Predictors of survival among Japanese patients receiving first‐line chemoimmunotherapy for advanced non‐small cell lung cancer

Abstract

Background: First-line chemoimmunotherapy (CIT) has improved overall survival (OS) and progression-free survival (PFS) outcomes among patients with non-small cell lung cancer (NSCLC). The immunological and nutritional statuses of patients fluctuate during treatment using immune checkpoint inhibitors, and are closely related to treatment outcomes. However, it is unclear whether these markers are significant in patients who are receiving CIT. Methods: This retrospective single-center study evaluated 34 consecutive Japanese patients with NSCLC who were treated using first-line CIT. Previously reported markers that reflect immunological and nutritional statuses were evaluated at three time points: at the start of CIT, after three weeks, and at the end of induction therapy. Results: The median PFS was 7.2 months (95% confidence interval: 6.3 monthsnot reached) and the median OS was not reached (95% confidence interval: 9.6 months-not reached). The PFS duration was significantly associated with the baseline neutrophil-to-lymphocyte ratio and the three-week values for the modified Glasgow prognostic score, C-reactive protein-albumin ratio, prognostic nutrition index, and advanced lung cancer inflammation index. The OS duration was significantly associated with the pre-treatment values for the neutrophil-tolymphocyte ratio and advanced lung cancer inflammation index, as well as the prognostic nutrition index at the end of induction therapy. Conclusions: Immunological and nutritional markers could be useful for predicting the outcomes of CIT for Japanese patients with advanced non-small cell lung cancer. The timing of their evaluation may also be important.

[Retracted] The Treatment Combining Antiangiogenesis with Chemoradiotherapy Impinges on the Peripheral Circulation Vascular Endothelial Cells and Therapeutic Effect in the Patients with Locally Advanced Nasopharyngeal Carcinoma

“…Antitumor neovascularization is an important aspect of targeted therapy, but the evaluation standard for tumor efficacy is mainly the evaluation to chemotherapy drugs' efficacy (17)(18)(19). Antiangiogenic drugs act on the blood vessels of tumors, and most of them cannot quickly shrink tumors, because tumorous volume change often comes later than blood supply inhibition.…”

Prognostic Nutritional Index Predicts Response and Prognosis in Cancer Patients Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

“…Five publications showed that PNI was an independent predictor of unfavorable PFS in cancer patients with immunotherapy (18,19,26,27,34), whereas five cohort studies detected no significant relationship between PNI and PFS (20,28,30,31,33). The combined analysis of ten studies that enrolled 1,282 participants showed that a higher PNI level was associated with worse PFS (pHR = 1.61, 95% CI = 1.37-1.88, Figure 3).…”

“…Five observational studies reported that PNI was an independent indicator for a shortened OS in cancer patients with immunotherapy (18,19,(26)(27)(28), while PNI was not considered as a prognostic factor for OS in seven studies (20,(29)(30)(31)(32)(33)(34). Pooled analysis of all selected publications revealed that the PNI values higher than the cutoff value predicted a poor OS (pHR = 2.24, 95% CI = 1.57-3.20, Figure 2) in advanced cancer patients treated with immune checkpoint inhibitors.…”

Prognostic Value of Post First-Line Chemotherapy Glasgow Prognostic Score in Advanced Non-Small Cell Lung Cancer

“…There was no significant association between B-GPS and response to chemotherapy. Studies of the prognostic role of GPS in cancer comprise more than 70 000 patients, [7][8][9] but only a few have looked at the impact of GPS measured during or after treatment: Three small studies (n = 24-64) reported that elevated GPS measured 3 to 6 weeks after initiation of immune checkpoint inhibitor therapy was associated with poor survival in advanced NSCLC 30,31 and renal cell carcinoma. 32 Others have found that elevated GPS after initiation of palliative chemotherapy for colorectal cancer 33 and after surgery for localized NSCLC 34 and gastric cancer 15 was associated with poor prognosis.…”