Progression‐free survival assessed per immune‐related or conventional response criteria, which is the better surrogate endpoint for overall survival in trials of immune‐checkpoint inhibitors in lung cancer: A systematic review and meta‐analysis

Zhu, Guoxuan; Yang, Kai‐Bin; Tang, Siqi; Peng, Liang

doi:10.1002/cam4.4347

Cited by 6 publications

(3 citation statements)

References 70 publications

(153 reference statements)

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“…Multiple causes, such as tissue inflammation triggered by tumour growth or invasion, cancer itself, and the release of inflammatory mediators induced by leukocytes, contribute to systemic inflammation in cancer patients ( 23 ). Inflammatory marker readings have predictive relevance for cancer patients ( 24 , 25 ) because systemic inflammatory responses are responsible for cancer growth, invasion, metastasis, and resistance to chemotherapy. Specifically, for patients treated with immune checkpoint inhibitors, neutrophil-produced cytokines and chemokines can promote angiogenesis and extracellular matrix remodelling ( 26 ), creating a favourable microenvironment for cancer growth and impacting the efficacy of immune checkpoint inhibitors ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Advanced lung cancer inflammation index predicts survival outcomes of hepatocellular carcinoma patients receiving immunotherapy

Ma²,

Wang³

2023

Front. Oncol.

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ObjectiveWe evaluate the predictive significance of the Advanced Lung Cancer Inflammation Index (ALI) in patients with advanced hepatocellular carcinoma (HCC) following therapy with immune checkpoint drugs.MethodsIn 2018-2020, 98 patients with advanced hepatocellular carcinoma who were treated with immune checkpoint inhibitors at our hospital were compiled. Using the receiver operating characteristic (ROC) curve, the appropriate cut-off point for ALI was determined. Kaplan-Meier analysis, the Cox proportional hazards model, and Nomogram plots highlighted the relationship between ALI and overall survival (OS). The model was validated using calibration plots, receiver operating characteristic curves (ROC), and decision curve analysis (DCA), which was performed on 52 patient sets by external validation.ResultsThe AUC for ALI was 0.663. The best cutoff value was 36.5, with a median overall survival (OS) of 473 days for patients with ALI≤ 36.5 and 611 days for those with ALI > 36.5. Univariate analysis revealed that the presence or absence of local treatment, alpha-fetoprotein (AFP), and ALI were prognostic factors; LASSO regression analysis identified four candidate variables. Multifactorial COX analysis revealed that high ALI was an independent prognostic factor for overall survival in both groups (HR = 0.411; 95% CI: 0.244-0.651; P<0.001). In addition, the Nomogram model that included ALI was able to predict the success of immunotherapy in patients with advanced liver cancer more accurately.ConclusionALI is a novel prognostic marker in immunotherapy-treated patients with advanced hepatocellular cancer.

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Section: Discussionmentioning

confidence: 99%

Advanced lung cancer inflammation index predicts survival outcomes of hepatocellular carcinoma patients receiving immunotherapy

Ma²,

Wang³

2023

Front. Oncol.

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“…Systemic inflammation in cancer patients is caused by a variety of mechanisms ( 23 , 25 ), such as tissue inflammation induced by tumor growth or invasion, the cancer itself, and the production of inflammatory mediators induced by leukocytes. Systemic inflammatory responses are responsible for both cancer growth, invasion, metastasis, and resistance to chemotherapy, and have prognostic value for cancer patients ( 26 , 27 ). ICIs are now increasingly used in a variety of tumors, including hepatocellular liver cancer, and the use of ICIs can significantly improve the OS of patients with many advanced tumors.…”

Section: Discussionmentioning

confidence: 99%

The value of the Advanced Lung Cancer Inflammation Index (ALI) in assessing the prognosis of patients with hepatocellular carcinoma treated with camrelizumab: a retrospective cohort study

