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Carril-Ajuria L, Lavaud P, Dalban C, Negrier S, Gravis G, Motzer RJ, Chevreau C, Tannir NM, Oudard S, McDermott DF, Laguerre B, Hammers HJ, Barthelemy P, Plimack ER, Borchiellini D, Gross-Goupil M, Jiang R, Lee CW, de Silva H, Rini BI, Escudier B, Albigès L. Validation of the Lung Immune Prognostic Index (LIPI) as a prognostic biomarker in metastatic renal cell carcinoma. Eur J Cancer 2024; 204:114048. [PMID: 38653033 DOI: 10.1016/j.ejca.2024.114048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/31/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The Lung Immune Prognostic Index (LIPI) is associated with immune checkpoint inhibitors (ICI) outcomes across different solid tumors, particularly in non-small cell lung cancer. Data regarding the prognostic and/or predictive role of LIPI in metastatic renal cell carcinoma (mRCC) are still scarce. The aim of this study was to evaluate whether LIPI could be predictive of survival in mRCC patients. METHODS We used patient level data from three different prospective studies (NIVOREN trial: nivolumab; TORAVA trial: VEGF/VEGFR-targeted therapy (TT); CheckMate 214: nivolumab-ipilimumab vs sunitinib). LIPI was calculated based on a derived neutrophils/(leukocyte-neutrophil) ratio > 3 and lactate-dehydrogenase >upper limit of normal, classifying patients into three groups (LIPI good, 0 factors;LIPI intermediate (int), 1 factor;LIPI poor, 2 factors) and/or into two groups (LIPI good, 0 factors;LIPI int/poor, 1-2 factors) according to trial sample size. Primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS). RESULTS In the Nivolumab dataset (n = 619), LIPI was significantly associated with OS (LIPI-good 30.1 vs 13.8 months in the LIPI int/poor; HR= 0.47) and PFS (HR=0.74). In the VEGF/VEGFR-TT dataset (n = 159), only a correlation with PFS was observed. In the CheckMate214 dataset (n = 1084), LIPI was significantly associated with OS (nivolumab-ipilimumab OS LIPI good vs int/poor: HR=0.55, p < 0.0001; sunitinib: OS LIPI good vs int/poor: 0.38, p < 0.0001) in both treatment groups in univariate and multivariate analysis. CONCLUSIONS Pretreatment-LIPI correlated with worse survival outcomes in mRCC treated with either ICI or antiangiogenic therapy, confirming LIPI's prognostic role in mRCC irrespective of systemic treatment used.
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Affiliation(s)
| | | | - Cecile Dalban
- Department of Biostatistics, Centre Leon Bernard, Lyon, France
| | | | | | | | | | - Nizar M Tannir
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stéphane Oudard
- Hôpital Européen Georges Pompidou, Oncology department, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | | | | | | | | | | | | | - Marine Gross-Goupil
- Department of Medical Oncology, Bordeaux University Hospital, Bordeaux, France
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Riudavets M, Auclin E, Mosteiro M, Dempsey N, Majem M, Prelaj A, López-Castro R, Bosch-Barrera J, Pilotto S, Escalera E, Tagliamento M, Mosquera J, Zalcman G, Aboubakar Nana F, Ponce S, Albarrán-Artahona V, Dal Maso A, Spotti M, Mielgo X, Mussat E, Reyes R, Benítez JC, Lupinacci L, Duchemann B, De Giglio A, Blaquier JB, Audigier-Valette C, Scheffler M, Nadal E, Lopes G, Signorelli D, Garcia-Campelo R, Menis J, Bluthgen V, Campayo M, Recondo G, Besse B, Mezquita L, Planchard D. Association Between Lung Immune Prognostic Index and Durvalumab Consolidation Outcomes in Patients With Locally Advanced Non-Small-Cell Lung Cancer. Clin Lung Cancer 2024; 25:233-243.e8. [PMID: 38105153 DOI: 10.1016/j.cllc.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The LIPI, based on pretreatment derived neutrophils/[leukocytes-neutrophils] ratio (dNLR) and LDH, is associated with immune checkpoint inhibitors (ICI) outcomes in advanced non-small-cell lung cancer (NSCLC). We aimed to assess baseline LIPI correlation with durvalumab consolidation outcomes in the locally advanced setting. MATERIAL AND METHODS Multicentre retrospective study (330 patients) with stage III unresectable NSCLC treated with durvalumab after chemo-radiotherapy between April 2015 and December 2020; 65 patients treated with chemo-radiotherapy only. Baseline LIPI characterized 3 groups: good (dNLR≤3+LDH≤ULN), intermediate (dNLR>3/LDH>ULN) and poor (dNLR>3+LDH>ULN). Primary endpoint was overall survival (OS). RESULTS In the durvalumab cohort, median age was 67 years, 95% smokers, 98% with a performance status of 0-1; 60% had nonsquamous histology and 16% a PD-L1 expression <1%. Radiotherapy was delivered concurrently in 81%. LIPI was evaluable in 216 patients: 66% good, 31% intermediate, 3% poor. LIPI significantly correlated with median OS (median follow-up: 19 months): 18.1 months vs. 47.0 months vs. not reached in poor, intermediate and good LIPI groups, respectively (P = .03). A trend between objective response rate and LIPI groups was observed: 0% vs. 41% vs. 45%, respectively (P = .05). The pooled intermediate/poor LIPI group was associated with shorter OS (HR 1.97; P = .03) and higher risk of progressive disease (OR 2.68; P = .047). Survivals and response were not influenced in the control cohort. CONCLUSION Baseline LIPI correlated with outcomes in patients with locally advanced NSCLC treated with durvalumab consolidation, but not in those who only received chemo-radiotherapy, providing further evidence of its prognostic and potential predictive role of ICI benefit in NSCLC.
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Affiliation(s)
- Mariona Riudavets
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France
| | - Edouard Auclin
- Medical Oncology Department, Hôpital Européen Georges Pompidou, AP-HP Centre, Université Paris Cité, Paris, France
| | - Miguel Mosteiro
- Medical Oncology Department, Institut Català d'Oncologia - ICO Hospitalet, Barcelona, Spain
| | - Naomi Dempsey
- Medical Oncology Department, Jackson Memorial Hospital, Miami, FL
| | - Margarita Majem
- Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Arsela Prelaj
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milan, Milano, Italy
| | - Rafael López-Castro
- Medical Oncology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Joaquim Bosch-Barrera
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Josep Trueta, Girona, Spain
| | - Sara Pilotto
- Medical Oncology Department, University and Hospital Trust of Verona, Verona, Italy
| | - Elena Escalera
- Medical Oncology Department, Hospital Clínico de Salamanca, Salamanca, Spain
| | - Marco Tagliamento
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France; Internal Medicine and Medical Specialties Department, University of Genova, Genova, Italy
| | - Joaquin Mosquera
- Medical Oncology Department, Hospital Universitario A Coruña, A Coruña, Spain
| | - Gérard Zalcman
- Université Paris Cité, Thoracic Oncology Department, CIC Inserm 1425, Hôpital Bichat-Claude Bernard, Paris, France
| | | | - Santiago Ponce
- Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Víctor Albarrán-Artahona
- Medical Oncology Department, Department of Medicine, Hospital Clinic, Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Alessandro Dal Maso
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Martina Spotti
- Medical Oncology Department, Hospital Alemán, Buenos Aires, Argentina
| | - Xabier Mielgo
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Elodie Mussat
- Medical Oncology Department, Hôpital Européen Georges Pompidou, AP-HP Centre, Université Paris Cité, Paris, France
| | - Roxana Reyes
- Medical Oncology Department, Department of Medicine, Hospital Clinic, Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jose-Carlos Benítez
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France; Medical Oncology Department, Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain
| | - Lorena Lupinacci
- Medical Oncology Department, Hospital Italiano, Buenos Aires, Argentina
| | - Boris Duchemann
- Medical Oncology Department, Hôpital Avicenne, Bobigny, France
| | - Andrea De Giglio
- Medical Oncology Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Juan Bautista Blaquier
- Medical Oncology Department, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | - Matthias Scheffler
- Internal Medicine I Department, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ernest Nadal
- Medical Oncology Department, Institut Català d'Oncologia - ICO Hospitalet, Barcelona, Spain
| | - Gilberto Lopes
- Medical Oncology Department, Jackson Memorial Hospital, Miami, FL
| | - Diego Signorelli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milan, Milano, Italy; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Jessica Menis
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Virginia Bluthgen
- Medical Oncology Department, Hospital Alemán, Buenos Aires, Argentina
| | - Marc Campayo
- Medical Oncology Department, Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain
| | - Gonzalo Recondo
- Medical Oncology Department, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Benjamin Besse
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France
| | - Laura Mezquita
- Medical Oncology Department, Department of Medicine, Hospital Clinic, Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - David Planchard
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France
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Zhang L, Bonomi PD. Immune System Disorder and Cancer-Associated Cachexia. Cancers (Basel) 2024; 16:1709. [PMID: 38730660 PMCID: PMC11083538 DOI: 10.3390/cancers16091709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Cancer-associated cachexia (CAC) is a debilitating condition marked by muscle and fat loss, that is unresponsive to nutritional support and contributes significantly to morbidity and mortality in patients with cancer. Immune dysfunction, driven by cytokine imbalance, contributes to CAC progression. This review explores the potential relationship between CAC and anti-cancer immune response in pre-clinical and clinical studies. Pre-clinical studies showcase the involvement of cytokines like IL-1β, IL-6, IL-8, IFN-γ, TNF-α, and TGF-β, in CAC. IL-6 and TNF-α, interacting with muscle and adipose tissues, induce wasting through JAK/STAT and NF-κB pathways. Myeloid-derived suppressor cells (MDSCs) exacerbate CAC by promoting inflammation. Clinical studies confirm elevated pro-inflammatory cytokines (IL-6, IL-8, TNFα) and immune markers like the neutrophil-to-lymphocyte ratio (NLR) in patients with CAC. Thus, immunomodulatory mechanisms involved in CAC may impact the anti-neoplastic immune response. Inhibiting CAC mechanisms could enhance anti-cancer therapies, notably immunotherapy. R-ketorolac, a new immunomodulator, reversed the weight loss and increased survival in mice. Combining these agents with immunotherapy may benefit patients with cancer experiencing CAC. Further research is vital to understand the complex interplay between tumor-induced immune dysregulation and CAC during immunotherapy.
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Affiliation(s)
| | - Philip D. Bonomi
- Division of Hematology/Oncology, Rush University Medical Center, Chicago, IL 60612, USA;
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Ertekin SS, Mangas C, Riquelme-Mc Loughlin C, Carrera C, Malvehy J, Puig S, Podlipnik S. Prognostic Value of the Neutrophil-to-lymphocyte Ratio, Platelet-to- lymphocyte Ratio and Monocyte-to-lymphocyte Ratio in Melanoma Patients: A Cohort Study. Acta Derm Venereol 2024; 104:adv27571. [PMID: 38655656 PMCID: PMC11064678 DOI: 10.2340/actadv.v104.27571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/14/2024] [Indexed: 04/26/2024] Open
Abstract
The prognostic value of the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio in patients with melanoma has yielded controversial results in the literature. A retrospective single-centre cohort study was conducted from 1998 to 2020, including patients diagnosed with invasive melanoma. A total of 2,721 patients were included in the study. The median follow-up was 8.23 years (IQR 4.41-13.25). The median baseline neutrophil- lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio values increased significantly (p < 0.001) with the increasing American Joint Committee on Cancer stage. The optimal cut-off values for neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio were determined as 2.1, 184 and 0.2, respectively. In the multivariate analysis, high levels of neutrophil-lymphocyte ratio (≥ 2.1), platelet-lymphocyte ratio (≥ 184) and monocyte-lymphocyte ratio (≥ 0.2) were independently associated with significantly shorter melanoma-specific survival (neutrophil-lymphocyte ratio: HR 1.30, 95% CI 1.06-1.60, p = 0.013; platelet-lymphocyte ratio: HR 1.37, 95% CI 1.06-1.76, p = 0.014; monocyte- lymphocyte ratio: HR 1.29, 95% CI 1.05-1.58, p = 0.015) and overall survival (neutrophil-lymphocyte ratio: HR 1.39, 95% CI 1.19-1.64, p < 0.001; platelet- lymphocyte ratio: HR 1.44, 95% CI 1.19-1.74, p < 0.001; monocyte-lymphocyte ratio: HR 1.42, 95% CI 1.21-1.66, p < 0.001). High levels of neutrophil- lymphocyte ratio and monocyte-lymphocyte ratio were also associated with poor relapse-free survival, while platelet-lymphocyte ratio was not. In conclusion, baseline neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio were identified as independent predictors for the prognosis of melanoma.
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Affiliation(s)
- Sümeyre Seda Ertekin
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | - Cristina Mangas
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | | | - Cristina Carrera
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Josep Malvehy
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Susana Puig
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
| | - Sebastian Podlipnik
- Department of Dermatology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Mokbel S, Baciarello G, Lavaud P, Omlin A, Calabrò F, Cathomas R, Aeppli S, Parent P, Giannatempo P, Koster KL, Appel N, Gonnet P, Angius G, Tsantoulis P, Arkenau HT, Cattrini C, Messina C, Zeghondy J, Morelli C, Loriot Y, Formica V, Patrikidou A. Development and Validation of an Inflammatory Prognostic Index to Predict Outcomes in Advanced/Metastatic Urothelial Cancer Patients Receiving Immune Checkpoint Inhibitors. Cancers (Basel) 2024; 16:1465. [PMID: 38672547 PMCID: PMC11048042 DOI: 10.3390/cancers16081465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) improve overall survival (OS) in advanced/metastatic urothelial cancer (a/mUC) patients. Preliminary evidence suggests a prognostic role of inflammatory biomarkers in this setting. We aimed to develop a disease-specific prognostic inflammatory index for a/mUC patients on ICIs. METHODS Fifteen variables were retrospectively correlated with OS and progression-free survival (PFS) in a development (D, n = 264) and a validation (V, n = 132) cohort of platinum-pretreated a/mUC pts receiving ICIs at L2 or further line. A nomogram and inflammatory prognostic index (U-IPI) were developed. The index was also tested in a control cohort of patients treated with chemotherapy only (C, n = 114). RESULTS The strongest predictors of OS were baseline platelet/lymphocyte (PLR) and neutrophil/lymphocyte (NLR) ratios, and lactate dehydrogenase (LDH), NLR, and albumin changes at 4 weeks. These were used to build the U-IPI, which can distinctly classify patients into good or poor response groups. The nomogram scoring is significant for PFS and OS (p < 0.001 in the D, V, and combined cohorts) for the immunotherapy (IO) cohort, but not for the control cohort. CONCLUSIONS The lack of a baseline systemic inflammatory profile and the absence of early serum inflammatory biomarker changes are associated with significantly better outcomes on ICIs in a/mUC pts. The U-IPI is an easily applicable dynamic prognostic tool for PFS and OS, allowing for the early identification of a sub-group with dismal outcomes that would not benefit from ICIs, while distinguishing another that draws an important benefit.
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Affiliation(s)
- Sara Mokbel
- Faculty of Medicine, UCL—University College London, London WC1H 0AP, UK;
| | - Giuilia Baciarello
- Medical Oncology Department, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, Italy; (G.B.); (G.A.)
| | - Pernelle Lavaud
- Medical Oncology Department, Gustave Roussy Cancer Campus, 94805 Villejuif, France; (P.L.); (J.Z.); (Y.L.)
| | - Aurelius Omlin
- Medical Oncology and Haematology Department, OnkoZentrum Zürich, 8038 Zurich, Switzerland;
| | - Fabio Calabrò
- Medical Oncology 1, IRCCS National Cancer Institute Regina Elena, 00144 Rome, Italy; (F.C.)
| | - Richard Cathomas
- Medical Oncology 1, IRCCS National Cancer Institute Regina Elena, 00144 Rome, Italy; (F.C.)
| | - Stefanie Aeppli
- Department of Medical Oncology and Haematology, Cantonal Hospital St.Gallen, 9000 St. Gallen, Switzerland; (S.A.); (K.-L.K.)
| | - Pauline Parent
- Medical Oncology Departement, CHU Lille—Centre Hospitalier Régional Universitaire de Lille, 59000 Lille, France;
| | - Patrizia Giannatempo
- Medical Oncology Department, Fondazione IRCCS—Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Kira-Lee Koster
- Department of Medical Oncology and Haematology, Cantonal Hospital St.Gallen, 9000 St. Gallen, Switzerland; (S.A.); (K.-L.K.)
| | - Naara Appel
- Medical Oncology Departement, HUG—Hopitaux Universitaires Geneve, 1205 Geneva, Switzerland; (N.A.); (P.G.)
| | - Philippe Gonnet
- Medical Oncology Departement, HUG—Hopitaux Universitaires Geneve, 1205 Geneva, Switzerland; (N.A.); (P.G.)
| | - Gesuino Angius
- Medical Oncology Department, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, Italy; (G.B.); (G.A.)
| | - Petros Tsantoulis
- Medical Oncology Departement, HUG—Hopitaux Universitaires Geneve, 1205 Geneva, Switzerland; (N.A.); (P.G.)
| | | | - Carlo Cattrini
- Maggiore della Carità University Hospital, 28100 Novara, Italy;
| | | | - Jean Zeghondy
- Medical Oncology Department, Gustave Roussy Cancer Campus, 94805 Villejuif, France; (P.L.); (J.Z.); (Y.L.)
| | - Cristina Morelli
- Medical Oncology Unit, Policlinico Tor Vergata, 00133 Rome, Italy; (C.M.); (V.F.)
| | - Yohann Loriot
- Medical Oncology Department, Gustave Roussy Cancer Campus, 94805 Villejuif, France; (P.L.); (J.Z.); (Y.L.)
| | - Vincenzo Formica
- Medical Oncology Unit, Policlinico Tor Vergata, 00133 Rome, Italy; (C.M.); (V.F.)
| | - Anna Patrikidou
- Medical Oncology Department, Gustave Roussy Cancer Campus, 94805 Villejuif, France; (P.L.); (J.Z.); (Y.L.)
