Baseline and early changes in circulating Serum Amyloid A (SAA) predict survival outcomes in advanced non-small cell lung cancer patients treated with Anti-PD-1/PD-L1 monotherapy

He, Lina; Fu, Sha; Zhang, Xuanye; Hu, Qiaozhen; Du, Wei; Li, Haifeng; Chen, Tao; Chen, Chen; Jiang, Yongluo; Zhou, Yixin; Lin, Zuan; Yang, Yunpeng; Huang, Yan; Zhao, Hongyun; Fang, Wenfeng; Zhang, Li; Hong, Shaodong

doi:10.1016/j.lungcan.2021.05.030

Cited by 11 publications

(4 citation statements)

References 37 publications

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“…It can also serve as an evaluation indicator for the diagnosis, prognosis, and posttreatment follow-up of multiple diseases. SAA level increases notably with the progression of cancer (10)(11)(12)(13)(14)(15), as well as in patients with rheumatoid arthritis or osteoarthritis (16)(17)(18). SAA also changes markedly and shows a rapid response in cardiovascular diseases, reflecting the disease activity well (19).…”

Section: Discussionmentioning

confidence: 99%

Clinical performance evaluation of serum amyloid A module of Mindray BC-7500CS automated hematology analyzer

Dai¹,

Zhang²,

Zhou³

et al. 2023

Transl Pediatr

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Background Laboratory detection of high values of serum amyloid A (SAA) is impaired by the hook effect. In response to this problem, Mindray has launched the new generation BC-7500CS automated hematology analyzer with an SAA autodilution (SAA-D) function. The present study aimed to verify the performance of the SAA module. Methods Venous whole-blood specimens anticoagulated with EDTA-K2 were randomly collected from outpatients and inpatient of the Children’s Hospital of Nanjing Medical University (CH). Background, repeatability, precision, linear range, intermode comparison, and interference of the SAA module of the Mindray BC-7500CS were evaluated, and the performance of the SAA-D function was verified. Results The Mindray BC-7500CS showed an SAA background of 0.14 mg/L, well below that claimed by the manufacturer. Repeatability of SAA with standard deviation (SD) <0.6 mg/L and coefficient of variation (CV) <6%, the quality control (QC) precision was less than 8%. The measured value of the linear range was essentially consistent with the theoretical value, and the maximum measured values could reach 1932.38 mg/L. The deviation between whole-blood mode and micro-whole-blood mode was small (r=0.999), and the SAA module displayed high anti-interference ability. In addition, the measured results of specimens with high SAA concentration diluted by SAA-D were close to those after manual dilution (r=0.993). Conclusions The SAA module of the Mindray BC-7500CS had excellent performance, and the SAA-D function was highly accurate at measuring specimens with high SAA concentration, enabling reliable SAA detection in the laboratory and clinical practice.

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Section: Discussionmentioning

confidence: 99%

Clinical performance evaluation of serum amyloid A module of Mindray BC-7500CS automated hematology analyzer

Dai¹,

Zhang²,

Zhou³

et al. 2023

Transl Pediatr

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“…In this study, we showed that the baseline SAA levels with cut-off value of 8.2 mg/L was an independent prognostic factor for OS and PFS in patients with APC received chemotherapy. Therefore, baselines SAA can not only be used as an important biomarker to predict the prognosis of patients with gastric cancer, 26 lung cancer, 27 and kidney cancer 28 but also has a good prognostic value in patients with APC received chemotherapy. In addition, further analysis of our study showed that baselines SAA could well predict OS and PFS regardless of chemotherapy regimens, which has shown promise for a wide range of applications in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Serum Amyloid a Predicts Prognosis and Chemotherapy Efficacy in Patients with Advanced Pancreatic Cancer