Li¹,

Ma²,

Tsilimigras³

et al. 2022

Ann Transl Med

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Background: The Advanced Lung Cancer Inflammation Index (ALI) is considered a useful prognostic biomarker for clinical outcome in patients with malignancy. However, the prognostic value of ALI in patients with advanced hepatocellular carcinoma (HCC) is unclear. In this study we assessed the prognostic value of the ALI in patients with HCC treated with camrelizumab.Methods: This retrospective study analyzed patients with advanced hepatocellular carcinoma treated with the ICI, camrelizumab alone or in combination at Henan Cancer Hospital from January 2017 to January 2020. Sixty-five patients were finally screened for at least 2 years of follow-up according to the inclusion criteria, with no significant differences in patient baseline data. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off point for the ALI which was compared to other clinical indicators for predicting survival. A Kaplan-Meier analysis and Cox proportional analysis were conducted to examine the association between the ALI and patient prognosis. Results:The median overall survival (OS) for the overall group of patients was 383 days, the area under the curve for ALI was 0.815 and the optimal cut-off value for predicting OS was 34.65. The median OS for patients with an ALI score ≤34.65 was 336 days and that for patients with an ALI score >34.65 was 524 days.The univariate analysis showed that the Eastern Cooperative Oncology Group (ECOG) score, aspartate aminotransferase (AST) level, and the ALI score predicted OS. The multivariate analysis showed that the ALI score was an independent prognostic factor of OS in patients with advanced HCC who had been treated with immunotherapy [hazard ratio (HR) =0.285, 95% confidence interval (CI): 0.097-0.833, P=0.022]. A nomogram that included ALI performed well relative to the prediction of prognosis after immunotherapy for patients with advanced liver cancer. Conclusions:The ALI may be a new prognostic marker in patients with advanced HCC undergoing immunotherapy.

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“…Compared with OS, the follow-up duration of PFS is significantly shortened and has been used as a favorable surrogate endpoint for OS in different cancer therapies such as chemotherapy, radiotherapy, targeted therapy, etc. However, in the field of immunotherapy, whether PFS performs better than traditional response evaluation criteria such as OS in evaluating efficacy or clinical benefits has not been verified in clinical trial settings ( Zhu et al, 2021 ). Besides, several studies have demonstrated that advanced esophageal cancer patients with biomarker differences including no 11q13 chromosomal amplification, high tumor mutation burden (TMB), and microsatellite instability-high (MSI-H) tended to have greater OS rather than PFS benefit from PD-1/PD-L1 inhibitors ( Mocellin et al, 2001 ; Greally and Ku, 2018 ; Lu et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of PD-1/PD-L1 inhibitors in patients with advanced gastroesophageal cancer: An updated meta-analysis based on randomized controlled trials

Huang

Qiu

et al. 2022

Front. Pharmacol.

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Background: This study aimed to investigate the clinical efficacy of programmed death-1 receptor and ligand-1 (PD-1/PD-L1) inhibitors in gastroesophageal cancer patients and the relationship between their clinicopathological features and curative treatment effects.Methods: A systematic search was conducted for articles published before April 2022 from online databases (PubMed, EMBASE, Web of Science and the Cochrane Library). The main outcome was overall survival (OS).Results: This meta-analysis comprised 16 studies involving 9,304 participants. The results indicated that compared with chemotherapy, patients treated with PD-1/PD-L1 inhibitors had significantly improved OS (HR = 0.80; p < 0.001) but no significant improvement in progression-free survival (PFS) (p = 0.185). Subgroup analyses demonstrated that PD-1/PD-L1 inhibitors combined with chemotherapy, esophageal squamous cell carcinoma, male, Asian patients and combined positive score (CPS) ≥1 were significantly associated with better survival outcomes. Further, subgroup analysis of gender revealed that the OS of all subgroups containing male patients was significantly improved compared with chemotherapy, unlike that of female patients. In addition, the line of therapy, Lauren classification, age and eastern cooperative oncology group (ECOG) performance status were not associated with PD-1/PD-L1 inhibitors efficacy.Conclusion: The results indicated that PD-1/PD-L1 inhibitors could prolong the OS of advanced gastroesophageal cancer patients. Clinicopathological features such as therapeutic schedules, tumor types, histological type, gender, geographical region and PD-L1 expression status (CPS) seemed to be associated with survival outcomes.

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Progression‐free survival assessed per immune‐related or conventional response criteria, which is the better surrogate endpoint for overall survival in trials of immune‐checkpoint inhibitors in lung cancer: A systematic review and meta‐analysis

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 6 publications

References 70 publications

Advanced lung cancer inflammation index predicts survival outcomes of hepatocellular carcinoma patients receiving immunotherapy

Advanced lung cancer inflammation index predicts survival outcomes of hepatocellular carcinoma patients receiving immunotherapy

The value of the Advanced Lung Cancer Inflammation Index (ALI) in assessing the prognosis of patients with hepatocellular carcinoma treated with camrelizumab: a retrospective cohort study

Efficacy of PD-1/PD-L1 inhibitors in patients with advanced gastroesophageal cancer: An updated meta-analysis based on randomized controlled trials

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