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Butner JD, Dogra P, Chung C, Koay EJ, Welsh JW, Hong DS, Cristini V, Wang Z. Hybridizing mechanistic mathematical modeling with deep learning methods to predict individual cancer patient survival after immune checkpoint inhibitor therapy. RESEARCH SQUARE 2024:rs.3.rs-4151883. [PMID: 38586046 PMCID: PMC10996814 DOI: 10.21203/rs.3.rs-4151883/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
We present a study where predictive mechanistic modeling is used in combination with deep learning methods to predict individual patient survival probabilities under immune checkpoint inhibitor (ICI) therapy. This hybrid approach enables prediction based on both measures that are calculable from mechanistic models (but may not be directly measurable in the clinic) and easily measurable quantities or characteristics (that are not always readily incorporated into predictive mechanistic models). The mechanistic model we have applied here can predict tumor response from CT or MRI imaging based on key mechanisms underlying checkpoint inhibitor therapy, and in the present work, its parameters were combined with readily-available clinical measures from 93 patients into a hybrid training set for a deep learning time-to-event predictive model. Analysis revealed that training an artificial neural network with both mechanistic modeling-derived and clinical measures achieved higher per-patient predictive accuracy based on event-time concordance, Brier score, and negative binomial log-likelihood-based criteria than when only mechanistic model-derived values or only clinical data were used. Feature importance analysis revealed that both clinical and model-derived parameters play prominent roles in neural network decision making, and in increasing prediction accuracy, further supporting the advantage of our hybrid approach. We anticipate that many existing mechanistic models may be hybridized with deep learning methods in a similar manner to improve predictive accuracy through addition of additional data that may not be readily implemented in mechanistic descriptions.
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Affiliation(s)
- Joseph D Butner
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Institute for Data Science in Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Master in Clinical Translation Management Program, The Cameron School of Business, University of St. Thomas, Houston, TX 77006, USA
| | - Prashant Dogra
- Mathematics in Medicine Program, Houston Methodist Research Institute, Houston, TX 77030, USA
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10065, USA
| | - Caroline Chung
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Institute for Data Science in Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Eugene J Koay
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - James W Welsh
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - David S Hong
- Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas 77230, USA
| | - Vittorio Cristini
- Mathematics in Medicine Program, Houston Methodist Research Institute, Houston, TX 77030, USA
- Neal Cancer Center, Houston Methodist Research Institute, Houston, TX 77030, USA
- Physiology, Biophysics, and Systems Biology Program, Graduate School of Medical Sciences, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX 77230, USA
| | - Zhihui Wang
- Mathematics in Medicine Program, Houston Methodist Research Institute, Houston, TX 77030, USA
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10065, USA
- Neal Cancer Center, Houston Methodist Research Institute, Houston, TX 77030, USA
- Department of Medical Education, Texas A&M University School of Medicine, Bryan, TX 77807, USA
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7
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Habib S, Osborn G, Willsmore Z, Chew MW, Jakubow S, Fitzpatrick A, Wu Y, Sinha K, Lloyd-Hughes H, Geh JLC, MacKenzie-Ross AD, Whittaker S, Sanz-Moreno V, Lacy KE, Karagiannis SN, Adams R. Tumor associated macrophages as key contributors and targets in current and future therapies for melanoma. Expert Rev Clin Immunol 2024:1-17. [PMID: 38533720 DOI: 10.1080/1744666x.2024.2326626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/29/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION Despite the success of immunotherapies for melanoma in recent years, there remains a significant proportion of patients who do not yet derive benefit from available treatments. Immunotherapies currently licensed for clinical use target the adaptive immune system, focussing on Tcell interactions and functions. However, the most prevalent immune cells within the tumor microenvironment (TME) of melanoma are macrophages, a diverse immune cell subset displaying high plasticity, to which no current therapies are yet directly targeted. Macrophages have been shown not only to activate the adaptive immune response, and enhance cancer cell killing, but, when influenced by factors within the TME of melanoma, these cells also promote melanoma tumorigenesis and metastasis. AREAS COVERED We present a review of the most up-to-date literatureavailable on PubMed, focussing on studies from within the last 10 years. We also include data from ongoing and recent clinical trials targeting macrophages in melanoma listed on clinicaltrials.gov. EXPERT OPINION Understanding the multifaceted role of macrophages in melanoma, including their interactions with immune and cancer cells, the influence of current therapies on macrophage phenotype and functions and how macrophages could be targeted with novel treatment approaches, are all critical for improving outcomes for patients with melanoma.
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Affiliation(s)
- Shabana Habib
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
| | - Gabriel Osborn
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
| | - Zena Willsmore
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
| | - Min Waye Chew
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
| | - Sophie Jakubow
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
| | - Amanda Fitzpatrick
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
- Oncology Department, Guy's and St Thomas' Hospital, London, UK
- Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Innovation Hub, Guy's Hospital, London, UK
| | - Yin Wu
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
- Oncology Department, Guy's and St Thomas' Hospital, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Khushboo Sinha
- St John's Institute of Dermatology, Guy's, King's and St. Thomas' Hospitals NHS Foundation Trust, London, England
| | - Hawys Lloyd-Hughes
- Department of Plastic Surgery, Guy's, King's and St. Thomas' Hospitals, London, England
| | - Jenny L C Geh
- St John's Institute of Dermatology, Guy's, King's and St. Thomas' Hospitals NHS Foundation Trust, London, England
- Department of Plastic Surgery, Guy's, King's and St. Thomas' Hospitals, London, England
| | | | - Sean Whittaker
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
| | - Victoria Sanz-Moreno
- The Breast Cancer Now Toby Robins Research Centre, Division of Breast Cancer Research, The Institute of Cancer Research, London
| | - Katie E Lacy
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
| | - Sophia N Karagiannis
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
- Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Innovation Hub, Guy's Hospital, London, UK
| | - Rebecca Adams
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, UK
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8
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Kopecký J, Pásek M, Lakomý R, Melichar B, Mrazová I, Kubeček O, Arenbergerová M, Lemstrová R, Švancarová A, Tretera V, Hlodáková A, Žváčková K. The outcome in patients with BRAF-mutated metastatic melanoma treated with anti-programmed death receptor-1 monotherapy or targeted therapy in the real-world setting. Cancer Med 2024; 13:e6982. [PMID: 38491825 PMCID: PMC10943370 DOI: 10.1002/cam4.6982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/24/2023] [Accepted: 01/15/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Immunotherapy and targeted therapy are currently two alternative backbones in the therapy of BRAF-mutated malignant melanoma. However, predictive biomarkers that would help with treatment selection are lacking. METHODS This retrospective study investigated outcomes of anti-programmed death receptor-1 monotherapy and targeted therapy in the first-line setting in patients with metastatic BRAF-mutated melanoma, focusing on clinical and laboratory parameters associated with treatment outcome. RESULTS Data from 174 patients were analysed. The median progression-free survival (PFS) was 17.0 months (95% CI; 8-39) and 12.5 months (95% CI; 9-14.2) for immunotherapy and targeted therapy, respectively. The 3-year PFS rate was 39% for immunotherapy and 25% for targeted therapy. The objective response rate was 72% and 51% for targeted therapy and immunotherapy. The median overall (OS) survival for immunotherapy has not been reached and was 23.6 months (95% CI; 16.1-38.2) for targeted therapy, with a 3-year survival rate of 63% and 40%, respectively. In a univariate analysis, age < 70 years, a higher number of metastatic sites, elevated serum LDH and a neutrophil-lymphocyte ratio above the cut-off value were associated with inferior PFS regardless of the therapy received, but only serum LDH level and the presence of lung metastases remained significant predictors of PFS in a multivariate analysis. CONCLUSIONS Present real-world data document the high effectiveness of immunotherapy and targeted therapy. Although targeted therapy had higher response rates, immunotherapy improved PFS and OS. While the prognostic value of LDH was confirmed, the potential use of blood cell count-derived parameters to predict outcomes needs further investigation.
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Affiliation(s)
- Jindřich Kopecký
- Department of Clinical Radiotherapy and OncologyUniversity Hospital in Hradec KraloveHradec KraloveCzech Republic
| | - Marek Pásek
- Department of Dermatovenereology, Third Faculty of MedicineCharles University and Kralovske Vinohrady University HospitalPragueCzech Republic
| | - Radek Lakomý
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of MedicineMasaryk UniversityBrnoCzech Republic
| | - Bohuslav Melichar
- Department of Oncology, Faculty of Medicine and DentistryPalacký University and University HospitalOlomoucCzech Republic
| | - Ivona Mrazová
- Department of OncologyCounty HospitalČeské BudějoviceCzech Republic
| | - Ondřej Kubeček
- Department of Clinical Radiotherapy and OncologyUniversity Hospital in Hradec KraloveHradec KraloveCzech Republic
| | - Monika Arenbergerová
- Department of Dermatovenereology, Third Faculty of MedicineCharles University and Kralovske Vinohrady University HospitalPragueCzech Republic
| | - Radmila Lemstrová
- Department of Oncology, Faculty of Medicine and DentistryPalacký University and University HospitalOlomoucCzech Republic
| | - Alžběta Švancarová
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of MedicineMasaryk UniversityBrnoCzech Republic
| | - Vojtěch Tretera
- Department of Dermatovenereology, Third Faculty of MedicineCharles University and Kralovske Vinohrady University HospitalPragueCzech Republic
| | - Alžběta Hlodáková
- Department of Clinical Radiotherapy and OncologyUniversity Hospital in Hradec KraloveHradec KraloveCzech Republic
| | - Kamila Žváčková
- Department of Oncology, Faculty of Medicine and DentistryPalacký University and University HospitalOlomoucCzech Republic
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9
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Liu X, Liu S, Jiang Z, Yang C, Yang X, Li J, Liu H. Peripheral B-cell levels predict efficacy and overall survival in advanced melanoma patients under PD-1 immunotherapy. Immunotherapy 2024; 16:223-234. [PMID: 38126156 DOI: 10.2217/imt-2023-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Aims: Programmed death-1 (PD-1) blockade is a vital therapy for solid tumors, but not all patients benefit. Identifying which patients will benefit from immunotherapy is a key focus in oncology research. Patients & Methods: This study analyzed the correlation between the number of peripheral lymphocytes and the efficacy and prognosis of immunotherapy in advanced malignant melanoma. Results: Patients with a partial response had significantly lower peripheral B cell levels, and patients with a lower number of B lymphocytes had a longer survival time. Conclusion: These results suggest that peripheral B cells are correlated with the efficacy of PD-1 antibody and prognosis and are thus potential biomarkers for the efficacy and prognosis of PD-1 antibody immunotherapy in malignant melanoma.
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Affiliation(s)
- Xiaoli Liu
- Department of Integrated Traditional Chinese & Western Medicine, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Shuochuan Liu
- Henan Breast Cancer Centre, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Zhiqiang Jiang
- Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Chengliang Yang
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Xuchu Yang
- Department of Integrated Traditional Chinese & Western Medicine, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Jia Li
- Department of Integrated Traditional Chinese & Western Medicine, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Huaimin Liu
- Department of Integrated Traditional Chinese & Western Medicine, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
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10
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Shimoyama R, Imamura Y, Uryu K, Mase T, Shiragami M, Fujimura Y, Hayashi M, Ohtaki M, Ohtani K, Shinozaki N, Minami H. Inflammation‑based prognostic markers of metastatic pancreatic cancer using real‑world data in Japan: The Tokushukai REAl‑world Data (TREAD) project. Oncol Lett 2024; 27:136. [PMID: 38357476 PMCID: PMC10865166 DOI: 10.3892/ol.2024.14269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Inflammation-based prognostic markers based on a combination of blood-based parameters, including the modified Glasgow prognostic score (mGPS), have been associated with clinical outcomes in patients with various types of cancer. The present study aimed to evaluate and compare the accuracy of these previously reported markers in patients with metastatic pancreatic cancer receiving first-line chemotherapy. A total of 846 patients were identified between April 2010 and March 2020 as part of a nationwide real-world study from 46 Tokushukai medical group hospitals in Japan. Blood laboratory data collected within 14 days of starting first-line chemotherapy assessed 17 inflammation-based prognostic markers. Information from patients with no missing data was used to compare the accuracy and performance of the inflammation-based prognostic markers. A total of 487 patients were eligible for this supplemental analysis. The 17 inflammation-based markers demonstrated significant prognostic value. Among them, the concordance rate with overall survival (OS) was highest for mGPS. The median OS time of patients with mGPS 0, 1 and 2 was 8.2, 6.0 and 2.9 months, respectively. Compared with mGPS 0, mGPS 1 and 2 showed hazard ratios of 1.39 (95% confidence interval, 1.07-1.81) and 2.63 (2.00-3.45), respectively. The present real-world data analysis showed that various previously reported inflammation-based markers had significant prognostic value in patients with metastatic pancreatic cancer. Among these markers, the mGPS demonstrated the highest level of accuracy. This trial has been registered in the University Hospital Medical Information Network Clinical Trials Registry as UMIN000050590 on April 1, 2023.
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Affiliation(s)
- Rai Shimoyama
- Department of General Surgery, Shonan Kamakura General Hospital, Kamakura, Kanagawa 247-8533, Japan
| | - Yoshinori Imamura
- Department of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Kiyoaki Uryu
- Department of Medical Oncology, Yao Tokushukai General Hospital, Osaka 581-0011, Japan
| | - Takahiro Mase
- Department of Breast Surgery, Ogaki Tokushukai Hospital, Ogaki, Gifu 503-0015, Japan
| | | | | | - Maki Hayashi
- Mirai Iryo Research Center Inc., Tokyo 102-0074, Japan
| | - Megu Ohtaki
- deCult Co., Ltd., Hatsukaichi, Hiroshima 739-0413, Japan
| | - Keiko Ohtani
- deCult Co., Ltd., Hatsukaichi, Hiroshima 739-0413, Japan
| | - Nobuaki Shinozaki
- Department of General Surgery, Shonan Kamakura General Hospital, Kamakura, Kanagawa 247-8533, Japan
| | - Hironobu Minami
- Department of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
- Cancer Center, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
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11
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Losurdo A, Dipasquale A, Giordano L, Persico P, Lorenzi E, Di Muzio A, Barigazzi C, Korolewicz J, Mehan A, Mohammed O, Scheiner B, Pinato DJ, Santoro A, Simonelli M. Refining patient selection for next-generation immunotherapeutic early-phase clinical trials with a novel and externally validated prognostic nomogram. Front Immunol 2024; 15:1323151. [PMID: 38298193 PMCID: PMC10828843 DOI: 10.3389/fimmu.2024.1323151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024] Open
Abstract
Introduction Identifying which patient may benefit from immunotherapeutic early-phase clinical trials is an unmet need in drug development. Among several proposed prognostic scores, none has been validated in patients receiving immunomodulating agents (IMAs)-based combinations. Patients and methods We retrospectively collected data of 208 patients enrolled in early-phase clinical trials investigating IMAs at our Institution, correlating clinical and blood-based variables with overall survival (OS). A retrospective cohort of 50 patients treated with IMAs at Imperial College (Hammersmith Hospital, London, UK) was used for validation. Results A total of 173 subjects were selected for analyses. Most frequent cancers included non-small cell lung cancer (26%), hepatocellular carcinoma (21.5%) and glioblastoma (13%). Multivariate analysis (MVA) revealed 3 factors to be independently associated with OS: line of treatment (second and third vs subsequent, HR 0.61, 95% CI 0.40-0.93, p 0.02), serum albumin as continuous variable (HR 0.57, 95% CI 0.36-0.91, p 0.02) and number of metastatic sites (<3 vs ≥3, HR 0.68, 95% CI 0.48-0.98, p 0.04). After splitting albumin value at the median (3.84 g/dL), a score system was capable of stratifying patients in 3 groups with significantly different OS (p<0.0001). Relationship with OS reproduced in the external cohort (p=0.008). Then, from these factors we built a nomogram. Conclusions Prior treatment, serum albumin and number of metastatic sites are readily available prognostic traits in patients with advanced malignancies participating into immunotherapy early-phase trials. Combination of these factors can optimize patient selection at study enrollment, maximizing therapeutic intent.