Ding¹,

Yang²,

Mao³

et al. 2023

JIR

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Purpose There is an urgent need to discover a predictive biomarker to help patients with advanced pancreatic cancer (APC) choose appropriate chemotherapy regimens. This study aimed to determine whether baseline serum amyloid A (SAA) levels were associated with overall survival (OS), progression-free survival (PFS), and treatment response in patients with APC received chemotherapy. Patients and Methods This retrospective study included 268 patients with APC who received first-line chemotherapy at the Sun Yat-Sen University Cancer Center between January 2017 and December 2021. We examined the effect of baseline SAA on OS, PFS and chemotherapy response. The X-Tile program was used to determine the critical value for optimizing the significance of segmentation between Kaplan-Meier survival curves. The Kaplan-Meier curves and Cox regression analyses were used to analyze OS and PFS. Results The best cut-off value of baseline SAA levels for OS stratification was 8.2 mg/L. Multivariate analyses showed that SAA was an independent predictor of OS (Hazard Ratio (HR) = 1.694, 95% Confidence Interval (CI) = 1.247–2.301, p = 0.001) and PFS (HR = 1.555, 95% CI = 1.152–2.098, p = 0.004). Low SAA was associated with longer OS (median, 15.7 months vs 10.0 months, p < 0.001) and PFS (median, 7.6 months vs 4.8 months, p < 0.001). The patients with a low SAA who received mFOLFIRINOX had longer OS (median, 28.5 months vs 15.1 months, p = 0.019) and PFS (median, 12.0 months vs 7.4 months, p = 0.035) than those who received nab-paclitaxel plus gemcitabine (AG) or SOXIRI, whereas there was no significant difference among the three chemotherapy regimens in patients with a high SAA. Conclusion Owing to the rapid and simple analysis of peripheral blood, baseline SAA might be a useful clinical biomarker, not only as a prognostic biomarker for patients with APC, but also as a guide for the selection of chemotherapy regimens.

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“…SAA is involved in various immunological activities, including effects on cytokine synthesis and neutrophil chemotaxis to mediate immune escape 16 . Furthermore, SAA can act as a biomarker for the resistance of PD-1 antibodies in advanced non-small cell lung cancer 17 . However, the potential mechanisms underlying the participatory or regulatory role of SAA in the immune regulation of the TME remains unexplored.…”

Section: Introductionmentioning

confidence: 99%

Serum amyloid A promotes glycolysis of neutrophils during PD-1 blockade resistance in hepatocellular carcinoma

He,

Liu,

Chen

et al. 2024

Nat Commun

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The response to programmed death-1 (PD-1) blockade varies in hepatocellular carcinoma (HCC). We utilize a panel of 16 serum factors to show that a circulating level of serum amyloid A (SAA) > 20.0 mg/L has the highest accuracy in predicting anti-PD-1 resistance in HCC. Further experiments show a correlation between peritumoral SAA expression and circulating SAA levels in patients with progressive disease after PD-1 inhibition. In vitro experiments demonstrate that SAA induces neutrophils to express PD-L1 through glycolytic activation via an LDHA/STAT3 pathway and to release oncostatin M, thereby attenuating cytotoxic T cell function. In vivo, genetic or pharmacological inhibition of STAT3 or SAA eliminates neutrophil-mediated immunosuppression and enhances antitumor efficacy of anti-PD-1 treatment. This study indicates that SAA may be a critical inflammatory cytokine implicated in anti-PD-1 resistance in HCC. Targeting SAA-induced PD-L1+ neutrophils through STAT3 or SAA inhibition may present a potential approach for overcoming anti-PD1 resistance.

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Baseline and early changes in circulating Serum Amyloid A (SAA) predict survival outcomes in advanced non-small cell lung cancer patients treated with Anti-PD-1/PD-L1 monotherapy

Cited by 11 publications

References 37 publications

Clinical performance evaluation of serum amyloid A module of Mindray BC-7500CS automated hematology analyzer

Clinical performance evaluation of serum amyloid A module of Mindray BC-7500CS automated hematology analyzer

Serum Amyloid a Predicts Prognosis and Chemotherapy Efficacy in Patients with Advanced Pancreatic Cancer

Serum amyloid A promotes glycolysis of neutrophils during PD-1 blockade resistance in hepatocellular carcinoma

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