Effect of C‐reactive protein/albumin ratio on prognosis in advanced non–small‐cell lung cancer

Ni, Xuefeng; Wu, Jun; Ji, Mei; Shao, Yingjie; Xu, Bin; Jiang, Jingting; Wu, Changping

doi:10.1111/ajco.13055

Cited by 61 publications

(34 citation statements)

References 33 publications

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“…On these bases, we believe that the study of both inflammatory and infection markers in mNSCLC patients addressed to receive immune-checkpoint blocking mAbs could have a key role in understanding their effective interference in CTL activation and consequently on the outcome of these patients. At the present, the majority of the studies in the literature rely on the prognostic role of unspecific inflammatory markers such as white cell counts, NLR, CRP, ESR, LDH or more sophisticated techniques including tumor immune-profiling or microbiology studies (14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Markers and Procalcitonin Predict the Outcome of Metastatic Non-Small-Cell-Lung-Cancer Patients Receiving PD-1/PD-L1 Immune-Checkpoint Blockade

Nardone¹,

Giannicola

Bianco

et al. 2021

Front. Oncol.

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Peripheral-immune-checkpoint blockade (P-ICB) with mAbs to PD-1 (nivolumab and pembrolizumab) or PD-L1 (atezolizumab, durvalumab, avelumab) alone or combination with chemotherapy represents a novel active treatment for mNSCLC patients. However, this therapy can be associated to immune-related adverse events (irAEs) and high cost. Therefore, finding reliable biomarkers of response and irAEs is strongly encouraged to accurately select patients who may potentially benefit from the immuno-oncological treatment. This is a retrospective multi-institutional analysis performed on ninety-five mNSCLC patients who received real-world salvage therapy with nivolumab or atezolizumab between December 2015 and April 2020. The outcome of these patients in term of PFS and OS was evaluated in comparison with different serum levels of C-reactive protein (CRP), Erythrocyte Sedimention Rate (ESR) and Procalcitonin (PCT) by performing Kaplan–Meier and Log-rank test and multivariate analysis. We found that high baseline levels of CRP, ESR, and PCT were strongly predictive of poor outcome (P <0.05) with the worse prognosis detected in those patients with a baseline levels of both ESR and PCT over the pre-established cut off (median OS recorded in patients with no marker over the cut off vs. those with just one marker over the cut off vs. those with both markers over the cut off: 40 ± 59 vs. 15.5 ± 5.5 vs. 5.5 ± 1.6 months, respectively; P <0.0001). Our results suggest the predictive value of systemic inflammation and suggest a potential role of PCT in predicting a poor outcome in mNSCLC receiving PD-1/PD-L1 blocking mAbs. This finding also suggests a potential role of subclinical bacterial infections in defining the response to PD-1/PD-L1 blocking mAbs that deserves further and more specific investigations.

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Section: Introductionmentioning

confidence: 99%

Inflammatory Markers and Procalcitonin Predict the Outcome of Metastatic Non-Small-Cell-Lung-Cancer Patients Receiving PD-1/PD-L1 Immune-Checkpoint Blockade

Nardone¹,

Giannicola

Bianco

et al. 2021

Front. Oncol.

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“…Perhaps in non-small cell lung cancer, it is preferable to use a system of two or more determinants to create a prognostic tool for clinicians, as with the use of albumin and beta2-microglobulin in multiple myeloma in the International Prognostic Score (ISS). Similar to previous studies 29,37,45 , it was a retrospective, single-institution study with relatively few patients. In order to make up for the de ciencies and improve the research design, the predictive value of CRP kinetics and initial apoA-I would be veri ed in multicenter prospective studies, with more patients and longer follow-up time.…”

Section: Discussionmentioning

confidence: 74%

Prognostic Values of Combined Detection of Serum of CRP Kinetics and Initial apoA-I in Advanced NSCLC

