dNLR-Based Score Predicting Overall Survival Benefit for The Addition of Platinum-Based Chemotherapy to Pembrolizumab in Advanced NSCLC With PD-L1 Tumor Proportion Score ≥50

Copyright © 2021 Elsevier Inc. All rights reserved..

INTRODUCTION: Both pembrolizumab (P) as a monotherapy or in combination with platinum-based chemotherapy (PCT) represent standard first-line treatment options for advanced non-small cell lung cancer (aNSCLC) with PD-L1 tumor proportion score (TPS)≥50%. No predictive biomarkers exist to guide treatment decisions.

METHODS: 423 consecutive patients with EGFR/ALK/ROS1-wild-type PD-L1 TPS≥50% aNSCLC receiving P (n = 302) or PCT (n = 121) as a first-line treatment were identified in the electronic databases of 5 Israeli cancer centers. Overall survival (OS, months [mo]) was assessed in correlation with blood biomarkers (BB: NLR, dNLR, PLR, SII, LIPI, ALI); a predictive score was developed.

RESULTS: In the propensity score matching analysis (n = 236; 118 patients in each group matched for age, sex and ECOG PS), mOS was 17.2mo (95% CI, 13.2-36.5) and 21.3mo (95% CI, 14.8-NR) in groups P and PCT, respectively (P = .44). In group P, NLR, dNLR, PLR, LIPI, and ALI significantly correlated with OS in uni- and multivariate COX regression analyses (P < .05), whereas in group PCT, none of the BB demonstrated a significant correlation. A predictive score was developed (each parameter receiving one point): age≥65, female sex, never-smoking status, adenocarcinoma histology, dNLR≥3. In patients with predictive score 3-5, OS was significantly longer with PCT as compared to P: mOS NR (95% CI, 15.3-NR) and 8.7mo (95% CI, 5.8-13.7) (P = .0005), while OS didn't differ significantly in patients with predictive score 0-2 (P = .61).

CONCLUSION: With the limitations of the retrospective analysis, the proposed dNLR-based score appears to predict OS with P and PCT.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:23

Enthalten in:

Clinical lung cancer - 23(2022), 2 vom: 07. März, Seite 122-134

Sprache:

Englisch

Beteiligte Personen:

Holtzman, Liran [VerfasserIn]
Moskovitz, Mor [VerfasserIn]
Urban, Damien [VerfasserIn]
Nechushtan, Hovav [VerfasserIn]
Keren, Shoshana [VerfasserIn]
Reinhorn, Daniel [VerfasserIn]
Wollner, Mira [VerfasserIn]
Daher, Sameh [VerfasserIn]
Rottenberg, Yakir [VerfasserIn]
Rovitzky, Yulia [VerfasserIn]
Shochat, Tzippy [VerfasserIn]
Bar, Jair [VerfasserIn]
Dudnik, Elizabeth [VerfasserIn]

Links:

Volltext

Themen:

49DFR088MY
Antibodies, Monoclonal, Humanized
B7-H1 Antigen
Biomarkers
CD274 protein, human
DNLR
DPT0O3T46P
Dnlr
Immune check-point inhibitors
Journal Article
NSCLC
PD-L1 high
Pembrolizumab
Platinum

Anmerkungen:

Date Completed 17.03.2022

Date Revised 17.03.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.cllc.2021.12.006

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM335696597