1
|
Chen Y, Guan Z, Shen G. Naples prognostic score: a novel predictor of survival in patients with HER2-positive breast cancer. Future Oncol 2022; 18:2655-2665. [PMID: 35592939 DOI: 10.2217/fon-2022-0212] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: The predictive significance of the Naples prognostic score (NPS) in HER2-positive breast cancer is unclear. Hence we sought to evaluate the relationship between NPS and the clinical outcomes in HER2-positive breast cancer patients. Methods: This study retrospectively collected and analyzed data from 173 HER2-positive breast cancer patients between August 2004 and February 2014. The Cox regression model was applied in univariate and multivariate statistical analysis. Results: In multivariate analysis, increased NPS score correlated significantly with poor overall survival (p = 0.001) and disease-free survival (p < 0.001). Conclusion: Our findings may point to NPS being a novel and reliable prognostic score system with favorable predictive ability for HER2-positive breast cancer patients.
Collapse
Affiliation(s)
- Yuye Chen
- Department of Oncology, Zhuji People's Hospital of Zhejiang Province, Zhuji, Shaoxing City, 311800, China
| | - Zheming Guan
- Weifang People's Hospital, Weifang City, 261000, China
| | - Guo Shen
- Department of General Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou City, 311202, China
| |
Collapse
|
2
|
Xuan J, Peng J, Wang S, Cai Y. Prognostic significance of Naples prognostic score in non-small-cell lung cancer patients with brain metastases. Future Oncol 2022; 18:1545-1555. [PMID: 35107367 DOI: 10.2217/fon-2021-1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: The authors aimed to evaluate the prognostic value of Naples prognostic score (NPS) in advanced non-small-cell lung cancer patients with brain metastases. Materials & methods: A total of 186 consecutive advanced non-small-cell lung cancer patients were retrospectively analyzed. Kaplan-Meier survival analysis and Cox proportional regression models were used to assess the significance of NPS in overall survival and disease-free survival. Results: Multivariate Cox proportional regression analysis revealed that NPS was a significant independent predictive indicator for overall survival (hazard ratio: 1.897; 95% CI: 1.184-3.041; p = 0.008) and disease-free survival (hazard ratio: 2.169; 95% CI: 1.367-3.44; p = 0.001). Conclusion: NPS was a powerful prognostic indicator for outcome in advanced non-small-cell lung cancer patients with brain metastases.
Collapse
Affiliation(s)
- Junmei Xuan
- Department of General medicine, Shaoxing People's Hospital, Shaoxing City, 312000, China
| | - Jianghua Peng
- Department of General medicine, Shaoxing People's Hospital, Shaoxing City, 312000, China
| | - Shuai Wang
- Department of Thoracic surgery, Yidu Central Hospital of Weifang, Weifang City, 261000, China
| | - Yaojie Cai
- Department of Neurology, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing City, 312000, China
| |
Collapse
|
3
|
Liu Q, Jiang L, Li K, Li H, Lv G, Lin J, Qiu L. Immuno-PET imaging of 68Ga-labeled nanobody Nb109 for dynamic monitoring the PD-L1 expression in cancers. Cancer Immunol Immunother 2021; 70:1721-1733. [PMID: 33386467 DOI: 10.1007/s00262-020-02818-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 12/02/2020] [Indexed: 12/11/2022]
Abstract
The checkpoint blockade immunotherapy has become a potent treatment strategy for cancers, and programmed death ligand-1 (PD-L1) is a prominent checkpoint ligand that is highly expressed in some cancers. The identification of immune checkpoint marker PD-L1 is critical for improving the success of immunotherapy. Accordingly, the binding specificity and dynamic monitoring property of a non-blocking nanobody tracer 68Ga-NOTA-Nb109 to PD-L1 were assessed in this study. The endogenous expression level of PD-L1 in several cancer cells was measured by flow cytometry, Western blot, and cellular uptake assay. Sensitivity and specificity of 68Ga-NOTA-Nb109 in monitoring the expression of PD-L1 in vivo were evaluated by PET imaging of different tumor-bearing models (U87, high PD-L1 expression; HCT 116, medium PD-L1 expression; and NCI-H1299, low PD-L1 expression). In vivo PET imaging results agreed well with those detected in vitro. In addition, PET imaging of PD-L1 expression in U87 and NCI-H1299 xenografts using 18F-FDG was also performed for comparison. The maximum tumor-to-muscle uptake ratio of 68Ga-NOTA-Nb109 was more than twofold that of 18F-FDG in U87 xenograft. The change of PD-L1 expression in NCI-H1299 cells and xenografts induced by cisplatin (CDDP) was sensitively monitored by 68Ga-NOTA-Nb109. This study demonstrated the feasibility of tracer 68Ga-NOTA-Nb109 for specifically targeting endogenous PD-L1 and dynamic monitoring the change of PD-L1 expression, and could guide the immunotherapy and immunochemotherapy for refractory cancers.