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Affiliation(s)
- Agnese Losurdo
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Angelo Dipasquale
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Laura Giordano
- Biostatistic Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Pasquale Persico
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Elena Lorenzi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Antonio Di Muzio
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Chiara Barigazzi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - James Korolewicz
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Aman Mehan
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Oreoluwa Mohammed
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Benhard Scheiner
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - David J. Pinato
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
- Division of Oncology, Department of Translational Medicine (DIMET), Università del Piemonte Orientale A. Avogadro, Novara, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Matteo Simonelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
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12
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Hou K, Ye W, Huang Q, Li W, Tan Z, Tao N, Yang D, Lin H, Deng Z, Xia Y, Yu G. The predictive value of peripheral blood CD4 cells ATP concentration for immune-related adverse events in advanced non-small cell lung cancer patients. BMC Immunol 2024; 25:3. [PMID: 38184521 PMCID: PMC10771702 DOI: 10.1186/s12865-023-00592-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/13/2023] [Indexed: 01/08/2024] Open
Abstract
OBJECTIVE Lung cancer with the highest incidence and mortality in the world. Immune checkpoint inhibitors (ICIs), can bring long-term survival benefits to patients, but also can bring immune-related adverse events (irAEs) in some patients during therapy. Therefore, the aim of this study was to investigate the predictive effect of peripheral blood WBC, NLR, sATPCD4 and nATPCD4 on irAEs in advanced non-small cell lung cancer (NSCLC). METHODS Clinical data of 112 patients with advanced NSCLC who were treated with PD -1/PD -L1 inhibitor in the Fifth Affiliated Hospital of Guangzhou Medical University from December 15, 2019 to April 30, 2023 were retrospectively analyzed. These patients were divided into the irAEs group (n = 27) and non-irAEs group (n = 85). The clinical data of the two groups were compared. Receiver operating characteristic (ROC) curves were drawn to determine the threshold value of baseline peripheral blood parameters to predict the occurrence of irAEs. Multivariate logistic regression analysis was used to explore the relationship between peripheral blood markers and the incidence of irAEs. RESULTS The patient characteristics have no significant difference between irAEs and non-irAEs group. But the baseline peripheral blood WBC, sATPCD4 and nATPCD4 of patients in the irAEs group were higher than those in the non-irAEs group (p < 0.05), and the NLR in irAEs group was similar to in the non-irAEs group (p = 0.639).Univariate analysis showed that high WBC, sATPCD4 and nATPCD4 may the risk factors for the occurrence of irAEs (p < 0.05). Multivariate logistic regression analysis showed that high sATPCD4 and nATPCD4 were independent risk factors for the occurrence of irAEs (p < 0.05). The best critical values of WBC, sATPCD4 and nATPCD4 before treatment for predicting the occurrence of irAEs were 8.165 × 109cells/L (AUC = 0.705) ,484.5 ng/mL (AUC = 0.777), and 156 ng/mL (AUC = 0.840), respectively. CONCLUSIONS sATPCD4 and nATPCD4 were independent risk factors for the occurrence of irAEs in advanced NSCLC patients. This discovery provides a new method to predict the occurrence of irAEs in patients. Based on the prediction results, corresponding treatment measures can be taken to reduce the incidence of adverse events.
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Affiliation(s)
- Kailian Hou
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Weipeng Ye
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Qunfeng Huang
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Weiyi Li
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Zhiqiong Tan
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Na Tao
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Dongheng Yang
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Haoxin Lin
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Zihao Deng
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Yuanyuan Xia
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China
| | - Guifang Yu
- Department of Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou, 510700, China.
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13
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Zattarin E, Mariani L, Menichetti A, Leporati R, Provenzano L, Ligorio F, Fucà G, Lobefaro R, Lalli L, Vingiani A, Nichetti F, Griguolo G, Sirico M, Bernocchi O, Marra A, Corti C, Zagami P, Agostinetto E, Jacobs F, Di Mauro P, Presti D, Sposetti C, Giorgi CA, Guarneri V, Pedersini R, Losurdo A, Generali D, Curigliano G, Pruneri G, de Braud F, Dieci MV, Vernieri C. Peripheral blood lymphocytes predict clinical outcomes in hormone receptor-positive HER2-negative advanced breast cancer patients treated with CDK4/6 inhibitors. Ther Adv Med Oncol 2023; 15:17588359231204857. [PMID: 38130467 PMCID: PMC10734364 DOI: 10.1177/17588359231204857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/14/2023] [Indexed: 12/23/2023] Open
Abstract
Background Cyclin-Dependent Kinase 4/6 inhibitors (CDK4/6i) combined with Endocrine Therapy (ET) are the standard treatment for patients with Hormone Receptor-positive/HER2-negative advanced breast cancer (HR+/HER2- aBC). Objectives While CDK4/6i are known to reduce several peripheral blood cells, such as neutrophils, lymphocytes and platelets, the impact of these modulations on clinical outcomes is unknown. Design A multicenter, retrospective-prospective Italian study. Methods We investigated the association between baseline peripheral blood cells, or their early modifications (i.e. 2 weeks after treatment initiation), and the progression-free survival (PFS) of HR+/HER2- aBC patients treated with ETs plus CDK4/6i. Random Forest models were used to select covariates associated with patient PFS among a large list of patient- and tumor-related variables. Results We evaluated 638 HR+/HER2- aBC patients treated with ET plus CDK4/6i at six Italian Institutions between January 2017 and May 2021. High baseline lymphocyte counts were independently associated with longer PFS [median PFS (mPFS) 20.1 versus 13.2 months in high versus low lymphocyte patients, respectively; adjusted Hazard Ratio (aHR): 0.78; 95% confidence interval (CI): 0.66-0.92; p = 0.0144]. Moreover, patients experiencing a lower early reduction of lymphocyte counts had significantly longer PFS when compared to patients undergoing higher lymphocyte decrease (mPFS 18.1 versus 14.5 months; aHR: 0.82; 95% CI: 0.73-0.93; p = 0.0037). Patients with high baseline lymphocytes and undergoing a lower reduction, or even an increase, of lymphocyte counts during CDK4/6i therapy experienced the longest PFS, while patients with lower baseline lymphocytes and undergoing a higher decrease of lymphocytes had the lowest PFS (mPFS 21.4 versus 11 months, respectively). Conclusion Baseline and on-treatment modifications of peripheral blood lymphocytes have independent prognostic value in HR+/HER2- aBC patients. This study supports the implementation of clinical strategies to boost antitumor immunity in patients with HR+/HER2- aBC treated with ETs plus CDK4/6i.
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Affiliation(s)
- Emma Zattarin
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigi Mariani
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alice Menichetti
- Oncology 2, Istituto Oncologico Veneto IOV – IRCCS, Padova, Italy
| | - Rita Leporati
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Leonardo Provenzano
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesca Ligorio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- IFOM ETS, the AIRC Institute of Molecular Oncology, Milan, Italy
| | - Giovanni Fucà
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Riccardo Lobefaro
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luca Lalli
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Vingiani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Federico Nichetti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Computational Oncology, Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gaia Griguolo
- Oncology 2, Istituto Oncologico Veneto IOV – IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | | | - Antonio Marra
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chiara Corti
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paola Zagami
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elisa Agostinetto
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Institut Jules Bordet and l’Université Libre de Bruxelles, Bruxelles, Belgium
| | - Flavia Jacobs
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Daniele Presti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Caterina Sposetti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Valentina Guarneri
- Oncology 2, Istituto Oncologico Veneto IOV – IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | | | - Agnese Losurdo
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Daniele Generali
- Breast Cancer Unit & Translational Research Unit, ASST Cremona, Cremona, Italy
- Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giancarlo Pruneri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Maria Vittoria Dieci
- Oncology 2, Istituto Oncologico Veneto IOV – IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | - Claudio Vernieri
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milan 20133, Italy IFOM ETS, the AIRC Institute of Molecular Oncology, Milan, Italy
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Sekido K, Imaue S, Tachinami H, Tomihara K, Naruto N, Yamagishi K, Ikeda A, Fujiwara K, Noguchi M. Successful treatment with nivolumab in a patient with unresectable oral squamous cell carcinoma following ineffective chemoradiotherapy. Clin Case Rep 2023; 11:e8219. [PMID: 38033699 PMCID: PMC10683031 DOI: 10.1002/ccr3.8219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 12/02/2023] Open
Abstract
Key clinical message Nivolumab has been clinically successful in prolonging the overall survival of patients with recurrent and metastatic head and neck cancer, complete remission is rare. Synergistic combinations of immunotherapy and conventional cancer treatments, such as radiotherapy or chemotherapy, are likely to be the most viable strategies for improving patient responses. Abstract Immune checkpoint inhibitors have revolutionized recurrent, metastatic oral cancer treatment; however complete remission in advanced stages is unusual. We present a case of complete remission of advanced oral squamous cell carcinoma for >4 years in a 64-year-old Japanese woman, that responded poorly to chemoradiotherapy but well to subsequent nivolumab treatment.
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Affiliation(s)
- Katsuhisa Sekido
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic AssemblyUniversity of Toyama 2630 SugitaniToyama CityJapan
- Department of Oral and Maxillofacial SurgeryToyama Red Cross HospitalToyama CityJapan
| | - Shuichi Imaue
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic AssemblyUniversity of Toyama 2630 SugitaniToyama CityJapan
| | - Hidetake Tachinami
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic AssemblyUniversity of Toyama 2630 SugitaniToyama CityJapan
| | - Kei Tomihara
- Divisions of Oral and Maxillofacial SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Norihito Naruto
- Department of Radiology, Faculty of Medicine, Academic AssemblyUniversity of ToyamaToyama CityJapan
| | - Kentaro Yamagishi
- Department of Radiology, Faculty of Medicine, Academic AssemblyUniversity of ToyamaToyama CityJapan
| | - Atsushi Ikeda
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic AssemblyUniversity of Toyama 2630 SugitaniToyama CityJapan
| | - Kumiko Fujiwara
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of MedicineOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Makoto Noguchi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic AssemblyUniversity of Toyama 2630 SugitaniToyama CityJapan
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15
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Pozorski V, Park Y, Mohamoud Y, Tesfamichael D, Emamekhoo H, Birbrair A, Albertini MR, Ma VT. Neutrophil-to-eosinophil ratio as a biomarker for clinical outcomes in advanced stage melanoma patients treated with anti-PD-1 therapy. Pigment Cell Melanoma Res 2023; 36:501-511. [PMID: 37903733 DOI: 10.1111/pcmr.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/08/2023] [Accepted: 06/20/2023] [Indexed: 11/01/2023]
Abstract
Neutrophil-to-lymphocyte ratios (NLR) and eosinophil counts are associated with improved survival in melanoma patients treated with immune checkpoint inhibitors, but no study has investigated neutrophil-to-eosinophil ratios (NER) as a predictive indicator in this population. In this retrospective study evaluating anti-PD-1 treated patients with advanced melanoma, progression-free survival (PFS), overall survival (OS), objective response rates (ORR), and risk of high-grade (grade ≥3) immune-related adverse events (irAEs) were compared between groups defined by median pretreatment NLR and NER as well as median NLR and NER at 1-month post-treatment. Lower baseline NLR and NER were associated with improved OS [HR: 0.504, 95% CI: 0.328-0.773, p = .002 and HR: 0.442, 95% CI: 0.288-0.681, p < .001, respectively] on univariate testing. After accounting for multiple covariates, our multivariate analysis found that lower pretreatment NER was associated with better ORR (by irRECIST) (OR: 2.199, 95% CI: 1.071-4.582, p = .033) and improved OS (HR: 0.480, 95% CI: 0.296-0.777, p = .003). Baseline NLR, 1-month NLR, and 1-month NER were not associated with ORR, PFS, or OS outcomes; but 1-month NER correlated with lower risk of grade ≥3 irAEs (OR: 0.392, 95% CI: 0.165-0.895, p = .029). Our findings suggest baseline NER merits additional investigation as a novel prognostic marker for advanced melanoma patients receiving anti-PD-1-based regimens.
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Affiliation(s)
- Vincent Pozorski
- University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Yeonhee Park
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Yusuf Mohamoud
- University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Dahlia Tesfamichael
- University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Hamid Emamekhoo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Internal Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Alexander Birbrair
- University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
- Department of Dermatology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Mark R Albertini
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Internal Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Dermatology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- William S. Middleton Memorial Veterans Hospital, Madison, Wisonsin, USA
| | - Vincent T Ma
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Internal Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Dermatology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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16
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Liang S, Wang H, Tian H, Xu Z, Wu M, Hua D, Li C. The prognostic biological markers of immunotherapy for non-small cell lung cancer: current landscape and future perspective. Front Immunol 2023; 14:1249980. [PMID: 37753089 PMCID: PMC10518408 DOI: 10.3389/fimmu.2023.1249980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
The emergence of immunotherapy, particularly programmed cell death 1 (PD-1) and programmed cell death ligand-1 (PD-L1) produced profound transformations for treating non-small cell lung cancer (NSCLC). Nevertheless, not all NSCLC patients can benefit from immunotherapy in clinical practice. In addition to limited response rates, exorbitant treatment costs, and the substantial threats involved with immune-related adverse events, the intricate interplay between long-term survival outcomes and early disease progression, including early immune hyperprogression, remains unclear. Consequently, there is an urgent imperative to identify robust predictive and prognostic biological markers, which not only possess the potential to accurately forecast the therapeutic efficacy of immunotherapy in NSCLC but also facilitate the identification of patient subgroups amenable to personalized treatment approaches. Furthermore, this advancement in patient stratification based on certain biological markers can also provide invaluable support for the management of immunotherapy in NSCLC patients. Hence, in this review, we comprehensively examine the current landscape of individual biological markers, including PD-L1 expression, tumor mutational burden, hematological biological markers, and gene mutations, while also exploring the potential of combined biological markers encompassing radiological and radiomic markers, as well as prediction models that have the potential to better predict responders to immunotherapy in NSCLC with an emphasis on some directions that warrant further investigation which can also deepen the understanding of clinicians and provide a reference for clinical practice.
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Affiliation(s)
- Shuai Liang
- Department of Oncology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Hanyu Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Haixia Tian
- Department of Oncology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Zhicheng Xu
- Department of Oncology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Min Wu
- Suzhou Cancer Center Core Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Dong Hua
- Department of Oncology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Chengming Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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17
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Mallardo D, Fordellone M, White A, Ottaviano M, Sparano F, Bailey M, Facchini AB, Ong S, Maiolino P, Caracò C, Church S, Cavalcanti E, Warren S, Budillon A, Cesano A, Simeone E, Chiodini P, Ascierto PA. CD39 and LDHA affects the prognostic role of NLR in metastatic melanoma patients treated with immunotherapy. J Transl Med 2023; 21:610. [PMID: 37684649 PMCID: PMC10492378 DOI: 10.1186/s12967-023-04419-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/05/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Identifying response markers is highly needed to guide the treatment strategy in patients with metastatic melanoma. METHODS A retrospective study was carried out in patients with unresectable/metastatic melanoma (stage IIIb-IV), treated with anti-PD-1 in the first line setting, to better explore the role and the timing of neutrophil/lymphocyte ratio (NLR) as potential biomarker of response. The relationship of NLR with inflammation-immune mediators and the underlying negative effect of raising NLR during immunotherapy, have been investigated with transcriptomic gene analysis. RESULTS The results confirmed previous findings that a high baseline NLR is associated with a poorer prognosis and with higher serum level of lactate dehydrogenase (LDH), regardless of the presence of brain metastases. The transcriptomic analysis showed that high baseline NLR is associated with a characteristic gene signature CCNA1, LDHA and IL18R1, which correlates with inflammation and tumorigenesis. Conversely, low baseline NLR is associated with the signature CD3, SH2D1A, ZAP70 and CD45RA, linked to the immune-activation. The genes positively associated with NLR (CD39 (ENTPD1), PTEN, MYD88, MMP9 and LDH) are involved in processes of immunosuppression, inflammation and tumor-promoting activity. Increased expression of CD39 correlated with TGFβ2, a marker of the N2 neutrophils with immunosuppressive activity. CONCLUSIONS These results suggest that increasing NLR is associated with an increased neutrophil population, with polarization to the N2 phenotype, and this process may be the basis for the negatively prognostic role of NLR.
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Affiliation(s)
- Domenico Mallardo
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Mario Fordellone
- Universitiy of Campania "Luigi Vanvitelli", 81100, Naples, Italy
| | | | | | - Francesca Sparano
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | | | | | - Sufey Ong
- NanoString Technologies Inc, Seattle, WA, USA
| | - Piera Maiolino
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Corrado Caracò
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | | | | | | | - Alfredo Budillon
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | | | - Ester Simeone
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Paolo Chiodini
- Universitiy of Campania "Luigi Vanvitelli", 81100, Naples, Italy
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18
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Gou M, Zhang Y, Qu T, Jia R, Wang Z, Dai G. Prognostic value of the Lung Immune Prognostic Index for HER-2-negative metastatic gastric cancer. Biomark Med 2023; 17:711-721. [PMID: 38085163 DOI: 10.2217/bmm-2023-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Background: The aim of this study was to explore whether the Lung Immune Prognostic Index (LIPI) is associated with clinical outcomes in patients with metastatic gastric cancer (MGC) treated with anti-PD-1 and chemotherapy. Methods: Patients with MGC treated with an anti-PD-1 therapy or chemotherapy were enrolled. This study was composed of two cohorts including 266 patients in the anti-PD-1-treated group and 139 patients in the chemotherapy-treated group. Results: Patients treated with anti-PD-1 therapy that also showed a good LIPI showed a longer median progression-free survival and median overall survival in patients with an intermediate or poor LIPI. These outcomes were not observed in the chemotherapy cohort. Conclusion: Good LIPI correlated with better outcomes for patients with MGC in the anti-PD-1-treated group but not in the chemotherapy-treated group.
