Co-relation of overall survival with peripheral blood-based inflammatory biomarkers in advanced stage non-small cell lung cancer treated with anti-programmed cell death-1 therapy: results from a single institutional database

Naqash, Abdul Rafeh; Stroud, Chipman Robert Geoffrey; Butt, Muhammad; Dy, Grace K.; Hegde, Aparna; Muzaffar, Mahvish; Yang, Li V.; Hafiz, Maida; Cherry, Cynthia R.; Walker, Paul R.

doi:10.1080/0284186x.2017.1415460

Cited by 32 publications

(39 citation statements)

References 39 publications

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“…In a study by Diem et al [ 23 ] they categorized ANC:ALC into 3 groups (< 3.6, 3.6–6.5 and > 6.5) and those with an elevated ANC:ALC ratio were associated with worse OS (HR, 3.64, P < 0.001). Naqash et al [ 24 ], similarly to our results also found in multivariate analyses, that baseline ANC:ALC ≥5 was independently associated with inferior OS (median 5.5 vs. 8.4 months; HR 2.07, 95% CI 1.3–3.3; P = 0.002) and inferior PFS (median 1.9 vs. 2.8 months; HR 1.43, 95% CI 1.02–2.0; P = 0.04). Zer et al [ 25 ] described an improved disease control rate ( P = 0.025), duration of treatment ( P = 0.037), time to progression ( P = 0.053) and overall survival ( P = 0.019) when patients had a low ANC:ALC ≤4 compared to a higher ANC:ALC; and there was no difference with PD-L1 expression.…”

Section: Discussionmentioning

confidence: 99%

“…For example, a reference of 5.0 for ANC:ALC has been used in the melanoma literature. Different cutoff points for ANL:ALC have been used in other recent NSCLC studies [ 22 , 24 , 25 ]. The reason for this variation is likely attributed to the baseline difference in patient population, timing of ANC:ALC in relation to the treatment and statistical methods.…”

Section: Discussionmentioning

confidence: 99%

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Peripheral blood biomarkers correlate with outcomes in advanced non-small cell lung Cancer patients treated with anti-PD-1 antibodies

Soyano¹,

Dholaria²,

Marin-Acevedo³

et al. 2018

j. immunotherapy cancer

104

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BackgroundAnti-programmed cell death 1 (PD-1) antibodies have demonstrated improved overall survival (OS) and progression-free survival (PFS) in a subset of patients with metastatic or locally advanced non-small cell lung cancer (NSCLC). To date, no blood biomarkers have been identified in NSCLC to predict clinical outcomes of treatment with anti-PD-1 antibodies.Patient and methodsWe performed an analysis of retrospectively registered data of 157 patients with advanced NSCLC treated with anti-PD-1 antibodies at Mayo Clinic in Florida and Rochester. White blood cell count, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), ANC to ALC (ANC: ALC) ratio, absolute eosinophil count, absolute monocyte count (AMC), platelet counts, and myeloid to lymphoid (M:L) ratio at baseline and throughout treatment were assessed. Kaplan-Meier method and Cox proportional hazards model were performed.ResultsWe treated 146 patients with nivolumab and 11 with pembrolizumab between January 1, 2015 and April 15, 2017. At median follow-up of 20 months, median OS and PFS were 6.0 and 2.6 months, respectively. Higher baseline ANC, AMC, ANC: ALC ratio and M: L ratio correlated with worse clinical outcomes in patients who underwent anti-PD-1 treatment. A baseline ANC: ALC ratio of 5.9 or higher had a significantly increased risk of death (hazard ratio [HR] =1.94; 95% confidence interval [CI], 1.24–3.03; P = 0.004) and disease progression (HR, 1.65; 95% CI, 1.17–2.34; P = 0.005) compared with patients with lower ratio. Similarly, a baseline M: L ratio of 11.3 or higher had significantly increased risk of death (HR, 2.5; 95% CI, 1.54–4.05; P < 0.001), even after a multivariate analysis (HR, 2.31; P = 0.002), compared to those with lower ratio.ConclusionsIncreased baseline ANC: ALC ratio and M: L ratio before initiation of anti-PD1 antibodies were associated with poor PFS and OS in advanced NSCLC patients. The potential predictive value of these readily available biomarkers might help with risk stratification and treatment strategies. These findings warrant further investigation in a larger, prospective study.Electronic supplementary materialThe online version of this article (10.1186/s40425-018-0447-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Peripheral blood biomarkers correlate with outcomes in advanced non-small cell lung Cancer patients treated with anti-PD-1 antibodies

