Real-World Analysis of the Impact of Radiotherapy on Immunotherapy Efficacy in Non-Small Cell Lung Cancer

Onn, Amir; Gottfried, Teodor; Stemmer, Amos; Appel, Sarit; Lawrence, Yaacov Richard; Urban, Damien; Beller, Tamar; Daher, Sameh; Bar, Jair

doi:10.3390/cancers13112800

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…More than half of the studies were reported from the Far East (n = 15) (Ichiki et al, 2019;Jiang et al, 2020;Kitadai et al, 2020;Takada et al, 2020;Ke et al, 2021;Morimoto et al, 2021;Ng et al, 2021;Pu et al, 2021;Sato et al, 2021;Tokuyama et al, 2021;Chen et al, 2022;Kim et al, 2022;Li et al, 2022;Wu et al, 2022;Zhang et al, 2022), followed by Europe (n = 12) (Dercle et al, 2016;Bigot et al, 2017;Mezquita et al, 2018;Svaton et al, 2018;Cantini et al, 2020;Awada et al, 2021;Onn et al, 2021;Ruiz-Bañobre et al, 2021;Stares et al, 2021;Assié et al, 2022;Schneider et al, 2022;Stares et al, 2022). A 3.5 gr/dL albumin cut-off was most frequently used in the included studies (n = 20) (Dercle et al, 2016;Bigot et al, 2017;Mezquita et al, 2018;Formica et al, 2020;Jiang et al, 2020;Kitadai et al, 2020;Lee et al, 2020;Takada et al, 2020;Awada et al, 2021;Brown et al, 2021;Khaki et al, 2021;Morimoto et al, 2021;Ng et al, 2021;Onn et al, 2021;…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Thirty-four studies were included in the analyses for OS (Stroup et al, 2000;Dercle et al, 2016;Bigot et al, 2017;Mezquita et al, 2018;Svaton et al, 2018;Ichiki et al, 2019;Cantini et al, 2020;Formica et al, 2020;Jiang et al, 2020;Kitadai et al, 2020;Lee et al, 2020;Swami et al, 2020;Takada et al, 2020;Awada et al, 2021;Brown et al, 2021;de Kouchkovsky et al, 2021;Ke et al, 2021;Khaki et al, 2021;Morimoto et al, 2021;Ng et al, 2021;Onn et al, 2021;Pu et al, 2021;Ruiz-Bañobre et al, 2021;Sato et al, 2021;Stares et al, 2021;Tokuyama et al, 2021;Abuhelwa et al, 2022;Assié et al, 2022;Chen et al, 2022;Guo et al, 2022;Kim et al, 2022;Li et al, 2022;Stares et al, 2022;Wu et al, 2022;Yoo et al, 2022). In the meta-analysis, patients with lower albumin levels had a significantly increased risk of death (HR: 1.65, 95% CI: 1.52-1.80, p < 0.0001) than patients with higher albumin levels (Figure 1).…”

Section: The Association Between Hypoalbuminemia and Overall Survivalmentioning

confidence: 99%

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The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis

Güven

Şahin

Erul

et al. 2022

Front. Mol. Biosci.

105

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Background: The albumin levels may potentially be used as a prognostic biomarker in patients with cancertreated with immune checkpoint inhibitors (ICIs) due to its close relationship with nutritional and inflammatory status. However, the available data is limited with heterogeneous patient cohorts, sample sizes and variable cut-offs. Therefore, we conducted a systematic review and meta-analysis to evaluate the association between survival outcomes and albumin levels in patients treated with ICIs.Methods: We conducted a systematic review using the PubMed, Web of Science, and Embase databases to filter the published studies up to 1 June 2022. The meta-analyses were performed with the generic inverse-variance method with a random-effects model due to the high degree of heterogeneity. The primary outcome measure was hazard ratio (HR) with 95% confidence intervals (CI). The study protocol was registered with the PROSPERO registry (Registration Number: CRD42022337746).Results: Thirty-six studies encompassing 8406 cancer patients with advanced disease were included in the meta-analyses. Almost half of the studies were conducted in NSCLC cohorts (n = 15), and 3.5 gr/dL was the most frequently used albumin cut-off in the included studies (n = 20). Patients with lower albumin levels had a significantly increased risk of death (HR: 1.65, 95% CI: 1.52–1.80, p < 0.0001) than patients with higher albumin levels. Subgroup analyses for study location, sample size, tumor type and albumin cut-off were demonstrated consistent results. Furthermore, in the subgroup analysis of eight studies using albumin levels as a continuous prognostic factor, every 1 gr/dL decrease in albumin levels was associated with significantly increased risk of death by a factor of 10% (HR: 1.10, 95% CI: 1.05–1.16, p = 0.0002). Similar to analyses with overall survival, the patients with lower albumin levels had an increased risk of progression or death compared to patients with higher albumin levels (HR: 1.76, 95% CI: 1.40–2.21, p < 0.001).Conclusion: The available evidence demonstrates that albumin levels may be a prognostic biomarker in advanced cancer patients treated with ICIs. Further research is needed to delineate the role of albumin levels in patients treated with ICIs in the adjuvant setting, as well as the possible benefit of therapeutic approaches to improve hypoalbuminemia.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: The Association Between Hypoalbuminemia and Overall Survivalmentioning