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Affiliation(s)
- Miaomiao Gou
- Medical Oncology Department, the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yong Zhang
- Medical Oncology Department, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Tongtong Qu
- Medical Oncology Department, the Fifth Affiliated Hospital Sun YAT-SEN University, Zhuhan, China
| | - Ru Jia
- Medical Oncology Department, the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zhikuan Wang
- Medical Oncology Department, the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Guanghai Dai
- Medical Oncology Department, the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
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19
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Imai H, Wasamoto S, Tsuda T, Nagai Y, Kishikawa T, Masubuchi K, Osaki T, Miura Y, Umeda Y, Ono A, Minemura H, Yamada Y, Nakagawa J, Kozu Y, Taniguchi H, Ohta H, Kasai T, Kaira K, Kagamu H. Using the neutrophil-to-lymphocyte ratio to predict the outcome of individuals with nonsquamous non-small cell lung cancer receiving pembrolizumab plus platinum and pemetrexed. Thorac Cancer 2023; 14:2567-2578. [PMID: 37469246 PMCID: PMC10481141 DOI: 10.1111/1759-7714.15036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Factors predicting the response to pembrolizumab plus platinum and pemetrexed combination therapy (Pemb-Plt-PEM) in nonsquamous non-small cell lung cancer (non-sq NSCLC) are unclear. We investigated the Glasgow Prognostic (GP) score, neutrophil-to-lymphocyte ratio (NLR), and body mass index (BMI) as predictors of response to initial treatment with combination therapy in individuals with advanced non-sq NSCLC. METHODS We retrospectively reviewed 236 patients who received initial treatment with combination therapy for non-sq NSCLC at 13 institutions between December 2018 and December 2020. The usefulness of the GP score, NLR, and BMI as prognostic indicators was assessed. Cox proportional hazard models and the Kaplan-Meier method were used to compare progression-free survival (PFS) and overall survival (OS). RESULTS The response rate was 51.2% (95% CI: 44.9-57.5%). The median PFS and OS after beginning Pemb-Plt-PEM were 8.8 (95% CI: 7.0-11.9) months and 23.6 (95% CI: 18.7-28.6) months, respectively. The NLR independently predicted the efficacy of Pemb-Plt-PEM-the PFS and OS were more prolonged in individuals with NLR <5 than in those with NLR ≥5 (PFS: 12.8 vs. 5.3 months, p = 0.0002; OS: 29.4 vs. 12.0 months, p < 0.0001). BMI predicted the treatment response-individuals with BMI ≥22.0 kg/m2 had longer OS than did those with BMI < 22.0 kg/m2 (OS: 28.4 vs. 18.4 months, p = 0.0086). CONCLUSIONS The NLR significantly predicted PFS and OS, whereas BMI predicted OS, in individuals who initially received Pemb-Plt-PEM for non-sq NSCLC. These factors might be prognosis predictors in non-sq NSCLC.
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Affiliation(s)
- Hisao Imai
- Department of Respiratory MedicineComprehensive Cancer Center, International Medical Center, Saitama Medical UniversityHidakaSaitamaJapan
- Division of Respiratory MedicineGunma Prefectural Cancer CenterOtaGunmaJapan
| | - Satoshi Wasamoto
- Division of Respiratory MedicineSaku Central Hospital Advanced Care CenterSakuNaganoJapan
| | - Takeshi Tsuda
- Division of Respiratory MedicineToyama Prefectural Central HospitalToyamaToayamaJapan
| | - Yoshiaki Nagai
- Department of Respiratory MedicineJichi Medical University, Saitama Medical CenterSaitamaSaitamaJapan
| | - Takayuki Kishikawa
- Division of Thoracic OncologyTochigi Cancer CenterUtsunomiyaTochigiJapan
| | - Ken Masubuchi
- Division of Respiratory MedicineGunma Prefectural Cancer CenterOtaGunmaJapan
| | - Takashi Osaki
- Division of Respiratory MedicineNational Hospital Organization Shibukawa Medical CenterShibukawaGunmaJapan
| | - Yosuke Miura
- Division of Allergy and Respiratory Medicine, Integrative Centre of Internal MedicineGunma University HospitalMaebashiGunmaJapan
| | - Yukihiro Umeda
- Third Department of Internal MedicineFaculty of Medical Sciences, University of FukuiEiheijiFukuiJapan
| | - Akihiro Ono
- Division of Internal MedicineKiryu Kosei General HospitalKiryuGunmaJapan
| | - Hiroyuki Minemura
- Department of Pulmonary MedicineFukushima Medical UniversityFukushimaFukushimaJapan
| | - Yutaka Yamada
- Division of Respiratory MedicineIbaraki Prefectural Central HospitalKasamaIbarakiJapan
| | - Junichi Nakagawa
- Division of Respiratory MedicineNational Hospital Organization Takasaki General Medical CenterTakasakiGunmaJapan
| | - Yuki Kozu
- Division of Respiratory MedicineSaku Central Hospital Advanced Care CenterSakuNaganoJapan
| | - Hirokazu Taniguchi
- Division of Respiratory MedicineToyama Prefectural Central HospitalToyamaToayamaJapan
| | - Hiromitsu Ohta
- Department of Respiratory MedicineJichi Medical University, Saitama Medical CenterSaitamaSaitamaJapan
| | - Takashi Kasai
- Division of Thoracic OncologyTochigi Cancer CenterUtsunomiyaTochigiJapan
| | - Kyoichi Kaira
- Department of Respiratory MedicineComprehensive Cancer Center, International Medical Center, Saitama Medical UniversityHidakaSaitamaJapan
| | - Hiroshi Kagamu
- Department of Respiratory MedicineComprehensive Cancer Center, International Medical Center, Saitama Medical UniversityHidakaSaitamaJapan
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20
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Nishihara-Kato F, Imai H, Tsuda T, Wasamoto S, Nagai Y, Kishikawa T, Miura Y, Ono A, Yamada Y, Masubuchi K, Osaki T, Nakagawa J, Umeda Y, Minemura H, Kozu Y, Taniguchi H, Ohta H, Kaira K, Kagamu H. Prognostic Potential of the Prognostic Nutritional Index in Non-Small Cell Lung Cancer Patients Receiving Pembrolizumab Combination Therapy with Carboplatin and Paclitaxel/Nab-Paclitaxel. Oncology 2023; 102:30-42. [PMID: 37598676 DOI: 10.1159/000533604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Pembrolizumab (Pemb) therapy in conjunction with carboplatin and paclitaxel (PTX)/nab-PTX has been efficacious in treating non-small cell lung cancer (NSCLC). However, the response predictors of this combination therapy (Pemb-combination) remain undetermined. We aimed to evaluate whether Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio (NLR), body mass index (BMI), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) are potential factors in prognosticating the response to Pemb-combination therapy in advanced NSCLC patients. METHODS We retrospectively recruited 144 NSCLC patients receiving first-line treatment with Pemb-combination therapy from 13 institutions between December 1, 2018, and December 31, 2020. GPS, NLR, BMI, PLR, and PNI were assessed for their efficacy as prognostic indicators. Cox proportional hazard models and the Kaplan-Meier method were used to compare the progression-free survival (PFS) and overall survival (OS) of the patients. RESULTS The treatment exhibited a response rate of 63.1% (95% confidence interval [CI]: 55.0-70.6%). Following Pemb-combination administration, the median PFS and OS were 7.3 (95% CI: 5.3-9.4) and 16.5 (95% CI: 13.9-22.1) months, respectively. Contrary to PNI, NLR, GPS, BMI, and PLR did not display substantially different PFS in univariate analysis. However, multivariate analysis did not identify PNI as an independent prognostic factor for PFS. Furthermore, univariate analysis revealed that GPS, BMI, and PLR exhibited similar values for OS but not NLR and PNI. Patients with PNI ≥45 were predicted to have better OS than those with PNI <45 (OS: 23.4 and 13.9 months, respectively, p = 0.0028). Multivariate analysis did not establish NLR as an independent prognostic factor for OS. CONCLUSION The PNI evidently predicted OS in NSCLC patients treated with Pemb-combination as first-line therapy, thereby validating its efficiency as a prognostic indicator of NSCLC.
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Affiliation(s)
- Fuyumi Nishihara-Kato
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hisao Imai
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Takeshi Tsuda
- Division of Respiratory Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Satoshi Wasamoto
- Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Japan
| | - Yoshiaki Nagai
- Department of Respiratory Medicine, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | | | - Yosuke Miura
- Division of Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Japan
| | - Akihiro Ono
- Division of Internal Medicine, Kiryu Kosei General Hospital, Kiryu, Japan
| | - Yutaka Yamada
- Division of Respiratory Medicine, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Ken Masubuchi
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan
| | - Takashi Osaki
- Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Junichi Nakagawa
- Division of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - Yukihiro Umeda
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yuki Kozu
- Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Japan
| | - Hirokazu Taniguchi
- Division of Respiratory Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Hiromitsu Ohta
- Department of Respiratory Medicine, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
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21
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Tian BW, Han CL, Wang HC, Yan LJ, Ding ZN, Liu H, Mao XC, Tian JC, Xue JS, Yang LS, Tan SY, Dong ZR, Yan YC, Wang DX, Li T. Effect of liver metastasis on the efficacy of immune checkpoint inhibitors in cancer patients: a systemic review and meta-analysis. Clin Exp Metastasis 2023; 40:255-287. [PMID: 37308706 DOI: 10.1007/s10585-023-10217-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/05/2023] [Indexed: 06/27/2024]
Abstract
Liver metastasis is a frequent phenomenon in advanced tumor disease. Immune checkpoint inhibitors (ICIs) are a new class of therapeutics that can improve the prognosis of cancer patients. The purpose of this study is to elucidate the relationship between liver metastasis and survival outcomes of patients receiving ICIs treatment. We searched four main databases, including PubMed, EMBASE, Cochrane Library, and Web of Science. Overall survival (OS) and progression-free survival (PFS) were the survival outcomes of our concern. Hazard ratio (HR) with 95% confidence interval (CI) were used to evaluate the relationship between liver metastasis and OS/ PFS. Finally, 163 articles were included in the study. The pooled results showed that patients with liver metastasis receiving ICIs treatment had worse OS (HR=1.82, 95%CI:1.59-2.08) and PFS (HR=1.68, 95%CI:1.49-1.89) than patients without liver metastasis. The effect of liver metastasis on ICIs efficacy differed in different tumor types, and patients with urinary system tumors (renal cell carcinoma OS: HR=2.47, 95%CI:1.76-3.45; urothelial carcinoma OS: HR=2.37, 95%CI:2.03-2.76) had the worst prognosis, followed by patients with melanoma (OS: HR=2.04, 95%CI:1.68-2.49) or non-small cell lung cancer (OS: HR=1.81, 95%CI:1.72-1.91). ICIs efficacy in digestive system tumors (colorectal cancer OS: HR=1.35, 95%CI:1.07-1.71; gastric cancer/ esophagogastric cancer OS: HR=1.17, 95%CI:0.90-1.52) was less affected, and peritoneal metastasis and the number of metastases have a greater clinical significance than liver metastasis based on univariate data. For cancer patients receiving ICIs treatment, the occurrence of liver metastasis is associated with poor prognosis. Different cancer types and metastatic sites may hold a different prognostic effect on the efficacy of ICIs treatment in cancer patients.
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Affiliation(s)
- Bao-Wen Tian
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Cheng-Long Han
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Han-Chao Wang
- Institute for Financial Studies, Shandong Univeristy, Jinan, 250100, People's Republic of China
| | - Lun-Jie Yan
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Zi-Niu Ding
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Hui Liu
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Xin-Cheng Mao
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Jin-Cheng Tian
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Jun-Shuai Xue
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Long-Shan Yang
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Si-Yu Tan
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Zhao-Ru Dong
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Yu-Chuan Yan
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Dong-Xu Wang
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Tao Li
- Department of general surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China.
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Vandoni G, D'Amico F, Fabbrini M, Mariani L, Sieri S, Casirati A, Di Guardo L, Del Vecchio M, Anichini A, Mortarini R, Sgambelluri F, Celano G, Serale N, De Angelis M, Brigidi P, Gavazzi C, Turroni S. Gut Microbiota, Metabolome, and Body Composition Signatures of Response to Therapy in Patients with Advanced Melanoma. Int J Mol Sci 2023; 24:11611. [PMID: 37511376 PMCID: PMC10380337 DOI: 10.3390/ijms241411611] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Despite the recent breakthroughs in targeted and immunotherapy for melanoma, the overall survival rate remains low. In recent years, considerable attention has been paid to the gut microbiota and other modifiable patient factors (e.g., diet and body composition), though their role in influencing therapeutic responses has yet to be defined. Here, we characterized a cohort of 31 patients with unresectable IIIC-IV-stage cutaneous melanoma prior to initiation of targeted or first-line immunotherapy via the following methods: (i) fecal microbiome and metabolome via 16S rRNA amplicon sequencing and gas chromatography/mass spectrometry, respectively, and (ii) anthropometry, body composition, nutritional status, physical activity, biochemical parameters, and immunoprofiling. According to our data, patients subsequently classified as responders were obese (i.e., with high body mass index and high levels of total, visceral, subcutaneous, and intramuscular adipose tissue), non-sarcopenic, and enriched in certain fecal taxa (e.g., Phascolarctobacterium) and metabolites (e.g., anethole), which were potentially endowed with immunostimulatory and oncoprotective activities. On the other hand, non-response was associated with increased proportions of Streptococcus, Actinomyces, Veillonella, Dorea, Fusobacterium, higher neutrophil levels (and a higher neutrophil-to-lymphocyte ratio), and higher fecal levels of butyric acid and its esters, which also correlated with decreased survival. This exploratory study provides an integrated list of potential early prognostic biomarkers that could improve the clinical management of patients with advanced melanoma, in particular by guiding the design of adjuvant therapeutic strategies to improve treatment response and support long-term health improvement.
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Affiliation(s)
- Giulia Vandoni
- Clinical Nutrition Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Federica D'Amico
- Microbiomics Unit, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
| | - Marco Fabbrini
- Microbiomics Unit, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
| | - Luigi Mariani
- Data Science Unit, Fondazione IRCCS Istituito Nazionale dei Tumori, 20133 Milan, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Amanda Casirati
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Lorenza Di Guardo
- Melanoma Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Michele Del Vecchio
- Melanoma Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Andrea Anichini
- Human Tumors Immunobiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Roberta Mortarini
- Human Tumors Immunobiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Francesco Sgambelluri
- Human Tumors Immunobiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Giuseppe Celano
- Department of Soil, Plant and Food Science (DiSSPA), University of Bari Aldo Moro, 70126 Bari, Italy
| | - Nadia Serale
- Department of Soil, Plant and Food Science (DiSSPA), University of Bari Aldo Moro, 70126 Bari, Italy
| | - Maria De Angelis
- Department of Soil, Plant and Food Science (DiSSPA), University of Bari Aldo Moro, 70126 Bari, Italy
| | - Patrizia Brigidi
- Microbiomics Unit, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Cecilia Gavazzi
- Clinical Nutrition Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Silvia Turroni
- Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
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23
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Mohanty SK, Mishra SK, Amin MB, Agaimy A, Fuchs F. Role of Surgical Pathologist for the Detection of Immuno-oncologic Predictive Factors in Non-small Cell Lung Cancers. Adv Anat Pathol 2023; 30:174-194. [PMID: 37037418 DOI: 10.1097/pap.0000000000000395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Until very recently, surgery, chemotherapy, and radiation therapy have been the mainstay of treatment in non-small cell carcinomas (NSCLCs). However, recent advances in molecular immunology have unveiled some of the complexity of the mechanisms regulating cellular immune responses and led to the successful targeting of immune checkpoints in attempts to enhance antitumor T-cell responses. Immune checkpoint molecules such as cytotoxic T-lymphocyte associated protein-4, programmed cell death protein-1, and programmed death ligand (PD-L) 1 have been shown to play central roles in evading cancer immunity. Thus, these molecules have been targeted by inhibitors for the management of cancers forming the basis of immunotherapy. Advanced NSCLC has been the paradigm for the benefits of immunotherapy in any cancer. Treatment decisions are made based on the expression of PD-L1 on the tumor cells and the presence or absence of driver mutations. Patients with high PD-L1 expression (≥50%) and no driver mutations are treated with single-agent immunotherapy whereas, for all other patients with a lower level of PD-L1 expression, a combination of chemotherapy and immunotherapy is preferred. Thus, PD-L1 blockers are the only immunotherapeutic agents approved in advanced NSCLC without any oncogenic driver mutations. PD-L1 immunohistochemistry, however, may not be the best biomarker in view of its dynamic nature in time and space, and the benefits may be seen regardless of PD -L1 expression. Each immunotherapy molecule is prescribed based on the levels of PD-L1 expression as assessed by a Food and Drug Administration-approved companion diagnostic assay. Other biomarkers that have been studied include tumor mutational burden, the T-effector signature, tumor-infiltrating lymphocytes, radiomic assays, inflammation index, presence or absence of immune-related adverse events and specific driver mutations, and gut as well as local microbiome. At the current time, none of these biomarkers are routinely used in the clinical decision-making process for immunotherapy in NSCLC. However, in individual cases, they can be useful adjuncts to conventional therapy. This review describes our current understanding of the role of biomarkers as predictors of response to immune checkpoint molecules. To begin with a brief on cancer immunology in general and in NSCLC, in particular, is discussed. In the end, recent advancements in laboratory techniques for refining biomarker assays are described.
