Non-invasive early prediction of immune checkpoint inhibitor efficacy in non-small-cell lung cancer patients using on-treatment serum CRP and NLR
Non-invasive early prediction of immune checkpoint inhibitor efficacy in non-small-cell lung cancer patients using on-treatment serum CRP and NLR
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DOI：
10.1007/s00432-022-04300-x
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发表时间：
2022-08-25
影响因子：
3.6
通讯作者：
Hashimoto, Naozumi
中科院分区：
文献类型：
--
作者：
Matsuzawa, Reiko;Morise, Masahiro;Hashimoto, Naozumi
目的：研究血液中早期c反应蛋白（CRP）和中性粒细胞-淋巴细胞比值（NLR）变化作为促肿瘤炎症（PTI）的替代标志物，在预测非小细胞肺癌（NSCLC）患者程序性细胞死亡(PD)-1/程序性细胞死亡配体（PD- l） 1抑制剂治疗的临床结果中的临床意义。方法回顾性分析使用抗pd -1或PD-L1抑制剂治疗的非小细胞肺癌患者。早期CRP变化定义为6周CRP与基线CRP的比值，早期NLR变化定义为6周NLR与基线NLR的比值。通过联合评价早期CRP变化和早期NLR变化确定PTI指数，PTI指数低：两者均低，中：两者均低，高；这两个都很高。结果纳入217例患者。早期CRP变化和早期NLR变化均与PFS和OS相关。使用这两种标记物进行组合评价，可以明确PFS和OS的分层。PTI指数低组的中位PFS为13.9个月，PTI指数高组的中位PFS为2.5个月（p < 0.01， log-rank检验）。PTI指数低的患者中位总生存期未达到；PTI指数高的患者中位生存期仅为15.4个月（p < 0.01， log-rank检验）。结论联合早期CRP变化和早期NLR变化作为PTI生物标志物在鉴别使用PD-1/PD-L1抑制剂能够获得持久缓解和长期生存的非小细胞肺癌患者方面具有临床潜力。
Purpose We determined the clinical relevance of early C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) change in blood as surrogate markers of pro-tumor inflammation (PTI) for predicting clinical outcome of programmed cell death (PD)-1/programmed cell death ligand (PD-L) 1 inhibitor treatment in non-small-cell lung carcinoma (NSCLC). Methods We retrospectively reviewed NSCLC patients treated with anti-PD-1 or PD-L1 inhibitors. Early CRP change was defined as the ratio of 6 weeks CRP to baseline CRP, and early NLR change was defined as that of the 6 weeks NLR to baseline NLR. PTI index was determined by combinatorial evaluation of early CRP change and early NLR change, PTI index low: both of these were low, intermediate: either of these was low, high; both of these were high. Results The study included 217 patients. Early CRP change and early NLR change were both associated with PFS and OS. The combinatorial evaluation using these two markers enabled the clear stratification of PFS and OS. The median PFS in patient with PTI index low was 13.9 months, while the median PFS in those with PTI index high was 2.5 months (p < 0.01, log-rank test). The median OS in patients with PTI index low was not reached; the median OS in those with PTI index high was only 15.4 months (p < 0.01, log-rank test). Conclusions The combinatorial early CRP change and early NLR change as PTI biomarkers have clinical potential in identifying NSCLC patients who can achieve a durable response and long-term survival using PD-1/PD-L1 inhibitors.