Collapse
Affiliation(s)
- Qingzhu Liu
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, 214063, China
| | - Lei Jiang
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Ke Li
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, 214063, China
| | - Hang Li
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, 214063, China
| | - Gaochao Lv
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, 214063, China
| | - Jianguo Lin
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, 214063, China.
- Department of Radiopharmaceuticals, School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China.
| | - Ling Qiu
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, 214063, China.
- Department of Radiopharmaceuticals, School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China.
| |
Collapse
|
4
|
Li WC, Wang Z, Gao J, Zhou H, Li J, Zhu XX. Clinical Outcomes and Prognostic Factors of Salvage Stereotactic Body Radiotherapy for Post-Surgical Thoracic Oligo-Recurrence/Metastasis of Non-Small-Cell Lung Cancer. Cancer Manag Res 2021; 13:1887-1896. [PMID: 33654433 PMCID: PMC7914053 DOI: 10.2147/cmar.s287993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/21/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose The study aimed to assess the efficacy and safety of stereotactic body radiotherapy (SBRT) using CyberKnife (CK) in patients with postoperative thoracic oligo-recurrence/metastasis of non-small-cell lung cancer (NLCLC), and to analyze the prognostic factors affecting overall survival after SBRT. Patients and Methods A total of 44 patients with postoperative thoracic oligo-recurrence/metastatic of NLCLC treated with SBRT were reviewed. Thoracic oligo-recurrence/was defined as 1–3 loco-regional confined to lung lobe, hilar/mediastinal lymph nodes, bronchial stump, or chest wall. Primary endpoints included local control (LC), overall survival (OS), progression-free survival (PFS) and toxicity. Prognostic factors that affected these patients were analyzed by the univariate and multivariate analysis by Kaplan–Meier methods and Cox regression models, respectively. Results The median follow-up time after salvage SBRT was 48.5 months. Measuring from the date of salvage SBRT, the median OS of the 44 patients was 52.60 (95% CI: 29.59–75.60) months. 1-,3-and 5-year OS rates were 97.7%, 65.3% and 47.7%, respectively. The 1-,3-year and 5-year LC rates were 97.7%, 85.1% and 80.1%, respectively. At 1, 3 and 5 years, the PFS rates were 77.1%, 28.8% and 5.3%, respectively. Multivariate analysis demonstrated that pre-SBRT neutrophil-to-lymphocyte ratio (NLR) and Charlson comorbidity index (CCI) were independent prognostic factors (p < 0.05). The treatment-related side-effects were well tolerated. No patients developed grade 3 or greater pulmonary toxicity. Conclusion SBRT is a promising salvage therapeutic option for postoperative thoracic oligo-recurrence/metastasis of non-small-cell lung cancer with acceptable toxicity. Low pre-SBRT neutrophil-to-lymphocyte ratio (NLR) and low Charlson comorbidity index (CCI) were associated with a better prognosis and longer survival and might be considered as reliable and independent prognostic factors in these patients treated with SBRT.