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Affiliation(s)
- Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India and CORE Diagnostics, Gurgaon, HR
| | - Sourav K Mishra
- Department of Medical Oncology, All India Institute of Medical Sciences, DL, India
| | - Mahul B Amin
- Departments of Pathology and Laboratory Medicine and Urology, University of Tennessee Health Science Center, Memphis, TN
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Florian Fuchs
- Department of Internal Medicine-1, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Erlangen University Hospital and Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
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24
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Fortes C, Mastroeni S, Zappalà AR, Passarelli F, Ricci F, Abeni D, Michelozzi P. Early inflammatory biomarkers and melanoma survival. Int J Dermatol 2023; 62:752-758. [PMID: 36872079 DOI: 10.1111/ijd.16629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/05/2022] [Accepted: 02/09/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Few studies have investigated the role of inflammatory markers in predicting cutaneous melanoma survival. The aim of the study was to identify, if any, early inflammatory markers in the prognosis of all stages of primary cutaneous melanoma. METHODS We conducted a 10-year cohort study among 2,141 melanoma patients from the same geographic area (Lazio) with primary cutaneous melanoma diagnosed between January 2005 and December 2013. In situ cutaneous melanoma was excluded from the analysis (N = 288), leaving 1,853 cases of invasive cutaneous melanoma. The following hematological markers were obtained from clinical records: white blood cells count (WBC), count and percentages of neutrophils, basophils, monocytes, lymphocytes, and large unstained cells (LUC). Survival probability was estimated by Kaplan-Meier methods, and prognostic factors were evaluated by multivariate analysis (Cox proportional hazards model). RESULTS In the multivariate analysis, high levels of NLR (>2.1 vs. ≤2.1, HR: 1.61; 95% CI: 1.14-2.29, P = 0.007) and high levels of d-NLR (>1.5 vs. ≤1.5, HR: 1.65; 95% CI: 1.16-2.35, P = 0.005) were independently associated with an increased risk of 10-year melanoma mortality. However, when we stratified by Breslow thickness and clinical stage, we observed that NLR and d-NLR were good markers of prognosis only for patients with Breslow thickness of 2.0 mm and more (NLR, HR: 1.62; 95% CI: 1.04-2.50; d-NLR, HR: 1.69; 95% CI: 1.09-2.62) or clinical stage II-IV (NLR, HR: 1.55; 95% CI: 1.01-2.37; d-NLR, HR: 1.72; 95% CI: 1.11-2.66), independent of other prognostic factors. CONCLUSION We suggest that a combination of NLR and Breslow thickness may be a useful, cheap, and readily available prognostic marker for cutaneous melanoma survival.
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Affiliation(s)
| | | | | | | | | | | | - Paola Michelozzi
- Department of Epidemiology of the Regional Health Service, Rome, Italy
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25
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Tachinami H, Tomihara K, Yamada SI, Ikeda A, Imaue S, Hirai H, Nakai H, Sonoda T, Kurohara K, Yoshioka Y, Hasegawa T, Naruse T, Niiyama T, Shimane T, Ueda M, Yanamoto S, Akashi M, Umeda M, Kurita H, Miyazaki A, Arai N, Hayashi R, Noguchi M. Neutrophil-to-lymphocyte ratio as an early marker of outcomes in patients with recurrent oral squamous cell carcinoma treated with nivolumab: a pilot study. Br J Oral Maxillofac Surg 2023; 61:320-326. [PMID: 37061418 DOI: 10.1016/j.bjoms.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/14/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023]
Abstract
The immune checkpoint inhibitor (ICI), nivolumab, has revolutionised the treatment of recurrent and metastatic oral cancer. However, the response rate to ICIs remains low, and identifying predictors of nivolumab response is critical. Although the neutrophil-to-lymphocyte ratio (NLR) has been suggested as a predictive marker of nivolumab response in patients with various types of cancer, its utility in oral squamous cell carcinoma (OSCC) has not been elucidated. In this retrospective multicentre cohort study, we evaluated the association between NLR and outcome of nivolumab treatment in 64 patients with OSCC treated between 2017 and 2020. The objective response and disease control rates were 25.1% and 32.9%, respectively. The rates for complete and partial responses were 15.7% (10/64) and 9.4% (6/64), respectively; stable and progressive disease rates were 7.8% (5/64) and 67.1% (43/64), respectively. Complete and partial responses were classified as responders, and stable and progressive diseases were classified as non-responders. The median (range) pre-treatment NLR among responders was 4.3 (2.8-8.0), which decreased to 4.0 (2.6-6.3) after nivolumab treatment, and the median (range) pre-treatment NLR among non-responders was 5.1 (2.7-7.9), which increased to 6.4 (4.0-14.0) with tumour growth. Moreover, overall survival was significantly worse in the group with a higher post-treatment NLR (≥5) than in the group with a lower NLR (<5). Patients with a post-treatment NLR of ≥6 had worse outcomes for salvage chemotherapy following nivolumab treatment. Thus, post-treatment NLR could be a useful marker for predicting the response to nivolumab treatment or salvage chemotherapy in patients with OSCC.
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26
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Licata L, Mariani M, Rossari F, Viale G, Notini G, Naldini MM, Bosi C, Piras M, Dugo M, Bianchini G. Tissue- and liquid biopsy-based biomarkers for immunotherapy in breast cancer. Breast 2023; 69:330-341. [PMID: 37003065 PMCID: PMC10070181 DOI: 10.1016/j.breast.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/23/2023] [Accepted: 03/25/2023] [Indexed: 03/29/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy and now represent the mainstay of treatment for many tumor types, including triple-negative breast cancer and two agnostic registrations. However, despite impressive durable responses suggestive of an even curative potential in some cases, most patients receiving ICIs do not derive a substantial benefit, highlighting the need for more precise patient selection and stratification. The identification of predictive biomarkers of response to ICIs may play a pivotal role in optimizing the therapeutic use of such compounds. In this Review, we describe the current landscape of tissue and blood biomarkers that could serve as predictive factors for ICI treatment in breast cancer. The integration of these biomarkers in a "holistic" perspective aimed at developing comprehensive panels of multiple predictive factors will be a major step forward towards precision immune-oncology.
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Affiliation(s)
- Luca Licata
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Mariani
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Federico Rossari
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Viale
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Giulia Notini
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Matteo Maria Naldini
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Bosi
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Piras
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy
| | - Matteo Dugo
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Giampaolo Bianchini
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy; School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.
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Hu H, Archer C, Yip D, Peters G. Clinical predictors of survival in real world practice in stage IV melanoma. Cancer Rep (Hoboken) 2023; 6:e1691. [PMID: 36161287 PMCID: PMC9939985 DOI: 10.1002/cnr2.1691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 06/30/2022] [Accepted: 07/21/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND AND AIM While studies continually identify new clinical prognostic factors in stage IV melanoma, the introduction of targeted and immunotherapies have revolutionised the prognosis of advanced melanoma since 2011. The study aims to investigate the prognostic significance of past and newly identified clinical factors in a contemporary cohort. METHODS A retrospective analysis of The Canberra Hospital melanoma database identified 161 patients with Stage IV melanoma between 2011 and 2017. Survival was analysed by demographics and clinical factors with chi-square tests to determine significance. Logistic binary regression was performed to test the independence of the clinical factors on predicting the survival outcome. RESULTS Overall, the 3-month, 6-month, 9-month, and 12-month stage IV melanoma survival rate of our cohort was 79%, 67%, 55%, and 45%, respectively. Age, sex, and BRAF mutation status were found to have no impact on survival, whereas M1d category of the American Joint Committee on Cancer (AJCC) staging (8th edition), neutrophil-lymphocyte ratio (NLR) >3, elevated serum LDH, more than three metastatic sites, brain metastases, poorer Eastern cooperative oncology group (ECOG) status were associated with poorer survival. Binary logistic regression test identified AJCC staging, NLR (cutoff score 3), LDH, and brain metastases as independent prognostic factors. CONCLUSION Most clinical factors investigated in this study were found to have a statistically significant impact on survival, with AJCC (8th edition) staging M1a-M1d, NLR (cutoff score 3), LDH, and brain metastases identified as independent prognostic factors in stage IV melanoma from a contemporary cohort treated with targeted therapies and immunotherapies.
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Affiliation(s)
- Hsien‐Pang Hu
- ANU Medical SchoolAustralian National UniversityCanberraAustralia
| | - Christine Archer
- Department of Medical OncologyThe Canberra HospitalCanberraAustralia
- College of Nursing & Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Desmond Yip
- ANU Medical SchoolAustralian National UniversityCanberraAustralia
- Department of Medical OncologyThe Canberra HospitalCanberraAustralia
| | - Geoffrey Peters
- ANU Medical SchoolAustralian National UniversityCanberraAustralia
- Department of Medical OncologyThe Canberra HospitalCanberraAustralia
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28
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Wasamoto S, Imai H, Tsuda T, Nagai Y, Minemura H, Yamada Y, Umeda Y, Kishikawa T, Shiono A, Kozu Y, Shiihara J, Yamaguchi O, Mouri A, Kaira K, Kanazawa K, Taniguchi H, Kaburagi T, Minato K, Kagamu H. Pretreatment glasgow prognostic score predicts survival among patients administered first-line atezolizumab plus carboplatin and etoposide for small cell lung cancer. Front Oncol 2023; 12:1080729. [PMID: 36741711 PMCID: PMC9895374 DOI: 10.3389/fonc.2022.1080729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/30/2022] [Indexed: 01/22/2023] Open
Abstract
Background There are no established predictive biomarkers for the effectiveness of first-line atezolizumab plus carboplatin and etoposide therapy in patients with small-cell lung cancer (SCLC). Therefore, the current study aimed to investigate whether the Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio (NLR), and body mass index (BMI) can predict the effectiveness of first-line atezolizumab plus carboplatin and etoposide therapy in patients with extensive-disease SCLC. Methods We reviewed data from 84 patients who received first-line atezolizumab plus carboplatin and etoposide therapy for SCLC at nine Japanese institutions between August 2019 and May 2021. Further, we evaluated the prognostic value of the GPS, NLR, and BMI. The Kaplan-Meier and Cox proportional hazard models were used to examine differences in progression-free survival (PFS) and overall survival (OS). Moreover, the GPS, NLR, and BMI consisted of C-reactive protein and albumin concentrations, neutrophil and lymphocyte counts, and body weight and height, respectively. Results The response rate was 72.6% (95% confidence interval: 63.0-82.1%). The median PFS and OS from the initiation of treatment were 5.4 (95% CI: 4.9-5.9) months and 15.4 (95% CI: 11.4-16.8) months, respectively. The GPS independently predicted the effectiveness of first-line atezolizumab plus carboplatin and etoposide treatment, as a favorable GPS (GPS 0-1) was correlated with significantly better PFS and OS rates compared to a poor GPS (GPS 2) (PFS: 5.8 vs. 3.8 months, p = 0.0005; OS: 16.5 vs. 8.4 months, p<0.0001). Conclusions This is the first analysis to evaluate the association between the GPS, NLR, and BMI and the treatment effectiveness of survival among patients receiving first-line atezolizumab plus carboplatin and etoposide therapy for SCLC. Among patients receiving this treatment for SCLC, GPS was significantly associated with the PFS and OS rates, suggesting that GPS might be useful for evaluating therapeutic outcomes in these patients.
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Affiliation(s)
- Satoshi Wasamoto
- Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Nagano, Japan
| | - Hisao Imai
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan,Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Gunma, Japan,*Correspondence: Hisao Imai,
| | - Takeshi Tsuda
- Division of Respiratory Medicine, Toyama Prefectural Central Hospital, Toyama, Toyama, Japan
| | - Yoshiaki Nagai
- Department of Respiratory Medicine, Jichi Medical University, Saitama Medical Center, Saitama, Saitama, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yutaka Yamada
- Division of Respiratory Medicine, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan
| | - Yukihiro Umeda
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Takayuki Kishikawa
- Division of Thoracic Oncology, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan
| | - Ayako Shiono
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
| | - Yuki Kozu
- Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Nagano, Japan
| | - Jun Shiihara
- Department of Respiratory Medicine, Jichi Medical University, Saitama Medical Center, Saitama, Saitama, Japan
| | - Ou Yamaguchi
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
| | - Atsuto Mouri
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
| | - Kenya Kanazawa
- Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hirokazu Taniguchi
- Division of Respiratory Medicine, Toyama Prefectural Central Hospital, Toyama, Toyama, Japan
| | - Takayuki Kaburagi
- Division of Respiratory Medicine, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan
| | - Koichi Minato
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Gunma, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
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29
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Zhou Q, Deng G, Wang Z, Dai G. Preoperative lung immune prognostic index predicts survival in patients with pancreatic cancer undergoing radical resection. Front Surg 2023; 9:1002075. [PMID: 36684178 PMCID: PMC9852768 DOI: 10.3389/fsurg.2022.1002075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 12/05/2022] [Indexed: 01/08/2023] Open
Abstract
Background Lung immune prognostic index (LIPI), a combination of derived neutrophil-to-lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH), is currently attracting considerable interest as a potential prognostic indicator in many malignancies. Our study aimed to investigate the prognostic value of preoperative LIPI in patients with pancreatic ductal adenocarcinoma (PDAC) undergoing radical resection. Methods We retrospectively reviewed PDAC patients treated with radical resection from February 2019 to April 2021 at Chinese People's Liberation Army (PLA) general hospital. Based on the cut-off value of dNLR and LDH identified by X-tile, patients were divided into LIPI good and LIPI intermediate/poor group. Kaplan-Meier curve and log-rank test were used to compare the recurrence-free survival (RFS) and overall survival (OS) of the two groups. Univariate and multivariate Cox regression was used to identify the independent prognostic value of LIPI. Subgroup analysis was performed to identify specific population benefited from radical resection. Results A total of 205 patients were included and the median RFS and OS was 10.8 and 24.3 months, respectively. Preoperative LIPI intermediate/poor was related to worse RFS and OS (p < 0.05). Preoperative LIPI intermediate/poor, vascular invasion and no adjuvant chemotherapy were indicators of poor OS. Patients with LIPI intermediate/poor had worse OS especially among females and those with adjuvant chemotherapy (p < 0.05). Adjuvant chemotherapy related to better RFS and OS in patients with LIPI good (p < 0.05). Conclusions Preoperative LIPI intermediate/poor can be an indicator of poor prognosis in patients with PDAC undergoing radical resection. LIPI good could be an effective marker of benefit from adjuvant chemotherapy. Larger studies are warranted for further validation.
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Affiliation(s)
- Qian Zhou
- Department of Oncology, Medical School of Chinese People’s Liberation Army (PLA), Beijing, China,Department of Medical Oncology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Guochao Deng
- School of Medicine, Nankai University, Tianjin, China,Department of Medical Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhikuan Wang
- Department of Medical Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China,Correspondence: Zhikuan Wang Guanghai Dai
| | - Guanghai Dai
- Department of Oncology, Medical School of Chinese People’s Liberation Army (PLA), Beijing, China,Department of Medical Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China,Correspondence: Zhikuan Wang Guanghai Dai
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30
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Huang J, Pu H, He J, Tang X. Prognostic Value of the Lung Immune Prognostic Index for Metastatic Non-Small Cell Lung Cancer Patients: A Chinese Cohort Study. Int J Gen Med 2023; 16:881-893. [PMID: 36915421 PMCID: PMC10008001 DOI: 10.2147/ijgm.s393263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
Background Most cancer-related deaths around the globe are caused by lung cancer. The present treatments for metastatic non-small cell lung cancer (mNSCLC) are cytotoxic chemotherapy (CCT), targeted therapy (TT) and immunotherapy, but the benefit of the same regime varies greatly. Hence, it is important to identify biomarkers to predict the efficacy of modalities. Previous literature suggested certain parameters might be predictive factors. Nevertheless, the utility of these parameters is limited due to the types of solid tumors. Purpose The study aimed to examine whether the lung immune prognostic index (LIPI) was related to outcomes of CCT, immune checkpoint inhibitors (ICIs) and TT for mNSCLC patients. Materials and Methods A retrospective cohort study between September 2012 and May 2020 was conducted on 350 Chinese mNSCLC patients, including 147 patients receiving ICIs, 103 TT, and 100 CCT. The data were examined to analyze the prognostic value of LIPI among various treatments. Main Outcomes and Measures The associations between PFS and good, intermediate, or poor prognostic LIPI scores in ICIs, TT, and CCT were determined, respectively. Results In univariable analyses, there was a relevance between a good LIPI score and better PFS among patients receiving ICIs (HR, 0.81; 95% CI, 0.44-1.51), TT (HR, 0.35; 95% CI, 0.16-1.74), and CCT (HR, 0.39; 95% CI, 0.19-0.80). In multivariable analyses, the intermediate LIPI score was linked to better PFS only in patients receiving TT (HR, 0.31; 95% CI, 0.17-0.92) rather than ICIs (HR, 1.12; 95% CI, 0.66-2.45) or CCT (HR, 1.24; 95% CI, 0.49-4.55). Conclusion Baseline LIPI value is an important prognostic biomarker for mNSCLC patients treated with TT. Shorter PFS with TT was associated with poor baseline LIPI. Poor LIPI score may be considered as a promising indicator showing which patients are unlikely to respond well to TT. The prognostic value of LIPI can be more clearly determined through prospective clinical study.
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Affiliation(s)
- Jing Huang
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, People's Republic of China.,Department of Integrated Traditional Chinese and Western Medicine, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Centre, Kunming, People's Republic of China
| | - Hongjiang Pu
- Department of Oncology, Dazhou Central Hospital, Dazhou, Sichuan, People's Republic of China
| | - Jintao He
- Kunming Medical University, Kunming, People's Republic of China
| | - Xiaohu Tang
- Department of Rheumatology, The First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, People's Republic of China
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Wang JW, Yuan Q, Li L, Cao KH, Liu Q, Wang HL, Hu K, Wu X, Wan JH. Role of Systemic Immunoinflammation Landscape in the Overall Survival of Patients with Leptomeningeal Metastases from Lung Cancer. Onco Targets Ther 2023; 16:179-187. [PMID: 36993872 PMCID: PMC10041983 DOI: 10.2147/ott.s402389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Purpose Several biomarkers, such as baseline neutrophil-to-lymphocyte ratio (NLR), have been more investigated in patients with brain metastases (BM), while their role in patients with leptomeningeal metastases (LM) has not been clarified. Considering the difference between the clinical behaviour of BM and LM, there is the need for addressing the role of these biomarkers in LM. Methods The present study retrospectively analyzed 95 consecutive patients with LM from lung cancer who were diagnosed at the National Cancer Center, Cancer Hospital of Chinese Academy of Medical Sciences between January 2016 and December 2019. Baseline NLR, platelet-to-lymphocyte ratio (PLR), systemic immunoinflammation index (SII), and lymphocyte-to-monocyte ratio at diagnosis of LM were calculated based on complete blood count and correlated, along with other characteristics, with overall survival (OS) using univariate and multivariate analyses. The best cutoff values for systemic immunoinflammation biomarkers were derived using the surv_cutpoint function in R software, which optimized the significance of the split between Kaplan-Meier survival curves. Results Median OS of patients with LM was 12 months (95% CI 9-17 months). On univariate analysis, NLR, PLR, SII, LMR, sex, smoking history, ECOG performance status (PS) scores, histological subtypes and targeted therapy were all significantly associated with OS. Only NLR (P=0.034, 95% CI 1.060-4.578) and ECOG PS scores (P=0.019, 95% CI 0.137-0.839) maintained a significant association with OS on multivariate analysis. Furthermore, patients with baseline NLR >3.57 had significantly worse OS than patients with NLR ≤3.57 (median OS 7 vs 17 months), as did patients with ECOG PS scores >2 vs ≤2 (median OS 4 vs 15 months). Conclusion Both baseline NLR and PS scores at the time of LM diagnosis are helpful and available prognostic biomarkers for patients with LM from lung cancer.
