of immune‐inflammatory surrogates by the validated lung immuno‐oncology prognostic score (LIPS) score, including the neutrophil‐to‐lymphocyte ratio (NLR) and the pretreatment use of steroids, alongside other prognostic variables. A retrospective analysis of 128 patients with PS2 and PD‐L1 ≥50% mNSCLC treated between April 2018 and September 2019 with first‐line pembrolizumab in a real‐world setting was performed. Results With a median follow‐up of 15.3 months, the 1‐year overall survival (OS) and median progression‐free survival (PFS) were 32.3% (95% CI: 30.9–33.9) and 3.3 months (95% CI: 1.8–4.7), respectively. The NLR, lactate dehydrogenase (LDH) and pretreatment steroids results were the only significant prognostic factors on the univariate analysis and independent prognostic factors by the multivariate analysis on both OS and PFS. The LIPS score, including the NLR and pretreatment steroids, identified 29 (23%) favourable‐risk patients, with 0 factors, 1‐year OS of 67.6% and median PFS of 8.2 months; 57 (45%) intermediate‐risk patients, with 1 factor, 1‐year OS 32.1% and median PFS 2.7 months; 42 (33%) poor‐risk patients, with both factors, 1‐year OS of 10.7% and median PFS of 1.2 months. Conclusions The assessment of pre‐existing imbalance of the host immune response by combined blood and clinical immune‐inflammatory markers may represent a way to unravel the heterogeneous outcome and assessment of patients with mNSCLC and poor PS in the immune‐oncology setting.

【 授权许可】

Unknown