confidence: 99%

The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis

Güven

Şahin

Erul

et al. 2022

Front. Mol. Biosci.

105

View full text Add to dashboard Cite

show abstract

“…A recent pan-cancer study with 1,714 patients has shown that hypoalbuminemia predicts poor survival upon ICI treatment, but this work lacked a melanoma-speci c analysis placing these associations into the context of other melanoma-speci c biomarkers (14). Multiple studies on NSCLC showed that hypoalbuminemia was associated with poor survival after immunotherapy, which held in a multivariate analysis adjusting for treatment line, prior radiotherapy, NLR, and ECOG PS (39,40). Another study comparing several laboratory and clinical factors in metastatic melanoma reported that albumin was an independent predictor for immunotherapy response after adjustment for LDH, CRP, NLR, brain metastasis, sex, and age (41,42).…”

Section: Discussionmentioning

confidence: 97%

Multi-omic analysis identifies hypoalbuminemia as independent biomarker of poor outcome upon PD-1 blockade in metastatic melanoma

Leek,

Notohardjo,

de Joode

et al. 2024

Preprint

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We evaluated the prognostic value of hypoalbuminemia in context of various biomarkers at baseline, including clinical, genomic, transcriptomic, and blood-based markers, in patients with metastatic melanoma treated with anti-PD-1 monotherapy or anti-PD-1/anti-CTLA-4 combination therapy (n=178). An independent validation cohort (n=79) was used to validate the performance of hypoalbuminemia compared to serum LDH (lactate dehydrogenase) levels. Pre-treatment hypoalbuminemia emerged as the strongest predictor of poor outcome for both OS (HR=4.01, 95% CI 2.10-7.67, Cox P=2.63e-05) and PFS (HR=3.72, 95% CI 2.06-6.73, Cox P=1.38e-05) in univariate analysis. In multivariate analysis, the association of hypoalbuminemia with PFS was independent of serum LDH, IFN-γ signature expression, TMB, ECOG PS, treatment line, treatment type (combination or monotherapy), brain and liver metastasis (HR=2.80, 95% CI 1.29-6.08, Cox P=0.00916). Our validation cohort confirmed the prognostic power of hypoalbuminemia for OS (HR=1.98, 95% CI 1.16-3.38; Cox P=0.0127) and was complementary to serum LDH in analyses for both OS (LDH-adjusted HR=2.12, 95% CI 1.2-3.72, Cox P=0.00925) and PFS (LDH-adjusted HR=1.91, 95% CI 1.08-3.38, Cox P=0.0261). In conclusion, pretreatment hypoalbuminemia was a powerful predictor of outcome in ICI in melanoma and showed remarkable complementarity to previously established biomarkers, including high LDH.

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Strategies to boost antibody selectivity in oncology

Blay,

Pandiella

2024

Trends in Pharmacological Sciences

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Real-World Analysis of the Impact of Radiotherapy on Immunotherapy Efficacy in Non-Small Cell Lung Cancer

Cited by 6 publications

References 36 publications

The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis

The association between albumin levels and survival in patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis

Multi-omic analysis identifies hypoalbuminemia as independent biomarker of poor outcome upon PD-1 blockade in metastatic melanoma

Strategies to boost antibody selectivity in oncology

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