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Affiliation(s)
- Jia-Wei Wang
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Qing Yuan
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Li Li
- Medical Records Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Kai-Hua Cao
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Qi Liu
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Hong-Liang Wang
- Department of Neurosurgery, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Ke Hu
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Ke Hu, Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Nanli Panjiayuan, Chaoyang District, Beijing, 100021, People’s Republic of China, Tel/Fax +86-10-87787350, Email
| | - Xi Wu
- General Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Xi Wu, General Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Nanli Panjiayuan, Chaoyang District, Beijing, 100021, People’s Republic of China, Tel/Fax +86-10-87788200, Email
| | - Jing-Hai Wan
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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Zippoli M, Ruocco A, Novelli R, Rocchio F, Miscione MS, Allegretti M, Cesta MC, Amendola PG. The role of extracellular vesicles and interleukin-8 in regulating and mediating neutrophil-dependent cancer drug resistance. Front Oncol 2022; 12:947183. [PMID: 36591453 PMCID: PMC9800989 DOI: 10.3389/fonc.2022.947183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
Tumor drug resistance is a multifactorial and heterogenous condition that poses a serious burden in clinical oncology. Given the increasing incidence of resistant tumors, further understanding of the mechanisms that make tumor cells able to escape anticancer drug effects is pivotal for developing new effective treatments. Neutrophils constitute a considerable proportion of tumor infiltrated immune cells, and studies have linked elevated neutrophil counts with poor prognosis. Tumor-associated neutrophils (TANs) can acquire in fact immunoregulatory capabilities, thus regulating tumor progression and resistance, or response to therapy. In this review, we will describe TANs' actions in the tumor microenvironment, with emphasis on the analysis of the role of interleukin-8 (IL-8) and extracellular vesicles (EVs) as crucial modulators and mediators of TANs biology and function in tumors. We will then discuss the main mechanisms through which TANs can induce drug resistance, finally reporting emerging therapeutic approaches that target these mechanisms and can thus be potentially used to reduce or overcome neutrophil-mediated tumor drug resistance.
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Affiliation(s)
- Mara Zippoli
- Research and Development (R&D), Dompé farmaceutici S.p.A., Naples, Italy
| | - Anna Ruocco
- Research and Development (R&D), Dompé farmaceutici S.p.A., Naples, Italy
| | - Rubina Novelli
- Research and Development (R&D), Dompé farmaceutici S.p.A., Milan, Italy
| | - Francesca Rocchio
- Research and Development (R&D), Dompé farmaceutici S.p.A., Naples, Italy
| | - Martina Sara Miscione
- Research and Development (R&D), Dompé farmaceutici S.p.A., Naples, Italy,Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | | | | | - Pier Giorgio Amendola
- Research and Development (R&D), Dompé farmaceutici S.p.A., Naples, Italy,*Correspondence: Pier Giorgio Amendola,
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Kopecky J, Kubecek O, Priester P, Vosmikova H, Cermakova E, Kyllarova A. Prognostic value of blood cell count-derived ratios in BRAF-mutated metastatic melanoma. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2022; 166:393-404. [PMID: 34446937 DOI: 10.5507/bp.2021.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/11/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The treatment and prognosis of metastatic melanoma have changed during the last decade to include immunotherapy or targeted therapy as standard therapeutic options for BRAF-mutated melanoma. However, predictive and/or prognostic markers are lacking, especially in clinical situations where several options are available. The aim of this study was to determine the association of pre-therapeutic blood cell count-derived ratios (BCDR) with survival in patients with BRAF-mutated metastatic melanoma. METHODS We evaluated the prognostic role of BCDR in therapy-naïve patients with BRAF-mutated metastatic melanoma treated with immune checkpoint inhibitors or targeted therapy. The impact of BCDR on survival was analysed using univariate and multivariate Cox proportional hazard models. RESULTS We enrolled 46 patients treated with BRAF inhibitors and 20 patients who received anti-PD-1 checkpoint inhibitors. The median progression-free survival (PFS) and overall survival (OS) were 8.3 and 18.2 months, respectively, with no statistical difference between groups. The objective response rate was 39% (30% in the anti-PD-1 and 44% in the targeted therapy groups). Baseline BCDR values were associated with improved PFS and OS in the immunotherapy group. Only the platelet-to-lymphocyte ratio (PLR) was associated with OS and PFS in the targeted therapy group. Independent prognostic indicators for PFS were lactate dehydrogenase, PLR and the lymphocyte-to-monocyte ratio (LMR) and those for OS were LMR, toxicity and the number of initial metastases. CONCLUSION BCDR had a substantial prognostic value in patients with BRAF-mutated metastatic melanoma treated with immune checkpoint inhibitors. However, a prognostic role for BCDR seemed less apparent in patients treated with targeted therapies.
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Affiliation(s)
- Jindrich Kopecky
- Department of Oncology and Radiotherapy, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Ondrej Kubecek
- Department of Oncology and Radiotherapy, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Peter Priester
- Department of Oncology and Radiotherapy, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Hana Vosmikova
- The Fingerland Department of Pathology, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Eva Cermakova
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Aneta Kyllarova
- Department of Oncology and Radiotherapy, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
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Cancer Cachexia among Patients with Advanced Non-Small-Cell Lung Cancer on Immunotherapy: An Observational Study with Exploratory Gut Microbiota Analysis. Cancers (Basel) 2022; 14:cancers14215405. [PMID: 36358821 PMCID: PMC9658074 DOI: 10.3390/cancers14215405] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022] Open
Abstract
Cancer cachexia exerts a negative clinical influence on patients with advanced non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI). The prognostic impact of body weight change during ICI treatment remains unknown. The gut microbiota (GM) is a key contributor to the response to ICI therapy in cancer patients. However, the association between cancer cachexia and GM and their association with the response to ICIs remains unexplored. This study examined the association of cancer cachexia with GM composition and assessed the impact of GM on clinical outcomes in patients with NSCLC treated with ICIs. In this observational, prospective study, which included 113 Japanese patients with advanced NSCLC treated with ICIs, the prevalence of cachexia was 50.4% (57/113). The median progression-free survival (PFS) and overall survival (OS) were significantly shorter in the cachexia group than in the non-cachexia group (4.3 vs. 11.6 months (p = 0.003) and 12.0 months vs. not reached (p = 0.02), respectively). A multivariable analysis revealed that baseline cachexia was independently associated with a shorter PFS. Moreover, a gain in body weight from the baseline (reversible cachexia) was associated with a significantly longer PFS and OS compared to irreversible cachexia. Microbiome profiling with 16S rRNA analysis revealed that the cachexia group presented an overrepresentation of the commensal bacteria, Escherichia-Shigella and Hungatella, while the non-cachexia group had a preponderance of Anaerostipes, Blautia, and Eubacterium ventriosum. Anaerostipes and E. ventriosum were associated with longer PFS and OS. Moreover, a cachexia status correlated with the systemic inflammatory marker-derived-neutrophil-to-lymphocytes ratio (dNLR) and Lung Immune Prognostic Index (LIPI) indexes. Our study demonstrates that cachexia and longitudinal bodyweight change have a prognostic impact on patients with advanced NSCLC treated with ICI therapy. Moreover, our study demonstrates that bacteria associated with ICI resistance are also linked to cachexia. Targeted microbiota interventions may represent a new type of treatment to overcome cachexia in patients with NSCLC.
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Chen S, Guo S, Gou M, Pan Y, Fan M, Zhang N, Tan Z, Dai G. A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitors. Front Oncol 2022; 12:951985. [DOI: 10.3389/fonc.2022.951985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThere are currently no established biomarkers that can predict whether advanced pancreatic carcinoma (PC) patients would benefit from immune checkpoint inhibitors (ICIs). Our study investigated whether the pretreatment composite biomarker of derived neutrophil–lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) can be used as a reliable prognostic factor for the survival of PC patients receiving PD-1 inhibitor therapy.MethodsPatients with advanced PC treated with PD-1 inhibitors at a single center from September 2015 to September 2020 were included. The high levels of dNLR (≥3) and LDH (≥250 U/L) were considered to be risk factors. Based on these two risk factors, patients in this study were categorized into two risk groups: the good dNLR-LDH group, without risk factors, and the intermediate/poor dNLR-LDH group, with one to two risk factors. Overall survival (OS) and progression-free survival (PFS) served as this study’s primary and secondary endpoints. Cox regression models were used to identify independent prognostic factors for survival benefit.ResultsThere were 98 patients in our study. The good group included 61 (62.2%) patients and the intermediate/poor group included 37 (37.8%). The overall patients with PC who received immunotherapy had a median OS of 12.1 months, and the good dNLR-LDH group had a significantly longer OS compared with the intermediate/poor dNLR-LDH group (44.2 vs. 6.4 months; p < 0.010); median PFS was 3.7 and 2.5 months (p = 0.010). The number of metastatic sites >2 and immunotherapy as third-line or later was associated with worse PFS, and the line of immunotherapy and the dNLR-LDH indicator were independent prognostic factors for OS, according to multivariate analysis.ConclusionThe pretreatment composite biomarker of dNLR and LDH can be used as a prognostic biomarker in patients with advanced PC treated with PD-1 inhibitors.
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Zhao X, Wu X, Yu H, Wang H, Sun S, Hu Z, Liu C, Zhang J, Shao Y, Wang J. Prognostic value of hematologic parameters in advanced non-small cell lung cancer patients receiving anti-PD-1 inhibitors. Front Immunol 2022; 13:1003581. [DOI: 10.3389/fimmu.2022.1003581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundThe association between hematologic parameters and anti-programmed death-1 (PD-1) inhibitors was generally examined without considering therapy lines and medicine types. The study was aimed to identify potential hematologic biomarkers associated with clinical outcome in patients with non-small cell lung cancer (NSCLC) treated with first-line pembrolizumab and subsequent-line nivolumab.Materials and methods161 NSCLC patients were categorized into first-line pembrolizumab group (pembrolizumab group) and subsequent-line nivolumab group (nivolumab group). Univariate and multivariate Cox regression analyses were used to evaluate the prognostic value of hematologic parameters for clinical outcomes.ResultsThe median progression-free survival (mPFS) was 9.6 months in the pembrolizumab group and 4.1 months in the nivolumab group (HR =1.61; P = 0.012); the median overall survival (mOS) was not reached in the pembrolizumab group and 17.7 months in the nivolumab group (HR =1.37; P = 0.23). Of the 79 patients in the pembrolizumab group, baseline PD-L1 tumor proportion score (TPS)≥1% was an independent factor of longer PFS and OS. Age≥60 years, absolute platelet count (APC)≥220×109/L and platelet-to-lymphocyte ratio (PLR)≥120 were associated with inferior PFS. Of the 82 patients in the nivolumab group, absolute neutrophil count (ANC)≥3×109/L was associated with longer PFS, while LDH (lactate dehydrogenase)≥160 U/L was associated with inferior PFS and derived neutrophil-to-lymphocyte ratio (dNLR)≥1.2 was associated with longer OS.ConclusionOur study identified multiple clinically accessible prognostic biomarkers in the peripheral blood in both the pembrolizumab and nivolumab subgroups.
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Goutam S, Stukalin I, Ewanchuk B, Sander M, Ding PQ, Meyers DE, Heng D, Cheung WY, Cheng T. Clinical Factors Associated with Long-Term Survival in Metastatic Melanoma Treated with Anti-PD1 Alone or in Combination with Ipilimumab. Curr Oncol 2022; 29:7695-7704. [PMID: 36290885 PMCID: PMC9600126 DOI: 10.3390/curroncol29100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) for treatment of metastatic melanoma (MM) offer lasting overall survival (OS) benefit in a subset of patients. However, outcomes remain poor for non-responders. Clinical predictors of long-term survival remain elusive. We utilized the Alberta Immunotherapy Database to investigate the association of host and disease characteristics, and treatment factors with overall survival (OS) greater than 3 years. We identified patients treated between August 2013 and May 2020 with single-agent anti-PD1 or combination (anti-PD1 and anti-CTLA4) ICI regimens. A logistic regression model was used to assess for independent association between clinical factors captured and survival greater than 3 years. Statistically significant factors on univariable analysis were assessed using multivariable analysis. In total, 284 of 460 patients were identified to have short-term (<1 year) or long-term (>3 years) survival with 186 surviving <1 year and 98 surviving >3 years. The median age was 64 and 18.4% of patients were ECOG ≥ 2. On logistic regression, Breslow's Depth ≤ 4 mm, normal serum LDH, normal serum albumin and M-stage 1a/b were associated with OS > 3 years on univariable and multivariable analysis. ECOG < 2, dNLR ≤ 3, normal hemoglobin were only associated with survival on the univariable analysis but not in the multivariable analysis. The objective response rate in long-term survivors was 83.7% compared to 7.5% in the short-term survivors. Our study identifies four easily accessible predictors of long-term survival in a large real-world MM cohort treated with ICI.
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Affiliation(s)
- Siddhartha Goutam
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R7, Canada
| | - Igor Stukalin
- Tom Baker Cancer Center, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Benjamin Ewanchuk
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Michael Sander
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Philip Q. Ding
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R7, Canada
- Oncology Outcomes, Calgary, AB T2N 4N2, Canada
| | - Daniel E. Meyers
- Tom Baker Cancer Center, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Daniel Heng
- Tom Baker Cancer Center, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Winson Y. Cheung
- Tom Baker Cancer Center, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Tina Cheng
- Tom Baker Cancer Center, University of Calgary, Calgary, AB T2N 4N2, Canada
- Correspondence: ; Tel.: +1-403-521-3723
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Sernicola A, Colpo A, Leahu AI, Alaibac M. Granulocyte Apheresis: Can It Be Associated with Anti PD-1 Therapy for Melanoma? Medicina (B Aires) 2022; 58:medicina58101398. [PMID: 36295558 PMCID: PMC9607554 DOI: 10.3390/medicina58101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/19/2022] Open
Abstract
In the field of advanced melanoma, there is an urgent need to investigate novel approaches targeting specific components of the cancer–immunity cycle beyond immune checkpoint inhibitors. The authors reviewed the basic understanding of the role of neutrophils in cancer biology, and the latest clinical evidence supporting the correlation between cancer-associated neutrophils and the prognosis and response to the immunotherapy of advanced melanoma. Finally, they propose that granulocyte and monocyte apheresis, an emerging non-pharmacological treatment in current dermatology, could become an investigative treatment targeting melanoma-associated neutrophils which could be potentially used in combination with the usual immune checkpoint inhibitors.
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Affiliation(s)
- Alvise Sernicola
- Dermatology Unit, Department of Medicine (DIMED), University of Padua, 35122 Padua, Italy
| | - Anna Colpo
- Apheresis Unit, Department of Transfusion Medicine, University Hospital of Padua, 35128 Padua, Italy
| | - Anca Irina Leahu
- Apheresis Unit, Department of Transfusion Medicine, University Hospital of Padua, 35128 Padua, Italy
| | - Mauro Alaibac
- Dermatology Unit, Department of Medicine (DIMED), University of Padua, 35122 Padua, Italy
- Correspondence:
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Elumalai T, Croxford W, Buijtenhuijs B, Conroy R, Sanderson B, Enting D, Aversa C, Doss G, Das A, Vasudev NS, Kitetere E, Tolan S, Law A, Hoskin P, Mistry H, Choudhury A. Using Real-world Data to Define a Validated Nomogram for Advanced Bladder Cancer Patients Who Respond to Immunotherapy. Clin Oncol (R Coll Radiol) 2022; 34:642-652. [PMID: 35282933 DOI: 10.1016/j.clon.2022.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/09/2022] [Accepted: 02/24/2022] [Indexed: 11/03/2022]
Abstract
AIMS Immune checkpoint inhibitors (ICIs) are used in incurable urothelial cancers, both in chemo-naïve and platinum-refractory patients. Efficacy and toxicity data published outside controlled clinical trials are limited. We report overall survival, progression-free survival and toxicities of ICIs in locally advanced (LABC) or metastatic bladder cancer (MBC). We aimed to develop and validate a prognostic model for these patients. MATERIALS AND METHODS A multicentre real-world individual patient-level data study (n = 272) evaluating ICIs in the first-line platinum-ineligible or platinum-refractory setting for LABC/MBC between March 2017 and February 2020 was undertaken. Cox regression analyses evaluated the association of prognostic factors with overall survival. Data were split to create a training (n = 208) and validation (n = 64) cohort. The backward elimination method with a P-value cut-off of 0.05 was used to develop a reduced prognostic model using the training data set. The concordance index and assessment of observed versus predicted survival probabilities were used to evaluate the final model. RESULTS The median follow-up was 18.9 (15.8-21.5) months. The median overall survival and progression-free survival in the training cohort were 9.2 (95% confidence interval 7.4-10.5) and 4.5 months (3.5-5.7), respectively. The most common grade 1/2 adverse events recorded were fatigue (47.8%) and infection (19.9%). Five key prognostic factors found in the training set were low haemoglobin, high neutrophil count, choice of immunotherapy favouring pembrolizumab, presence of liver metastasis and steroid use within 30 days of treatment. The concordance index for the training and validation cohorts was 0.66 (standard error = 0.05) and 0.64 (standard error = 0.04), respectively, for the final model. A nomogram was developed to calculate the expected survival probabilities based on risk factors. CONCLUSIONS Real-world data were used to produce a validated prognostic model for overall survival in LABC/MBC treated with ICIs. This model could assist in patient stratification, interpreting and framing future trials incorporating PD-1/PD-L1 inhibitors in LABC/MBC.
