C-reactive protein and lactate dehydrogenase serum levels potentially predict the response to checkpoint inhibitors in patients with advanced non-small cell lung cancer

Journal of Thoracic Disease

article

Yilun Wei¹  Jinhe Xu²  Xiulian Huang¹  Siting Xie¹  Ping Lin¹  Chenxi Wang¹  Yuxin Guo¹  Shumei Zou²  Zhongquan Zhao²  Wen Wen²  Yingfang Song²  Zhenming Bao²  Lei Zhang²  Wei Liu²  Wencui Kong²  Wenwu Wang³  Baochang He⁴  Shenghang Zhang⁵  Chengzhi Zhou⁶  Ying Chen²  Zongyang Yu² 

[1] Fu Zong Clinical Medicine, Fujian Medical University;Department of Pulmonary and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force;Department of Oncology, the Third Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine;Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University;Institute for Clinical Laboratory Medicine, The 900th Hospital of the Joint Logistic Support Force;Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, First Affiliated Hospital, Guangzhou Medical University

关键词: Non-small cell lung cancer (NSCLC);    checkpoint inhibitors;    C-reactive protein (CRP);    lactic dehydrogenase (LDH);   

DOI  :  10.21037/jtd-23-240

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: Programmed cell death-ligand 1 (PD-L1) expression and other biomarkers are not completely reliable predictors of the response to checkpoint inhibitors in patients with advanced non-small cell lung cancer (NSCLC). We investigated the value of peripheral serological inflammatory indicators and their combination in predicting the prognosis of patients with advanced NSCLC treated with checkpoint inhibitors. Methods: This study retrospectively analyzed 116 NSCLC patients treated with anti-programmed cell death protein 1 (PD-1)/PD-L1 monoclonal antibodies. Clinical data of the patients were collected before treatment. X-tile plots determined the optimal cut-point for C-reactive protein (CRP) and lactate dehydrogenase (LDH). A survival analysis was performed using the Kaplan-Meier method. Multi-factor Cox regression analysis was used to evaluate the statistically significant factors identified in the univariate analysis. Results: The X-tile plots show the cut-points of CRP and LDH were 8 mg/L and 312 U/L, respectively. Univariate analyses showed high baseline serum LDH and low CRP levels were associated with adverse progression-free survival (PFS). Multivariate analyses indicated that CRP (HR, 0.214, 95% CI: 0.053–0.857, P=0.029) could be a predictive indicator for PFS. In addition, we evaluated the combination of CRP and LDH, and univariate analyses showed that patients with high CRP and low LDH exhibited significantly better PFS than those in the other groups. Conclusions: Baseline levels of serum CRP and LDH have the potential to become a convenient clinical tool to predict response to immunotherapy in advanced non-small cell lung cancer.

【 授权许可】

Unknown