Soyano¹,

Dholaria²,

Marin-Acevedo³

et al. 2018

j. immunotherapy cancer

104

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“…For instance, one study found that mGPS was superior to NLR and other inflammation-based scores in determining outcomes in NSCLC patients treated with nivolumab, while another study refuted such an association. 150,151 In a disease area where anticancer immunotherapy is rapidly evolving, having led to the approval of nivolumab and pembrolizumab for the systemic treatment of advanced HCC, 152,153 Inflammatory scores are also being developed for advanced HCC. Foremost, evidence of deranged inflammatory markers at the start of treatment, or the derangement of these indices with time, could provide an objective method to streamline the use of systemic therapies, including potentially ICI, depending on their predicted efficacy.…”

Section: Molecularly Targeted Modulation Of Cancerrelated Inflammationmentioning

confidence: 99%

“…Similarly, contradictory results have arisen when evaluating the predictive role of mGPS in the setting of ICI treatment. For instance, one study found that mGPS was superior to NLR and other inflammation‐based scores in determining outcomes in NSCLC patients treated with nivolumab, while another study refuted such an association …”

Section: Introductionmentioning

confidence: 99%

The systemic inflammatory response as a source of biomarkers and therapeutic targets in hepatocellular carcinoma

Sanghera

Teh

Pinato

2019

Liver International

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The pathogenesis of hepatocellular carcinoma (HCC) strongly relates to inflammation, with chronic up‐regulation of pro‐inflammatory mediators standing as a potential unifying mechanism that underscores the origin and progression of HCC independent of aetiology. Activation of the diverse pro‐inflammatory mediators either within the tumour or its microenvironment is part of an active cross‐talk between the progressive HCC and the host, which is known to influence clinical outcomes including recurrence after radical treatments and long‐term survival. A number of clinical biomarkers to measure the severity of cancer‐related inflammation are now available, most of which emerge from routine blood parameters including neutrophil, lymphocyte, platelet counts, as well as albuminaemia and C‐reactive protein levels. In this review, we summarise the body of evidence supporting the biologic qualification of inflammation‐based scores in HCC and review their potential in facilitating the prognostic assessment and treatment allocation in the individual patient. We also discuss the evidence to suggest modulation of tumour‐promoting inflammation may act as a source of novel therapeutic strategies in liver cancer.

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“…Systemic inflammation investigated using commonly characterized blood-based biomarkers has been shown to be related to the treatment response to ICIs. Elevated C-reactive protein (CRP) levels have been associated with poor responses to ICIs [77][78][79][80]. Other widely acknowledged prognostic markers for deleterious systemic inflammation include an elevated neutrophil-to-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH).…”

Section: Circulating Markersmentioning

confidence: 99%

Possibilities of Improving the Clinical Value of Immune Checkpoint Inhibitor Therapies in Cancer Care by Optimizing Patient Selection

Iivanainen

Koivunen

2020

IJMS

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Immune checkpoint inhibitor (ICI) therapies have become the most important medical therapies in many malignancies, such as melanoma, non-small-cell lung cancer, and urogenital cancers. However, due to generally low response rates of PD-(L)1 monotherapy, both PD-(L)1 combination therapies and novel therapeutics are under large-scale clinical evaluation. Thus far, clinical trials have rather suboptimally defined the patient population most likely to benefit from ICI therapy, and there is an unmet need for negative predictive markers aiming to reduce the number of non-responding patients in clinical practice. Furthermore, there is a strong need for basic tumor immunology research and innovative clinical trials to fully unleash the potential of ICI combinations for the benefit of patients.

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Co-relation of overall survival with peripheral blood-based inflammatory biomarkers in advanced stage non-small cell lung cancer treated with anti-programmed cell death-1 therapy: results from a single institutional database

Cited by 32 publications

References 39 publications

Peripheral blood biomarkers correlate with outcomes in advanced non-small cell lung Cancer patients treated with anti-PD-1 antibodies

Peripheral blood biomarkers correlate with outcomes in advanced non-small cell lung Cancer patients treated with anti-PD-1 antibodies

The systemic inflammatory response as a source of biomarkers and therapeutic targets in hepatocellular carcinoma

Possibilities of Improving the Clinical Value of Immune Checkpoint Inhibitor Therapies in Cancer Care by Optimizing Patient Selection

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