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Affiliation(s)
- T Elumalai
- The Christie NHS Foundation Trust, Manchester, UK
| | - W Croxford
- The Christie NHS Foundation Trust, Manchester, UK.
| | | | - R Conroy
- The Christie NHS Foundation Trust, Manchester, UK
| | - B Sanderson
- The Christie NHS Foundation Trust, Manchester, UK; Royal Preston Hospital, Rosemere Cancer Centre, Preston, UK
| | - D Enting
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C Aversa
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - G Doss
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Das
- St James's Institute of Oncology, Leeds, UK
| | | | - E Kitetere
- Royal Marsden NHS Foundation Trust, London, UK
| | - S Tolan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - A Law
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - P Hoskin
- The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK; Mount Vernon Cancer Centre, Northwood, UK
| | - H Mistry
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - A Choudhury
- The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK
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Barr MP, Baird AM, Halliday S, Martin P, Allott EH, Phelan J, Korpanty G, Coate L, O’Brien C, Gray SG, Sui JSY, Hayes B, Cuffe S, Finn SP. Liquid Biopsy: A Multi-Parametric Analysis of Mutation Status, Circulating Tumor Cells and Inflammatory Markers in EGFR-Mutated NSCLC. Diagnostics (Basel) 2022; 12:diagnostics12102360. [PMID: 36292049 PMCID: PMC9600124 DOI: 10.3390/diagnostics12102360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/07/2022] [Accepted: 09/17/2022] [Indexed: 11/22/2022] Open
Abstract
The liquid biopsy has the potential to improve patient care in the diagnostic and therapeutic setting in non-small cell lung cancer (NSCLC). Consented patients with epidermal growth factor receptor (EGFR) positive disease (n = 21) were stratified into two cohorts: those currently receiving EGFR tyrosine kinase inhibitor (TKI) therapy (n = 9) and newly diagnosed EGFR TKI treatment-naïve patients (n = 12). Plasma genotyping of cell-free DNA was carried out using the FDA-approved cobas® EGFR mutation test v2 and compared to next generation sequencing (NGS) cfDNA panels. Circulating tumor cell (CTC) numbers were correlated with treatment response and EGFR exon 20 p.T790M. The prognostic significance of the neutrophil to lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) was also investigated. Patients in cohort 1 with an EGFR exon 20 p.T790M mutation progressed more rapidly than those with an EGFR sensitizing mutation, while patients in cohort 2 had a significantly longer progression-free survival (p = 0.04). EGFR exon 20 p.T790M was detected by liquid biopsy prior to disease progression indicated by computed tomography (CT) imaging. The cobas® EGFR mutation test detected a significantly greater number of exon 20 p.T790M mutations (p = 0.05). High NLR and derived neutrophil to lymphocyte ratio (dNLR) were associated with shorter time to progression and worse survival outcomes (p < 0.05). High LDH levels were significantly associated with shorter time to disease progression (p = 0.03). These data support the use of liquid biopsy for monitoring EGFR mutations and inflammatory markers as prognostic indicators in NSCLC.
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Affiliation(s)
- Martin P. Barr
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Correspondence: ; Tel.: +353-1-8963620
| | - Anne-Marie Baird
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Sophia Halliday
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Petra Martin
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- Department of Medical Oncology, Midlands Regional Hospital, R35 NY51 Tullamore, Ireland
| | - Emma H. Allott
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - James Phelan
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Greg Korpanty
- Department of Medical Oncology, University Hospital Limerick, V94 F858 Limerick, Ireland
| | - Linda Coate
- Department of Medical Oncology, University Hospital Limerick, V94 F858 Limerick, Ireland
| | - Cathal O’Brien
- Cancer Molecular Diagnostics Laboratory, St James’s Hospital, D08 W9RT Dublin, Ireland
| | - Steven G. Gray
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Jane S. Y. Sui
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
| | - Brian Hayes
- Department of Histopathology, Cork University Hospital, T12 XF62 Cork, Ireland
- Department of Pathology, University College Cork, T12 DC4A Cork, Ireland
| | - Sinead Cuffe
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- Department of Medical Oncology, St James’s Hospital, D08 NHY1 Dublin, Ireland
| | - Stephen P. Finn
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- Department of Histopathology, St James’s Hospital, D08 RX0X Dublin, Ireland
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Zhang Y, Liu B, Kotenko S, Li W. Prognostic value of neutrophil-lymphocyte ratio and lactate dehydrogenase in melanoma patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29536. [PMID: 35960066 PMCID: PMC9371534 DOI: 10.1097/md.0000000000029536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) showed promising therapeutic efficacy on melanoma. Neutrophil-to-lymphocyte ratio (NLR) and serum lactate dehydrogenase (LDH) showed predictive values on prognosis of various tumors, but not on melanoma yet. This meta-analysis was conducted to investigate the prognostic role of NLR and LDH levels in melanoma treated with ICIs. METHODS A search was conducted for all reports published till March 2020 in PubMed, Web of Science, Cochrane Library, EMBASE, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP). Studies were included if they investigated the association between pretreatment NLR/LDH and prognosis in melanoma patients treated with ICIs. Subgroup analysis, publication bias, and meta-regression were conducted to investigate heterogeneity. RESULTS A total of 6817 melanoma patients were included. Overall, high pretreatment NLR and LDH were associated with poor overall survival (OS) (P < .001) and PFS (P < .001). Subgroup analyses revealed that elevated NLR and LDH levels were associated with poor OS and PFS in patients treated with anti-CTLA-4 or anti-PD-1/PD-L1 alone. NLR level was superior in predicting OS if compared with LDH level in patients treated with anti-PD-1/PD-L1 + anti-CTLA-4. In subgroup analysis stratified by cutoff value, high NLR level was associated with poor OS and PFS regardless of cutoff value, but LDH works when cutoff value = upper normal limit (UNL). The predictive value of NLR and LDH levels on OS and PFS was partially compromised in the Asian populations, compared with the Western countries. CONCLUSION Blood NLR and LDH levels showed great potential to be used as early prognostic biomarkers in melanoma patients treated with ICIs.
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Affiliation(s)
- Yongchao Zhang
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Bozhi Liu
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Sergei Kotenko
- Department of Microbiology, Biochemistry and Molecular Genetics, Newark, NJ
- Center for Cell Signaling, Newark, NJ
- Center for Immunity and Inflammation, Rutgers New Jersey Medical School, RBHS, Newark, NJ
| | - Wei Li
- Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- * Correspondence: Wei Li, PhD, Cancer Center, Beijing Ditan Hospital, Capital Medical University, 8 Jingshun East Street, Chaoyang District, 100015 Beijing, People’s Republic of China (e-mail: )
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Guven DC, Sahin TK, Erul E, Cakir IY, Ucgul E, Yildirim HC, Aktepe OH, Erman M, Kilickap S, Aksoy S, Yalcin S. The Association between Early Changes in Neutrophil-Lymphocyte Ratio and Survival in Patients Treated with Immunotherapy. J Clin Med 2022; 11:jcm11154523. [PMID: 35956139 PMCID: PMC9369683 DOI: 10.3390/jcm11154523] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/15/2022] [Accepted: 07/24/2022] [Indexed: 02/05/2023] Open
Abstract
Dynamic changes in the blood-based biomarkers could be used as a prognostic biomarker in patients treated with immune checkpoint inhibitors (ICIs), although the data are limited. We evaluated the association between the neutrophil−lymphocyte ratio (NLR) and early NLR changes with survival in ICI-treated patients. We retrospectively evaluated the data of 231 patients with advanced-stage cancer. We recorded baseline clinical characteristics, baseline NLR and fourth-week NLR changes, and survival data. A compound prognostic score, the NLR2-CEL score, was developed with the following parameters: baseline NLR (<5 vs. ≥5), ECOG status (0 vs. ≥1), Charlson Comorbidity Index (CCI, <9 vs. ≥9), LDH (N vs. ≥ULN), and fourth-week NLR change (10% or over NLR increase). In the multivariable analyses, higher NLR (HR: 1.743, p = 0.002), 10% or over NLR increase in the fourth week of treatment (HR: 1.807, p = 0.001), higher ECOG performance score (HR: 1.552, p = 0.006), higher LDH levels (HR: 1.454, p = 0.017), and higher CCI (HR: 1.400, p = 0.041) were associated with decreased OS. Compared to patients with the lowest scores, patients in the highest score group had significantly lower OS (HR: 7.967, 95% CI: 3.531−17.979, p < 0.001) and PFS. The composite score had moderate success for survival prediction, with an AUC of 0.702 (95% CI: 0.626−0.779, p < 0.001). We observed significantly lower survival in patients with higher baseline NLR values and increased NLR values under treatment.
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Affiliation(s)
- Deniz Can Guven
- Department of Medical Oncology, Cancer Institute, Hacettepe University, 06100 Ankara, Turkey; (H.C.Y.); (O.H.A.); (M.E.); (S.K.); (S.A.); (S.Y.)
- Correspondence:
| | - Taha Koray Sahin
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey; (T.K.S.); (E.E.); (I.Y.C.); (E.U.)
| | - Enes Erul
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey; (T.K.S.); (E.E.); (I.Y.C.); (E.U.)
| | - Ibrahim Yahya Cakir
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey; (T.K.S.); (E.E.); (I.Y.C.); (E.U.)
| | - Enes Ucgul
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey; (T.K.S.); (E.E.); (I.Y.C.); (E.U.)
| | - Hasan Cagri Yildirim
- Department of Medical Oncology, Cancer Institute, Hacettepe University, 06100 Ankara, Turkey; (H.C.Y.); (O.H.A.); (M.E.); (S.K.); (S.A.); (S.Y.)
| | - Oktay Halit Aktepe
- Department of Medical Oncology, Cancer Institute, Hacettepe University, 06100 Ankara, Turkey; (H.C.Y.); (O.H.A.); (M.E.); (S.K.); (S.A.); (S.Y.)
| | - Mustafa Erman
- Department of Medical Oncology, Cancer Institute, Hacettepe University, 06100 Ankara, Turkey; (H.C.Y.); (O.H.A.); (M.E.); (S.K.); (S.A.); (S.Y.)
| | - Saadettin Kilickap
- Department of Medical Oncology, Cancer Institute, Hacettepe University, 06100 Ankara, Turkey; (H.C.Y.); (O.H.A.); (M.E.); (S.K.); (S.A.); (S.Y.)
- Department of Medical Oncology, Faculty of Medicine, Istinye University, 34396 Istanbul, Turkey
| | - Sercan Aksoy
- Department of Medical Oncology, Cancer Institute, Hacettepe University, 06100 Ankara, Turkey; (H.C.Y.); (O.H.A.); (M.E.); (S.K.); (S.A.); (S.Y.)
| | - Suayib Yalcin
- Department of Medical Oncology, Cancer Institute, Hacettepe University, 06100 Ankara, Turkey; (H.C.Y.); (O.H.A.); (M.E.); (S.K.); (S.A.); (S.Y.)
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Melanoma Stem Cells Educate Neutrophils to Support Cancer Progression. Cancers (Basel) 2022; 14:cancers14143391. [PMID: 35884452 PMCID: PMC9317939 DOI: 10.3390/cancers14143391] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary In melanoma patients, poor prognosis often correlates with high presence of cancer-associated neutrophils, indicating that tumors can recruit these immune cells to specifically sustain their own development and progression. However, the role of cancer stem cells (CSCs) in this dialogue has not been elucidated yet. Our results revealed that melanoma SCs can reshape the immune microenvironment by triggering a pro-tumor N2 phenotype in neutrophils, which in turn are able to confer stemness properties to melanoma cells. Abstract Background: It is now well-established that cancer stem cells (CSCs) can support melanoma progression by reshaping the tumor immune microenvironment. However, the molecular mechanisms underlying the crosstalk between melanoma SCs and cancer-associated neutrophils have not been elucidated yet. Methods: The aim of the present study was to unravel the role of melanoma SCs in neutrophil polarization. HL60 neutrophil-like (dHL60) cells were treated with conditioned medium from A375 melanoma SCs (CSC-CM), and their phenotype was investigated. Results: We demonstrated that CSC-CM could specifically activate immune cells by increasing CD66b and CD11b expression. In particular, we revealed that A375 CSCs could release various soluble factors, namely TGF-β, IL-6, and IL-8, able to promote the recruitment of neutrophils and their switch toward an N2 phenotype characterized by the activation of ERK, STAT3, and P38 pathways and the overexpression of CXCR2 and NF-kB. Moreover, after exposure to CSC-CM, dHL60 cells exhibited enhanced ROS production and NET release, without undergoing cell death; increased secretion of MMP-9 and pro-inflammatory cytokines was also observed. Finally, CSC-CM-activated neutrophils endowed A375 cells with stemness traits, stimulating both sphere formation and ABCG2 expression. Conclusion: Collectively, our results suggest that melanoma SCs can prime neutrophils to support cancer progression.
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Kim CG, Hong M, Jeung HC, Lee G, Chung HC, Rha SY, Kim HS, Lee CK, Lee JH, Han Y, Kim JH, Lee SY, Kim H, Shin SJ, Baek SE, Jung M. Hyperprogressive disease during PD-1 blockade in patients with advanced gastric cancer. Eur J Cancer 2022; 172:387-399. [PMID: 35839733 DOI: 10.1016/j.ejca.2022.05.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/17/2022] [Accepted: 05/28/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Investigations for programmed cell death-1 (PD-1) blockade-induced hyperprogressive disease (HPD) have not been stringently conducted in patients with advanced gastric cancer (AGC). We explored the occurrence of HPD and its clinical implications in patients with AGC and treated with PD-1 inhibitors. METHODS We enrolled 169 patients with AGC and treated with either the PD-1 blockade (nivolumab or pembrolizumab; N = 112) or irinotecan monotherapy (N = 57) as a single agent. Tumour growth dynamics based on tumour growth kinetics and tumour growth rate (TGR) and time to treatment failure were analysed to define HPD. The incidence, clinical consequences and predictive markers of HPD were investigated. RESULTS The optimal criteria for HPD were 4-fold increases in both tumour growth kinetics and TGR ratios and a 40% increase in TGR based on the analysis for patients treated with irinotecan. In total, 10.7% (12/112) of patients experienced HPD after PD-1 inhibitor treatment. Patients with HPD had both shorter progression-free survival (hazard ratio: 2.318; 95% confidence interval: 1.205-4.460) and overall survival (hazard ratio: 2.542; 95% confidence interval: 1.314-4.918) than patients with progressive disease without HPD, losing opportunities for subsequent systemic treatments. Although other variables including PD-L1 expression were not associated with the occurrence of HPD, hypoalbuminemia (<3.25 mg/dL) at baseline was significantly associated with the occurrence of HPD (P < 0.001) and inferior survival outcomes. CONCLUSIONS HPD occurs in a proportion of patients with AGC and treated with PD-1 inhibitors. PD-1 inhibitor-induced HPD is associated with worse outcome, loss of eligibility for subsequent treatment and hypoalbuminemia, warranting further investigation.
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Affiliation(s)
- Chang Gon Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Moonki Hong
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hei-Cheul Jeung
- Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Garden Lee
- Division of Hemato-Oncology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Hyun Cheol Chung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun Young Rha
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyo Song Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Choong-Kun Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Hyun Lee
- Division of Hemato-Oncology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Yejeong Han
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee Hung Kim
- Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seo Young Lee
- Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyunki Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su-Jin Shin
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Song-Ee Baek
- Division of Abdominal Imaging, Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Minkyu Jung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
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He X, Wang Y, Ye Q, Wang Y, Min L, Luo Y, Zhou Y, Tu C. Lung Immune Prognostic Index Could Predict Metastasis in Patients With Osteosarcoma. Front Surg 2022; 9:923427. [PMID: 35874141 PMCID: PMC9304694 DOI: 10.3389/fsurg.2022.923427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe lung immune prognostic index (LIPI), composed of serum lactate dehydrogenase (LDH) and the derived neutrophil to lymphocyte ratio (dNLR), is a novel prognostic factor of lung cancer. The prognostic effect of the LIPI has never been verified in osteosarcoma.MethodsWe retrospectively reviewed the osteosarcoma patients with metachronous metastasis from January 2016 to January 2021 in West China Hospital. We collected and analyzed the clinical data and constructed the LIPI for osteosarcoma. The correlation between the LIPI and metastasis was analyzed according to the Kaplan–Meier method and Cox regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs). Univariate analysis and multivariate analysis were conducted to clarify the independent risk factors of metastasis. The nomogram model was established by R software, version 4.1.0.ResultsThe area under the curve (AUC) and best cutoff value were 0.535 and 91, 0.519, and 5.02, 0.594 and 2.77, 0.569 and 227.14, 0.59 and 158, and 0.607 and 2.05 for ALP, LMR, NLR, PLR, LDH, and dNLR, respectively. The LIPI was composed of LDH and dNLR and showed a larger AUC than other hematological factors in the time-dependent operator curve (t-ROC). In total, 184 patients, 42 (22.8%), 96 (52.2%), and 46 (25.0%) patients had LIPIs of good, moderate, and poor, respectively (P < 0.0001). Univariate analysis revealed that pathological fracture, the initial CT report of suspicious nodule, and the NLR, PLR, ALP, and the LIPI were significantly associated with metastasis, and multivariate analysis showed that the initial CT report of suspicious nodule and the PLR, ALP, and LIPI were dependent risk factors for metastasis. Metastatic predictive factors were selected and incorporated into the nomogram construction, including the LIPI, ALP, PLR, initial CT report, and pathological fracture. The C-index of our model was 0.71. According to the calibration plot, this predictive nomogram could accurately predict 3- and 5-year metachronous metastasis. Based on the result of decision curve and clinical impact curve, this predictive nomogram could also help patients obtain significant net benefits.ConclusionWe first demonstrated the metastatic predictive effect of the LIPI on osteosarcoma. This LIPI-based model is useful for clinicians to predict metastasis in osteosarcoma patients and could help conduct timely intervention and facilitate personalized management of osteosarcoma patients.
