Prognostic impact of the Controlling Nutritional Status score in patients with non-small cell lung cancer treated with pembrolizumab

Ohba, Taro; Takamori, Shinkichi; Toyozawa, Ryo; Nosaki, Kaname; Umeyama, Yasuhiro; Haratake, Naoki; Miura, Naruhisa; Yamaguchi, Masafumi; Taguchi, Kenichi; Seto, Takashi; Shimokawa, Mototsugu; Takenoyama, Mitsuhiro

doi:10.21037/jtd.2019.09.29

Cited by 32 publications

(38 citation statements)

References 38 publications

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“…Furthermore, several recent studies have reported potential ICI biomarkers in the host, such as preexisting autoimmune antibodies 8 , steroid use 9 , microbiome 10 , white blood cell count 11 , sarcopenia 12 , and body mass index (BMI) 13 – 15 . Several inflammatory indices, such as the NLR, LMR, and PLR, which are recognized as important markers of inflammatory processes, have also been reported as potential predictors of the effectiveness of anti-PD-1 antibody therapy 16 – 18 . However, little is known regarding the subpopulation of NSCLC patients who exhibit clinical outcomes that require treatment with atezolizumab monotherapy.…”

Section: Introductionmentioning

confidence: 99%

Significance of inflammatory indexes in atezolizumab monotherapy outcomes in previously treated non-small-cell lung cancer patients

Katayama

Yamada

Chihara

et al. 2020

Sci Rep

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Cancer immunotherapy, including atezolizumab monotherapy, is a promising alternative strategy for patients with advanced non-small-cell lung cancer (NSCLC). Several inflammatory indices have been reported as potential biomarkers regarding the effectiveness of various treatments. This study aimed to analyze the efficacy of atezolizumab monotherapy using baseline inflammatory markers in NSCLC patients. We retrospectively enrolled 81 NSCLC patients who received atezolizumab monotherapy at six different medical institutions in Japan. The Cox proportional hazards model was used to assess the impact of the clinical variables, including inflammatory indexes, on clinical outcomes. Median progression-free survival (PFS) and overall survival (OS) were 60 days and 252 days, respectively. The objective response rate was 7.4%, and the disease control rate was 54.3%. Patients with high neutrophil to lymphocyte ratio (NLR), low lymphocyte to monocyte ratio (LMR), and/or high platelet to lymphocyte ratio (PLR), at baseline, demonstrated substantially shorter PFS and OS compared to those with a low NLR, high LMR, and/or low PLR. The multivariate analysis demonstrated that a high baseline NLR was substantially associated with short PFS and short OS. Our retrospective observations suggest that inflammatory indices may be a potential negative prognostic factor of atezolizumab monotherapy outcomes in NSCLC patients.

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Section: Introductionmentioning

confidence: 99%

Significance of inflammatory indexes in atezolizumab monotherapy outcomes in previously treated non-small-cell lung cancer patients

Katayama

Yamada

Chihara

et al. 2020

Sci Rep

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“…After reading the abstracts and full text, 116 of which were excluded for not fulfil the inclusion criteria. After reviewing 29 potentially eligible articles in detail, 8 studies were eventually included in this meta-analysis (21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Search Resultsmentioning

confidence: 99%

“…A total of 8 studies published from 2017 to 2020 met the criteria for this meta-analysis. Six studies (21,(23)(24)(25)(26)28) were conducted in Japan and the remaining two originated from Korea (27) and Turkey (22). All of studies were based on retrospective analysis of the data.…”

Section: Study Characteristicsmentioning

confidence: 99%

Controlling nutritional status is a prognostic factor for patients with lung cancer: a systematic review and meta-analysis

