A composite biomarker of neutrophil-lymphocyte ratio and hemoglobin level correlates with clinical response to PD-1 and PD-L1 inhibitors in advanced non-small cell lung cancers
| العنوان: | A composite biomarker of neutrophil-lymphocyte ratio and hemoglobin level correlates with clinical response to PD-1 and PD-L1 inhibitors in advanced non-small cell lung cancers |
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| المؤلفون: | Jonathan McCafferty, Shuyu D. Li, Scott Newman, Kyeryoung Lee, Fred R. Hirsch, Meng Ma, Jane J. Liu, Xiang Zhou, Eric E. Schadt, Philip C. Mack, Kristin L. Ayers, David Corrigan, Gaspard Debussche, Rong Chen |
| المصدر: | BMC Cancer BMC Cancer, Vol 21, Iss 1, Pp 1-11 (2021) |
| بيانات النشر: | BioMed Central, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | 0301 basic medicine, Oncology, Erythrocyte Indices, Male, Cancer Research, Lung Neoplasms, Neutrophils, Lymphocyte, Programmed Cell Death 1 Receptor, Immune checkpoint inhibitor, Kaplan-Meier Estimate, B7-H1 Antigen, Leukocyte Count, 0302 clinical medicine, Antineoplastic Agents, Immunological, Non-small cell lung cancer, Surgical oncology, Carcinoma, Non-Small-Cell Lung, Odds Ratio, Lymphocytes, Neoplasm Metastasis, RC254-282, Hazard ratio, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Anemia, Prognosis, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Biomarker (medicine), Female, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, Genetics, medicine, Biomarkers, Tumor, Humans, Neutrophil-lymphocyte ratio, Neoplasm Staging, business.industry, Research, Comprehensive metabolic panel, Retrospective cohort study, Biomarker, medicine.disease, 030104 developmental biology, business |
| الوصف: | Background Immune checkpoint inhibitors (ICIs) have been incorporated into various clinical oncology guidelines for systemic treatment of advanced non-small cell lung cancers (aNSCLC). However, less than 50% (and 20%) of the patients responded to the therapy as a first (or second) line of therapy. PD-L1 immunohistochemistry (IHC) is an extensively studied biomarker of response to ICI, but results from this test have equivocal predictive power. In order to identify other biomarkers that support clinical decision-making around whether to treat with ICIs or not, we performed a retrospective study of patients with aNSCLC who underwent ICI-based therapy in the Mount Sinai Health System between 2014 and 2019. Methods We analyzed data from standard laboratory tests performed in patients as a part of the routine clinical workup during treatment, including complete blood counts (CBC) and a comprehensive metabolic panel (CMP), to correlate test results with clinical response and survival. Results Of 11,138 NSCLC patients identified, 249 had been treated with ICIs. We found associations between high neutrophil-to-lymphocyte ratio (NLR ≥ 5) and poor survival in ICI-treated NSCLC. We further observed that sustained high NLR after initiation of treatment had a more profound impact on survival than baseline NLR, regardless of PD-L1 status. Hazard ratios when comparing patients with NLR ≥ 5 vs. NLR p = 0.02), 3.4 (p = 4.2 × 10− 8), and 3.9 (p = 1.4 × 10− 6) at baseline, 2–8 weeks, and 8–14 weeks after treatment start, respectively. Mild anemia, defined as hemoglobin (HGB) less than 12 g/dL was correlated with survival independently of NLR. Finally, we developed a composite NLR and HGB biomarker. Patients with pretreatment NLR ≥ 5 and HGB p = 1.8 × 10− 5), and a hazard ratio of 2.6 (95% CI 1.7–4.1, p = 3.5 × 10− 5). Conclusions We developed a novel composite biomarker for ICI-based therapy in NSCLC based on routine CBC tests, which may provide meaningful clinical utility to guide treatment decision. The results suggest that treatment of anemia to elevate HGB before initiation of ICI therapy may improve patient outcomes or the use of alternative non-chemotherapy containing regimens. |
| اللغة: | English |
| تدمد: | 1471-2407 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3e2aaff6f7d6e7d53c45299310f7efa4 http://europepmc.org/articles/PMC8059160 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....3e2aaff6f7d6e7d53c45299310f7efa4 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14712407 |
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