Baseline tumour size is an independent prognostic factor for overall survival in PD-L1 ≥ 50% non-small cell lung cancer patients treated with first-line pembrolizumab

Bureau, Mathilde; Chatellier, Thierry; Perennec, Tanguy; Goronflot, Thomas; Greilsamer, Charlotte; Chêne, Anne-Claire; Affi, Raafet; Frampas, É.; Bennouna, Jaafar; Pons‐Tostivint, Elvire

doi:10.1007/s00262-021-03108-x

Cited by 10 publications

(10 citation statements)

References 27 publications

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Section: Discussionmentioning

confidence: 99%

“…Accordingly, most biomarkers or risk model recommendations were extrapolated from subgroup analysis of clinical trials or some institutions' experiences with solid tumors, including NSCLC [ 14 – 17 , 21 , 24 – 36 ]. ECOG ≦ 2 [ 21 , 33 ], men (single-agent ICI) [ 29 , 30 ], women (combination of ICI and chemotherapy) [ 31 ], BTS [ 24 ], smoking status [ 25 ] and BMI ≧ 25 [ 32 ] suggest a longer prognosis. Malignant pleural effusion [ 27 , 33 ], brain and liver metastases [ 27 , 28 ], NLR [ 34 , 35 ], high levels of LDH [ 36 ], c-reactive protein (CRP) [ 33 ], and fibrinogen–albumin ratio index (FARI) [ 26 ] were independent poor prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

“…Apart from the above, the data in these studies [ 14 – 17 , 21 , 24 – 36 ] have only highlighted the value of tumor or non-tumor-related biomarkers or models as single or independent factors for OS, PFS, therapeutic approaches and clinical responses in NSCLC patients, but have ignored the improvement in prognosis and prediction when combined with PD-L1 expression. Our study suggested that the risk score could more accurately predict PFS and OS in combination with PD-L1 expression in both the training and validation cohorts.…”

Section: Discussionmentioning

confidence: 99%

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Non-tumor-related prognostic factors for immunotherapy–chemotherapy or immunotherapy alone as first-line in advanced non-small cell lung cancer (NSCLC)

Guo,

Wei,

Tang

et al. 2024

Clin Exp Med

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Besides programmed death ligand 1 (PD-L1) expression, rapid, cost-effective and validated scores or models are critical for the prognosis and prediction of patients received immune checkpoint inhibitors (ICIs). In this retrospective study, 182 patients with NSCLC receiving ICIs from 2015 to 2022 were divided 1:1 into a training cohort and a validation cohort. We identified a score established by three factors and analyzed the prognostic implications by Kaplan–Meier approach (Log rank test) and time-dependent receiver operating characteristic (ROC) analyses. A non-tumor-related score (NTRS) was established that could be used as a prognostic factor (HR 2.260, 95% CI 1.559–3.276, P < 0.001 in training cohort; HR 2.114, 95% CI 1.493–2.994, P < 0.001 in validation cohort) and had a high time-dependent ROC for overall survival (OS) (AUC 0.670–0.782 in training cohort; AUC 0.682–0.841 in validation cohort). PD-L1 (1–49%) and NTRS (score = 0, 1, 2, 3) combination significantly improved the assessment of patients’ OS and progress-free survival (PFS), which was statistically different in training cohorts (P < 0.001 for OS, 0.012 for PFS) and validation cohorts (P = 0.01 for OS, < 0.001 for PFS). The NTRS provided a better assessment of durable clinical benefit (DCB) compared to PD-L1 expression (P = 0.009 vs. 0.232 in training cohort; P = 0.004 vs. 0.434 in validation cohort). NTRS may help improve prognosis stratification of patients receiving ICIs in first-line NSCLC and may be combined with tumor-related parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Non-tumor-related prognostic factors for immunotherapy–chemotherapy or immunotherapy alone as first-line in advanced non-small cell lung cancer (NSCLC)

Guo,

Wei,

Tang

et al. 2024

Clin Exp Med

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“…Furthermore, in advanced NSCLC, anti‐PD‐1 therapy showed a greater effect when it was used in a first‐line setting in comparison to a second‐line or later settings 24 . It has been explained that the therapeutic effects from immune checkpoint inhibitors are stronger in cases with a lower tumor burden and earlier disease stage, supporting the immunological importance of regional LNs in anti‐PD‐1 therapy, not of circulating immune cells to target metastasized tumors or the exhausted tumor microenvironment after cytotoxic therapy 14,25 . Several ongoing studies are testing anti‐PD‐1 antibody therapy in an adjuvant setting with promising results 26–29 .…”