Zhang¹,

Li²,

Cong³

et al. 2021

Ann Palliat Med

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Background: Nowadays, controlling nutritional status (CONUT) has been used as a prognostic factor in variety of cancers. However, no consensus has been reached on the prognostic value of CONUT in lung cancer. In this study, we aim to investigate the role of CONUT in survival of patients with lung cancer.Methods: EMBASE, web of science, and Medline were used to search articles in English-language journals.The association between CONUT score and survival of patients with lung cancer was evaluated by using pooled HRs and their 95% CIs. Chi-square test and I-Square was used to test heterogeneity among studies.Analyses were all performed using Stata 13.0 (Stata Corporation, College Station, TX).Results: Eight studies with 1,836 patients were eventually included in this meta-analysis. The pooled results showed that high CONUT score had an unfavorable impact on OS (HR =1.63, 95% CI: 1.30-2.04),

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“…CONUT score is a comprehensive nutritional and immune index calculated from serum albumin, serum total cholesterol concentration, and peripheral TLC, as previously reported. 40 The three constituent parameters of CONUT score were scored based on the cut-off values reported in previous studies, [41][42][43] and the sum of the score was the CONUT score. Patients were stratified into four groups according to the CONUT score listed in Table 1.…”

Section: Conut Score Definition and Peripheral Blood Lymphocyte Subsementioning

confidence: 99%

<p>CONUT Score or/and Peripheral Blood CD4+/CD8+ Ratio-Based Web Dynamic Nomograms to Predict the Individualized Survival of Patients with Advanced Osteosarcoma</p>

Yang

Wang

et al. 2020

CMAR

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Background: Nutritional and immune status is paramount for the overall survival (OS) of patients with advanced osteosarcoma. Comprehensive prognostic predictors based on the two indices are scarce. This study aimed to construct and validate individualized web dynamic nomograms based on CONUT score or/and peripheral blood CD4+/CD8+ ratio for OS in patients with advanced osteosarcoma. Materials and Methods: The clinical data of 376 advanced osteosarcoma patients from January 2000 to December 2019 were retrospectively collected. Data from the 301 patients (diagnosed in the first 15 years) were used as the development set and data from the remaining 75 patients were assigned as the validation set. Multivariate Cox regression analyses were conducted and three prediction models were constructed, namely, CD4 +/CD8+ ratio univariate model (model 1), CONUT score univariate model (model 2), and CD4+/CD8+ ratio plus CONUT score (model 3). These models were visualized by conventional nomograms and individualized web dynamic nomograms, and their performances were further evaluated by C-index, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA), respectively. Results: In multivariate Cox analysis, age, metastasis, ALP, CD4+/CD8+ ratio, chemotherapy, and CONUT score were identified as independent prognostic factors for OS. The calibration curves of the three models all showed good agreement between the actual observation and nomogram prediction for 1-year overall survival. In the development set, the C-index and area under the curve (AUC) of model 3 (0.837, 0.848) were higher than that of model 1 (0.765, 0.773) and model 2 (0.712, 0.749). Similar trends were observed in the validation set. The net benefits of model 3 were better than the other two models within the threshold probability of 36-80% in DCA. Conclusion: CONUT score and peripheral CD4+/CD8+ ratio are easily available, reliable, and economical prognostic predictors for survival prediction and stratification in patients with advanced osteosarcoma, but the two predictors combined can establish a better prognosis prediction model.

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Prognostic impact of the Controlling Nutritional Status score in patients with non-small cell lung cancer treated with pembrolizumab

Cited by 32 publications

References 38 publications

Significance of inflammatory indexes in atezolizumab monotherapy outcomes in previously treated non-small-cell lung cancer patients

Significance of inflammatory indexes in atezolizumab monotherapy outcomes in previously treated non-small-cell lung cancer patients

Controlling nutritional status is a prognostic factor for patients with lung cancer: a systematic review and meta-analysis

<p>CONUT Score or/and Peripheral Blood CD4+/CD8+ Ratio-Based Web Dynamic Nomograms to Predict the Individualized Survival of Patients with Advanced Osteosarcoma</p>

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