Glasgow prognostic score for prediction of chemotherapy‐triggered acute exacerbation interstitial lung disease in patients with small cell lung cancer

Abstract

Background: Predicting the incidence of chemotherapy-triggered acute exacerbation of interstitial lung disease (AE-ILD) in patients with lung cancer is important because AE-ILD confers a poor prognosis. The Glasgow prognostic score (GPS), which is an inflammation-based index composed of serum levels of C-reactive protein and albumin, predicts prognosis in patients with small cell lung cancer (SCLC) without ILD. In this study, we investigated AE-ILD and survival outcome based on the GPS in patients with ILD associated with SCLC who were receiving chemotherapy. Methods: Medical records of patients who received platinum-based first-line chemotherapy between June 2010 and May 2019 were retrospectively reviewed to compare the incidence of AE-ILD and overall survival (OS) between GPS 0, 1, and 2. Results: Among our cohort of 31 patients, six (19.3%) experienced chemotherapytriggered AE-ILD. The AE-ILD incidence increased from 9.5% to 25.0% and 50.0% with increase in GPS of 0, 1, and 2, respectively. Univariate and multivariate analyses revealed remarkable associations between GPS 2 and both AE-ILD (odds ratio for GPS 2, 18.69; p = 0.046) and prognosis (hazard ratio of GPS 2, 13.52; p = 0.002). Furthermore, median OS in the GPS 0, 1, and 2 groups was 16.2, 9.8, and 7.1 months, respectively (p < 0.001). Conclusions: Our results suggest that GPS 2 is both a predictor of risk of chemotherapy-triggered AE-ILD and a prognostic indicator in patients with ILD associated with SCLC. We propose that GPS may be used as a guide to distinguish chemotherapy-tolerant patients from those at high risk of AE-ILD.

Impact of sarcopenia on chemotherapy‐triggered exacerbation of interstitial lung disease in patients with non‐small cell lung cancer

“… 2 , 12 , 13 Therefore, predicting ILD exacerbation may be beneficial in improving the prognosis of lung cancer with ILD. Although studies have already identified usual interstitial pneumonia patterns in high‐resolution computed tomography (HRCT), low forced vital capacity, Gender‐Age‐Physiology score, and Glasgow prognostic score (GPS) as predictors of exacerbation, 9 , 10 , 12 , 14 , 15 clinically effective factors that can reliably predict exacerbations have yet to be elucidated.…”

“…Although the etiology of sarcopenia remains unclear, chronic inflammation and malnutrition due to regulation of myokine production have been considered causative factors. 16 Our group have previously reported that GPS, which is calculated using serum C‐reactive protein and albumin, can predict the prognosis and exacerbation of ILD in patients with ILD‐complicated lung cancer, 14 , 15 suggesting the potential involvement of inflammation and nutrition in the pathophysiology of this disease. Therefore, the present study sought to determine whether the psoas major muscle area at the third lumbar vertebral level on CT, which has been used as an index that reflects the entire skeletal muscle mass, 28 could potentially be a biomarker for predicting exacerbation of ILD and overall survival (OS) in patients with ILD‐complicated lung cancer.…”

The role of miR1 and miR133a in new-onset atrial fibrillation after acute myocardial infarction

“…After acute myocardial infarction (AMI), the inflammatory response is vital in myocardial remodelling [ 23 , 24 ]. The Glasgow Prognostic Score (GPS) assesses serum albumin and C-reactive protein levels [ 25 ]. A drop in serum albumin level indicates a severe inflammatory response in the patient [ 26 ].…”

The role of miR1 and miR133a in new-onset atrial fibrillation after acute myocardial infarction

“…After AMI, the in ammatory response plays an important role in myocardial remodeling [19,20]. The Glasgow prognosis outcome scoring system assesses serum albumin and C-reactive protein levels [21]. When the serum albumin level drops, the patient has a severe in ammatory response [22].Therefore, the Glasgow prognosis score can accurately re ect the degree of the in ammatory response.…”