Section: Discussionmentioning

confidence: 99%

Significance of programmed death‐ligand 1 expression in resected lung cancer and its relationship with EGFR mutation

et al. 2023

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BackgroundSeveral studies have reported that the high expression of programmed death‐ligand 1 (PD‐L1) within tumor cells predicts a poor prognosis. However, the relationship between the PD‐L1 expression and lymph node metastasis or driver mutations in lung cancer remains poorly understood.MethodsA total of 356 consecutive patients who underwent surgical resection for primary lung cancer were included in the study. There were 268 adenocarcinomas including 100 EGFR mutations, 67 squamous cell carcinomas (Sq), and 21 other histologies. The high expression of PD‐L1 was defined as a tumor proportion score (TPS) of ≥50. The relationship between the PD‐L1 expression and clinicopathological factors and recurrence‐free survival (RFS) was analyzed.ResultsThe PD‐L1 expression was high in 75 patients. It was significantly related to smoking history, Sq histology, driver mutation negative, elevated serum carcinoembryonic antigen levels, and lymph node metastasis. Among patients with driver mutations, a high PD‐L1 TPS was found in patients with EGFR G719X mutation. A significant difference in RFS was observed in adenocarcinoma patients. A multivariate analysis of adenocarcinoma cases revealed that tumor size and lymph node metastasis were independent prognostic factors for poor RFS, while the PD‐L1 expression was not. A logistic regression analysis revealed that the absence of driver mutations, lymph node metastasis, and a history of smoking were significantly associated with the high expression of PD‐L1.ConclusionLymph node metastasis was positively related with the high expression of PD‐L1, resulting in poor RFS. A high PD‐L1 TPS was observed in patients with the EGFR G719X mutation.

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“…Adjuvant chemotherapy produces a substantial positive survival rate for resectable NSCLC patients (3); however, there are considerable differences in the survival rates of NSCLC patients who undergo adjuvant chemotherapy at the same stage. Although numerous clinicopathological parameters, such as tumor size (4), lymph node metastasis (LNMets) (5), margin status (6), and tumor node metastasis (TNM) system (7), can generally predict prognosis, simpler, more reliable, and lower-cost biomarkers are essential to forecast the prognosis of NSCLC patients receiving adjuvant chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

The preoperative hemoglobin, albumin, lymphocyte, and platelet score is a prognostic factor for non-small cell lung cancer patients undergoing adjuvant chemotherapy: a retrospective study

et al. 2022

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Background: Developing a simple, reliable and low-cost biomarkers is crucial to predict the prognosis of non-small cell lung cancer (NSCLC) patients receiving adjuvant chemotherapy. The score combining hemoglobin and albumin levels and lymphocyte and platelet counts (HALP score) is reportedly related to the prognosis of multiple types of tumors. However, few studies have focused on its prognostic value in patients with NSCLC. Our study aimed to investigate the prognostic role of the HALP score and develop a valuable prognostic model for patients with NSCLC undergoing adjuvant chemotherapy.Methods: A total of 362 individuals with NSCLC undergoing adjuvant chemotherapy between 2013 and 2015 were included. The HALP score was computed according to the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocytes (g/L)/platelets (g/L). Furthermore, demographic characteristic, including age, sex, smoking status, and drinking history, were collected from case report forms at admission. The main outcomes were overall survival (OS) and disease-free survival (DFS), which were assessed using Kaplan-Meier analysis with log-rank test. Furthermore, Cox regression analysis was employed to assess the prognostic role of HALP in NSCLC.Results: We found the significant associations of clinicopathological features, including sex, pathological stage, tumor size, and lymph node metastasis (LNMets) in univariate Cox regression analysis. In multivariate analysis, NSCLC patients with a high HALP score were significantly associated with lower OS [hazard ratio (HR): 0.707; 95% confidence interval (CI): 0.503-0.995] and DFS (HR: 0.671; 95% CI: 0.491-0.916). The Kaplan-Meier analysis showed that a low HALP score predicted poorer OS (P=0.02) and DFS (P<0.01) outcomes. Furthermore, we performed stratification analysis by tumor node metastasis (TNM) stage, and the result indicated a low HALP score predicted poor OS (P=0.01) and DFS (P=0.04) outcomes in stage III-IV NSCLC patients. Conclusions: Our study demonstrated that the HALP score might be a suitable prognostic index for NSCLC patients undergoing adjuvant chemotherapy. Combining demographic and clinicopathological features with the HALP score may help clinicians predict survival and treatment outcomes. Keywords: Non-small cell lung cancer (NSCLC); score combining hemoglobin and albumin levels and lymphocyte and platelet counts (HALP score); overall survival (OS); disease-free survival (DFS)

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Baseline tumour size is an independent prognostic factor for overall survival in PD-L1 ≥ 50% non-small cell lung cancer patients treated with first-line pembrolizumab

Cited by 10 publications

References 27 publications

Non-tumor-related prognostic factors for immunotherapy–chemotherapy or immunotherapy alone as first-line in advanced non-small cell lung cancer (NSCLC)

Non-tumor-related prognostic factors for immunotherapy–chemotherapy or immunotherapy alone as first-line in advanced non-small cell lung cancer (NSCLC)

Significance of programmed death‐ligand 1 expression in resected lung cancer and its relationship with EGFR mutation

The preoperative hemoglobin, albumin, lymphocyte, and platelet score is a prognostic factor for non-small cell lung cancer patients undergoing adjuvant chemotherapy: a retrospective study

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