Cheng

Zhang

Ling

et al. 2021

Preprint

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Purpose : This study was to evaluate the value of C-reactive protein (CRP) kinetics and initial apolipoproteinA1 (apoA-I) level as prognostic parameters in advanced non-small Cell Lung Cancer (NSCLC). Methods: Within a retrospective single-center study, serum CRP and apoA-I level were measured at baseline and at the start of each platinum-based chemotherapy cycle for 125 NSCLC patients. Survival analysis, calculated by the Kaplan–Meier method and log-rank test, was used to assess the prognostic significance of Serum CRP and apoA-I level and both levels. The non-parametric Spearman rank correlation coefficient (rs) was used to measure the correlation between apoA-I and CRP. Results: Lung cancer-specific survival were significantly different across three CRP kinetics groups (P<0.001), such significant differences were also seen between different apoA-I groups. In multivariate analysis, both CRP kinetics and apoA-I were independent significant factors for overall survival. Patients in non-normalized CRP group with lower apoA-I had a poor prognosis. Spearman’s rank correlation analysis revealed that the apoA-I level presented a negative correlation with the CRP level during treatment (r= -2.793, P<0.05).Conclusion: CRP kinetics and apoA-I may be useful to predict the prognosis of NSCLC patients treated with first-line platinum-based chemotherapy and facilitate individualized treatment.

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“…A large number of studies have proven that CRP, NLR, PLR, ALB, as poor prognostic indexes in cancers [26][27][28] . However, compared with other in ammatory predictors, both CRP and CRP kinetics are better independent predictors 29,[32][33][34] . Multiple studies have con rmed that ApoA-1, a prognostic factor plays a role in anti-in ammatory and antioxidant activities in various tumor diseases 30 37 .…”

Section: Discussionmentioning

confidence: 85%

The prognostic values of CRP kinetics and initial apoA-I in patients with advanced NSCLC: a retrospective study

Zhou

Cheng

Zhang

et al. 2020

Preprint

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Background: To analyse the value of C-reactive protein (CRP) kinetics and initial apolipoproteinA1 (apoA-I) level as prognostic parameters in advanced non-small Cell Lung Cancer (NSCLC). Methods : Within a retrospective single-center study, serum CRP and apoA-I level were measured at baseline and at the start of each platinum-based chemotherapy cycle for 125 NSCLC patients. Survival analysis, calculated by the Kaplan–Meier method and log-rank test, was used to assess the prognostic significance of Serum CRP and apoA-I level and both levels. The non-parametric Spearman rank correlation coefficient (rs) was used to measure the correlation between apoA-I and CRP. Results: Lung cancer-specific survival were significantly different across three CRP kinetics groups ( P <0.001), such significant differences were also seen between different apoA-I groups. In multivariate analysis, both CRP kinetics and apoA-I were independent significant factors for overall survival. Patients in non-normalized CRP group with lower apoA-I had a poor prognosis. Spearman’s rank correlation analysis revealed that the apoA-I level presented a negative correlation with the CRP level during treatment (r= -2.793, P <0.05). Conclusions: CRP kinetics and apoA-I may be useful to predict the prognosis of NSCLC patients treated with first-line platinum-based chemotherapy and facilitate individualized treatment.

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Effect of C‐reactive protein/albumin ratio on prognosis in advanced non–small‐cell lung cancer

Abstract: In advanced NSCLC patients, CAR may be a better predictor of prognosis compared with other inflammatory markers. A prospective multicenter study is needed to verify these findings.

Cited by 61 publications

References 33 publications

Inflammatory Markers and Procalcitonin Predict the Outcome of Metastatic Non-Small-Cell-Lung-Cancer Patients Receiving PD-1/PD-L1 Immune-Checkpoint Blockade

Inflammatory Markers and Procalcitonin Predict the Outcome of Metastatic Non-Small-Cell-Lung-Cancer Patients Receiving PD-1/PD-L1 Immune-Checkpoint Blockade

Prognostic Values of Combined Detection of Serum of CRP Kinetics and Initial apoA-I in Advanced NSCLC

The prognostic values of CRP kinetics and initial apoA-I in patients with advanced NSCLC: a retrospective study

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