Collapse
Affiliation(s)
- Wen-Cai Li
- Department of Radiation Oncology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China
| | - Zhen Wang
- Department of Medical Radiation Oncology, Jinling Hospital, Nanjing, Jiangsu, 210002, People's Republic of China
| | - Jie Gao
- Department of Medical Radiation Oncology, Jinling Hospital, Nanjing, Jiangsu, 210002, People's Republic of China
| | - Han Zhou
- Department of Medical Radiation Oncology, Jinling Hospital, Nanjing, Jiangsu, 210002, People's Republic of China
| | - Jing Li
- Department of Medical Radiation Oncology, Jinling Hospital, Nanjing, Jiangsu, 210002, People's Republic of China
| | - Xi-Xu Zhu
- Department of Medical Radiation Oncology, Jinling Hospital, First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, 210002, People's Republic of China
| |
Collapse
|
5
|
Liu Y, Li X, Yin Z, Lu P, Ma Y, Kai J, Luo B, Wei S, Liang X. Prognostic Prediction Models Based on Clinicopathological Indices in Patients With Resectable Lung Cancer. Front Oncol 2020; 10:571169. [PMID: 33194667 PMCID: PMC7658583 DOI: 10.3389/fonc.2020.571169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/05/2020] [Indexed: 12/25/2022] Open
Abstract
Serum enzymes, blood cytology indices, and pathological features are associated with the prognosis of patients with lung cancer, and we construct prognostic prediction models based on clinicopathological indices in patients with resectable lung cancer. The study includes 420 patients with primary lung cancer who underwent pneumonectomy. Cox proportional hazards regression was conducted to analyze the prognostic values of individual clinicopathological indices. The prediction accuracies of models for overall survival (OS) and progression-free survival (PFS) were estimated through Harrell’s concordance indices (C-index) and Brier scores. Nomograms of the prognostic models were plotted for individualized evaluations of death and cancer progression. We find that the prognostic model based on alkaline phosphatase (ALP), lactate dehydrogenase (LDH), age, history of tuberculosis, and pathological stage present exceptional performance for OS prediction [C-index: 0.74 (95% CI, 0.69-0.79) and Brier score: 0.10], and the prognostic model based on ALP, LDH, and platelet distribution width (PDW), age, pathological stage, and histological type presented outstanding performance for PFS prediction [C-index: 0.71 (95% CI, 0.66-0.75) and Brier score: 0.18]. These findings show that the models based on clinicopathological indices might serve as economic and efficient prognostic tools for resectable lung cancer.
Collapse
Affiliation(s)
- Yanyan Liu
- Division of Internal Medicine, Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinying Li
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Zhucheng Yin
- Department of Medical Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Lu
- Department of Medical Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yifei Ma
- Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jindan Kai
- Department of Thoracic Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Luo
- Department of Medical Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaozhong Wei
- Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinjun Liang
- Department of Medical Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
6
|
Zhang Q, Li J, Huang T, Zhang Y, Xu W, Huang L, Ai H, Yang B. Impacts of Mycoplasma loads and lung lesions on immune and hematological statuses of pigs in an eight-breed cross heterogeneous population. J Anim Sci 2020; 98:5876843. [PMID: 32717077 DOI: 10.1093/jas/skaa235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/23/2020] [Indexed: 02/01/2023] Open
Abstract
Developments of pulmonary diseases, often accompanied by infections of bacteria, severely affect the meat production and welfare of pigs. This study investigated 307 pigs at age of 240 d from an eight-breed cross reared under standardized housing conditions for associations among the extent of lung lesions, bacteria load inferred from 16S rRNA sequencing of bronchoalveolar lavage fluid, as well as 57 immune cells and 25 hematological traits. We showed that the pigs under study suffered substantial and varied lung lesions, and the Mycoplasma is the most associated bacteria genera. At a false discovery rate of 0.05 (FDR < 0.05), the severity of lung lesions were significantly associated with greater CD8+ to CD3+ cell ratio, neutrophil-to-lymphocyte ratio (NLR), and standard deviation of red blood cell volume distribution width (RDW-SD), and lower CD4-CD8-/CD3+, CD3+CD4-CD8-/PBMCs (peripheral blood mononuclear cells) and CD14-CD16-/PBMCs cell ratios, mean corpuscular hemoglobin concentration, lymphocyte count, and lymphocyte count percentage, reflecting an status of inflammation, immune suppression, and hypoxia of the pigs accompanying the progression of the lung lesions. The Mycoplasma abundance showed positive correlations with neutrophil count, neutrophil count percentage, NLR, monocyte count, coefficient of variation in red blood cell volume distribution width , and RDW-SD, and negative correlations with mean corpuscular hemoglobin concentration, lymphocyte count, and lymphocyte count percentage; these correlations are largely consistent with those of lung lesions, supporting the comorbidity of lung lesions and Mycoplasma infection. We also observed nonlinear associations that sharp increases in neutrophil count and neutrophil count percentage occurred only when Mycoplasma abundance raised above the population-average level. The results provide helpful insights into the changes of host immune status in response to Mycoplasma relevant lung diseases in pigs.