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Affiliation(s)
| | | | | | | | | | | | - Yong Zhou
- Correspondence: Yong Zhou Chongqi Tu
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Chen L, Zhao R, Sun H, Huang R, Pan H, Zuo Y, Zhang L, Xue Y, Li X, Song H. The Prognostic Value of Gastric Immune Prognostic Index in Gastric Cancer Patients Treated With PD-1/PD-L1 Inhibitors. Front Pharmacol 2022; 13:833584. [PMID: 35795575 PMCID: PMC9251404 DOI: 10.3389/fphar.2022.833584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to investigate the prognostic value of the gastric immune prognostic index (GIPI) in gastric cancer patients treated with programmed death 1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors.Methods: This study was conducted to elucidate the role of GIPI using the data from 146 gastric cancer patients treated with PD-1/PD-L1 inhibitors between August 2016 and December 2020 in Harbin Medical University Cancer Hospital. The GIPI calculation was based on dNLR and LDH. Patients were categorized into three groups: 1) GIPI good (LDH ≤250 U/L and dNLR ≤3); 2) GIPI intermediate (LDH >250 U/L and NLR >3); 3) GIPI poor (LDH >250 U/L and dNLR >3). The correlations between GIPI and clinicopathologic characteristics were determined by the Chi-square test or the Fisher’s exact test. The Kaplan–Meier analysis and log-rank test were used to calculate and compare progression-free survival (PFS) and overall survival (OS). The univariate and multivariate Cox proportional hazards regression model was used to detect prognostic and predictive factors of PFS and OS.Results: 146 patients treated with PD-1/PD-L1 inhibitors were included in this study, of which, 72.6% were GIPI good, 23.3% were GIPI intermediate, and 4.1% were GIPI poor. The GIPI was associated with the common blood parameters, including neutrophils and lymphocytes. The multivariate analysis showed that platelet, TNM stage, and treatment were the independent prognostic factors for PFS and OS. Patients with GIPI intermediate/poor were associated with shorter PFS (median: 24.63 vs. 32.50 months; p = 0.078) and OS (median: 28.37 months vs. not reached; p = 0.033) than those with GIPI good. GIPI intermediate/poor was correlated with shorter PFS and OS than GIPI good, especially in subgroups of patients with ICI treatment and patients with PD-1/PD-L1 positive status.Conclusions: The GIPI correlated with poor outcomes for PD-1/PD-L1 expression status and may be useful for identifying gastric cancer patients who are unlikely to benefit from treatment.
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Affiliation(s)
- Li Chen
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Ruihu Zhao
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Hao Sun
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Rong Huang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Hongming Pan
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Yanjiao Zuo
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Lele Zhang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Yingwei Xue
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Xingrui Li
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xingrui Li, ; Hongjiang Song,
| | - Hongjiang Song
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
- *Correspondence: Xingrui Li, ; Hongjiang Song,
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Alfranca YL, García MEO, Rueda AG, Ballesteros PÁ, Rodríguez DR, Velasco MT. Blood Biomarkers of Response to Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer. J Clin Med 2022; 11:jcm11113245. [PMID: 35683629 PMCID: PMC9181575 DOI: 10.3390/jcm11113245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/27/2022] [Indexed: 01/27/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment landscape of non-small cell lung cancer (NSCLC), either used in monotherapy or in combination with chemotherapy. While some patients achieve durable responses, some will not get benefit from this treatment. Early identification of non- responder patients could avoid unnecessary treatment, potentially serious immune-related adverse events and reduce treatment costs. PD-L1 expression using immunohistochemistry is the only approved biomarker for the selection of patients that can benefit from immunotherapy. However, application of PD-L1 as a biomarker of treatment efficacy shows many deficiencies probably due to the complexity of the tumor microenvironment and the technical limitations of the samples. Thus, there is an urgent need to find other biomarkers, ideally blood biomarkers to help us to identify different subgroups of patients in a minimal invasive way. In this review, we summarize the emerging blood-based markers that could help to predict the response to ICIs in NSCLC.
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Ebert MP, Meindl-Beinker NM, Gutting T, Maenz M, Betge J, Schulte N, Zhan T, Weidner P, Burgermeister E, Hofheinz R, Vogel A, Angermeier S, Bolling C, de Wit M, Jakobs R, Karthaus M, Stocker G, Thuss-Patience P, Leidig T, Gaiser T, Kather JN, Haertel N. Second-line therapy with nivolumab plus ipilimumab for older patients with oesophageal squamous cell cancer (RAMONA): a multicentre, open-label phase 2 trial. THE LANCET. HEALTHY LONGEVITY 2022; 3:e417-e427. [PMID: 36098320 DOI: 10.1016/s2666-7568(22)00116-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/28/2022] [Accepted: 04/28/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The overall survival of patients with advanced and refractory oesophageal squamous cell carcinoma, mostly aged 65 years and older, is poor. Treatment with PD-1 antibodies showed improved progression-free survival and overall survival. We assessed the safety and efficacy of combined nivolumab and ipilimumab therapy in this population. METHODS This multicentre, open-label, phase 2 trial done in 32 sites in Germany included patients aged 65 years and older with oesophageal squamous cell carcinoma and disease progression or recurrence following first-line therapy. Patients were treated with nivolumab (240 mg fixed dose once every 2 weeks, intravenously) in the safety run-in phase and continued with nivolumab and ipilimumab (nivolumab 240 mg fixed dose once every 2 weeks and ipilimumab 1 mg/kg once every 6 weeks, intravenously). The primary endpoint was overall survival, which was compared with a historical cohort receiving standard chemotherapy in the intention-to-treat population. This study is registered with ClinicalTrials.gov, NCT03416244. FINDINGS Between March 2, 2018, and Aug 20, 2020, we screened 75 patients with advanced oesophageal squamous cell carcinoma. We enrolled 66 patients (50 [76%] men and 16 [24%] women; median age 70·5 years [IQR 67·0-76·0]), 44 (67%) of whom received combined nivolumab and ipilimumab therapy and 22 (33%) received nivolumab alone. Median overall survival time at the prespecified data cutoff was 7·2 months (95% CI 5·7-12·4) and significantly higher than in a historical cohort receiving standard chemotherapy (p=0·0063). The most common treatment-related adverse events were fatigue (12 [29%] of 42), nausea (11 [26%]), and diarrhoea (ten [24%]). Grade 3-5 treatment-related adverse events occurred in 13 (20%) of 66 patients. Treatment-related death occurred in one patient with bronchiolitis obliterans while on nivolumab and ipilimumab treatment. INTERPRETATION Patients aged at least 65 years, with advanced oesophageal squamous cell carcinoma might benefit from combined nivolumab and ipilimumab therapy in second-line treatment. FUNDING Bristol Myers Squibb.
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Affiliation(s)
- Matthias P Ebert
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Institute for Innate Immunoscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany.
| | - Nadja M Meindl-Beinker
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Gutting
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Johannes Betge
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany; Junior Clinical Cooperation Unit Translational Gastrointestinal Oncology and Preclinical Models, German Cancer Research Center, Heidelberg, Germany
| | - Nadine Schulte
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tianzuo Zhan
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Philip Weidner
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Elke Burgermeister
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ralf Hofheinz
- Interdisciplinary Tumor Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arndt Vogel
- Department of Gastroenterology, Hepatology und Endocrinology, Hannover Medical School, Hannover, Germany
| | - Stefan Angermeier
- Department of Internal Medicine I, Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Claus Bolling
- Department of Internal Medicine, Agaplesion Markus Krankenhaus Frankfurt, Diakonie Kliniken, Frankfurt, Germany
| | - Maike de Wit
- Department of Internal Medicine, Hematology, Oncology and Palliative Medicine, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Ralf Jakobs
- Department of Medicine C, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany
| | - Meinolf Karthaus
- Department of Hematology, Oncology and Palliative Care, Klinikum Neuperlach, Munich, Germany
| | - Gertraud Stocker
- University Cancer Center, University Medicine Leipzig, Leipzig, Germany
| | - Peter Thuss-Patience
- Department of Hematology, Medical Oncology and Tumor Immunology, Charité Universitätsmedizin, Berlin, Germany
| | | | - Timo Gaiser
- Institute of Pathology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jakob N Kather
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Nicolai Haertel
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Guida M, Bartolomeo N, Quaresmini D, Quaglino P, Madonna G, Pigozzo J, Di Giacomo AM, Minisini AM, Tucci M, Spagnolo F, Occelli M, Ridolfi L, Queirolo P, De Risi I, Valente M, Sciacovelli AM, Chiarion Sileni V, Ascierto PA, Stigliano L, Strippoli S. Basal and one-month differed neutrophil, lymphocyte and platelet values and their ratios strongly predict the efficacy of checkpoint inhibitors immunotherapy in patients with advanced BRAF wild-type melanoma. J Transl Med 2022; 20:159. [PMID: 35382857 PMCID: PMC8981693 DOI: 10.1186/s12967-022-03359-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/24/2022] [Indexed: 12/12/2022] Open
Abstract
Background To evaluate the capability of basal and one-month differed white blood cells (WBC), neutrophil, lymphocyte and platelet values and their ratios (neutrophils-to-lymphocytes ratio, NLR, and platelets-to-lymphocytes ratio, PLR) in predicting the response to immune checkpoint inhibitors (ICI) in metastatic melanoma (MM). Methods We performed a retrospective study of 272 BRAF wild-type MM patients treated with first line ICI. Bivariable analysis was used to correlate patient/tumor characteristics with clinical outcomes. Variations between time 1 and time 0 (Δ) of blood parameters were also calculated and dichotomized using cut-off values assessed by ROC curve. Results At baseline, higher neutrophils and NLR negatively correlated with PFS, OS and disease control rate (DCR). Higher PLR was also associated with worse OS. In multivariable analysis, neutrophils (p = 0.003), WBC (p = 0.069) and LDH (p = 0.07) maintained their impact on PFS, while OS was affected by LDH (p < 0.001), neutrophils (p < 0.001) and PLR (p = 0.022), while DCR by LDH (p = 0.03) and neutrophils (p = 0.004). In the longitudinal analysis, PFS negatively correlated with higher Δplatelets (p = 0.039), ΔWBC (p < 0.001), and Δneutrophils (p = 0.020), and with lower Δlymphocytes (p < 0.001). Moreover, higher ΔNLR and ΔPLR identified patients with worse PFS, OS and DCR. In the multivariable model, only ΔNLR influenced PFS (p = 0.004), while OS resulted affected by higher ΔWBC (p < 0.001) and lower Δlymphocytes (p = 0.038). Higher ΔWBC also affected the DCR (p = 0.003). When clustering patients in 4 categories using basal LDH and ΔNLR, normal LDH/lower ΔNLR showed a higher PFS than high LDH/higher ΔNLR (20 vs 5 months). Moreover, normal LDH/higher Δlymphocytes had a higher OS than high LDH/lower Δlymphocytes (50 vs. 10 months). Conclusions Baseline and early variations of blood cells, together with basal LDH, strongly predict the efficacy of ICI in MM. Our findings propose simple, inexpensive biomarkers for a better selection of patient treatments. Prospective multicenter studies are warranted to confirm these data.
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Affiliation(s)
- Michele Guida
- Rare Tumors and Melanoma Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Viale O. Flacco, 6570124, Bari, Italy.
| | - Nicola Bartolomeo
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - Davide Quaresmini
- Rare Tumors and Melanoma Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Viale O. Flacco, 6570124, Bari, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Gabriele Madonna
- Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Napoli, Italy
| | - Jacopo Pigozzo
- Melanoma Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Anna Maria Di Giacomo
- Center for Immuno-Oncology, University Hospital of Siena, University of Siena, Siena, Italy
| | | | - Marco Tucci
- Medical Oncology Unit, University of Bari Aldo Moro, Bari, Italy.,IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | - Marcella Occelli
- Oncology Unit, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy
| | - Laura Ridolfi
- Immunotherapy, Cell Therapy and Biobank Unit, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Paola Queirolo
- Division of Melanoma Sarcoma and Rare Tumors, IEO European Institute of Oncology IRCCS Milan, Milan, Italy
| | - Ivana De Risi
- Rare Tumors and Melanoma Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Viale O. Flacco, 6570124, Bari, Italy
| | - Monica Valente
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Siena, Italy
| | | | | | - Paolo Antonio Ascierto
- Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Napoli, Italy
| | - Lucia Stigliano
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Sabino Strippoli
- Rare Tumors and Melanoma Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Viale O. Flacco, 6570124, Bari, Italy
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50
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Lecuelle J, Favier L, Fraisse C, Lagrange A, Kaderbhai C, Boidot R, Chevrier S, Joubert P, Routy B, Truntzer C, Ghiringhelli F. MER4 endogenous retrovirus correlated with better efficacy of anti-PD1/PD-L1 therapy in non-small cell lung cancer. J Immunother Cancer 2022; 10:jitc-2021-004241. [PMID: 35277462 PMCID: PMC8919440 DOI: 10.1136/jitc-2021-004241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2022] [Indexed: 12/15/2022] Open
Abstract
Background Endogenous retroviruses (ERVs) are highly expressed in various cancer types and are associated with increased innate immune response and better efficacy of antiprogrammed death-1/ligand-1 (anti-PD1/PD-L1)-directed immune checkpoint inhibitors (ICI) in preclinical models. However, their role in human non-small cell lung cancer (NSCLC) remains unknown. Methods We conducted a retrospective study of patients receiving ICI for advanced NSCLC in two independent cohorts. ERV expression was determined by RNA sequencing. The primary endpoint was progression-free survival (PFS) under ICI. The secondary endpoint was overall survival (OS) from ICI initiation. We studied expression of 6205 ERVs. Multivariate Cox regression model with lasso penalty was estimated on the training set to select ERVs significantly associated with survival. The predictive power of these ERVs was compared with that of previously described transcriptomic signatures. Results We studied two independent cohorts of 89 and 70 patients, used as training and validation sets. Clinicopathological characteristics included 75% of patients with non-squamous NSCLC. We selected four ERVs significantly associated with PFS. Only high MER4 ERV was associated with better PFS and OS in both cohorts. From a biological point of view, high MER4 expression is associated with higher infiltration of eosinophils and inflammatory gene signatures, while low MER4 expression is associated with enrichment in metabolism and proliferation signatures. Adding MER4 to previously described transcriptomic signatures of response to ICI improved their predictive power. Conclusions MER4 ERV expression is useful to stratify risk and predict PFS and OS in patients treated with ICI for NSCLC. It also improves the predictive power of other known transcriptomic signatures.
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Affiliation(s)
- Julie Lecuelle
- Platform of Transfer in Biological Oncology, Georges-Francois Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
- UMR INSERM 1231, Dijon, Bourgogne-Franche-Comté, France
- Genomic and Immunotherapy Medical Institute, Dijon University Hospital, Dijon, Bourgogne-Franche-Comté, France
- University of Burgundy-Franche Comté, Dijon, Bourgogne-Franche-Comté, France
| | - Laure Favier
- Departmnt of Medical Oncology, Georges François Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
| | - Cléa Fraisse
- Departmnt of Medical Oncology, Georges François Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
| | - Aurélie Lagrange
- Departmnt of Medical Oncology, Georges François Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
| | - Coureche Kaderbhai
- Departmnt of Medical Oncology, Georges François Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
| | - Romain Boidot
- Department of Biopathology, Georges François Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
| | - Sandy Chevrier
- Department of Biopathology, Georges François Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
| | - Philippe Joubert
- Department of Pathology, Quebec Heart and Lung Institute Research Center, Quebec City, Quebec, Canada
| | - Bertrand Routy
- Department of Medicine Montréal, Division of Oncology, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- Division of Hematology-Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Quebec City, Quebec, Canada
| | - Caroline Truntzer
- Platform of Transfer in Biological Oncology, Georges-Francois Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
- UMR INSERM 1231, Dijon, Bourgogne-Franche-Comté, France
- Genomic and Immunotherapy Medical Institute, Dijon University Hospital, Dijon, Bourgogne-Franche-Comté, France
- University of Burgundy-Franche Comté, Dijon, Bourgogne-Franche-Comté, France
| | - Francois Ghiringhelli
- Platform of Transfer in Biological Oncology, Georges-Francois Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
- UMR INSERM 1231, Dijon, Bourgogne-Franche-Comté, France
- Genomic and Immunotherapy Medical Institute, Dijon University Hospital, Dijon, Bourgogne-Franche-Comté, France
- University of Burgundy-Franche Comté, Dijon, Bourgogne-Franche-Comté, France
- Departmnt of Medical Oncology, Georges François Leclerc Cancer Center - UNICANCER, Dijon, Bourgogne-Franche-Comté, France
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