Collapse
Affiliation(s)
- Qing Zhang
- State Key Laboratory for Swine Genetic Improvement and Production Technology, Jiangxi Agricultural University, Nanchang, China
| | - Jing Li
- State Key Laboratory for Swine Genetic Improvement and Production Technology, Jiangxi Agricultural University, Nanchang, China
| | - Tao Huang
- State Key Laboratory for Swine Genetic Improvement and Production Technology, Jiangxi Agricultural University, Nanchang, China
| | - Yifeng Zhang
- State Key Laboratory for Swine Genetic Improvement and Production Technology, Jiangxi Agricultural University, Nanchang, China
| | - Wenwu Xu
- State Key Laboratory for Swine Genetic Improvement and Production Technology, Jiangxi Agricultural University, Nanchang, China
| | - Lusheng Huang
- State Key Laboratory for Swine Genetic Improvement and Production Technology, Jiangxi Agricultural University, Nanchang, China
| | - Huashui Ai
- State Key Laboratory for Swine Genetic Improvement and Production Technology, Jiangxi Agricultural University, Nanchang, China
| | - Bin Yang
- State Key Laboratory for Swine Genetic Improvement and Production Technology, Jiangxi Agricultural University, Nanchang, China
| |
Collapse
|
7
|
Prelaj A, Rebuzzi SE, Pizzutilo P, Bilancia M, Montrone M, Pesola F, Longo V, Del Bene G, Lapadula V, Cassano F, Petrillo P, Bafunno D, Varesano N, Lamorgese V, Mastrandrea A, Ricci D, Catino A, Galetta D. EPSILoN: A Prognostic Score Using Clinical and Blood Biomarkers in Advanced Non-Small-cell Lung Cancer Treated With Immunotherapy. Clin Lung Cancer 2020; 21:365-377.e5. [PMID: 32245624 DOI: 10.1016/j.cllc.2019.11.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/14/2019] [Accepted: 11/24/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Second-line immunotherapy (IO) has shown an overall survival benefit. However, only 18% to 20% of patients with advanced non-small-cell lung cancer (aNSCLC) will respond, with a median progression-free survival (PFS) of 2 to 4 months. Thus, biomarkers to select those patients most likely to benefit from IO are greatly needed. PATIENTS AND METHODS We conducted a retrospective analysis of 154 patients with aNSCLC who had received anti-programmed cell death 1 therapy as second line or further treatment. We assessed the absolute neutrophil, lymphocyte, monocyte, and eosinophil counts at baseline (T0) and the second (T1) and third (T2) cycles. The neutrophil/lymphocyte ratio (NLR), derived-NLR (dNLR), lymphocyte/monocyte ratio (LMR), and their percentage of change at T1 and T2 compared with T0 were evaluated. The clinical characteristics and lactate dehydrogenase (LDH) level were also considered. Univariate and multivariate analyses were performed. Significant biomarkers for PFS on multivariate analysis were combined in a prognostic score. RESULTS For overall survival, the negative prognostic biomarkers were Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2, NLR at T0, and dNLR at T1; the LMR at T0, T1, and T2 was identified as a positive prognostic biomarker. For PFS, the negative prognostic biomarkers were ECOG PS 2, liver metastases, NLR at T0, dNLR at T1 and T2, and ≥ 30% increase of NLR from T0 to T1; the positive prognostic biomarkers were heavy smoking, LDH, and LMR at T2. The ≥ 30% increase of LMR from T0 to T1 and T0 to T2 correlated with the overall response rate. A prognostic score (EPSILoN score; smoking, ECOG PS, liver metastases, LDH, NLR) identified 3 prognostic groups (median PFS, 10.2, 4.9, and 1.7 months, respectively; P < .001). CONCLUSIONS The EPSILoN score combines 5 baseline clinical and blood biomarkers and can help to identify patients with aNSCLC who will most likely benefit from second-line IO. Further studies are warranted.
Collapse
Affiliation(s)
- Arsela Prelaj
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy; Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | | | - Pamela Pizzutilo
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Massimo Bilancia
- Ionic Department in Legal and Economic System of Mediterranean: Society, Environment, and Culture, University of Bari Aldo Moro, Taranto, Italy
| | - Michele Montrone
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Francesco Pesola
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Vito Longo
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Gabriella Del Bene
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Vittoria Lapadula
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Flavio Cassano
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Patrizia Petrillo
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Daniela Bafunno
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Niccolò Varesano
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Vito Lamorgese
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Angelica Mastrandrea
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Donatella Ricci
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Annamaria Catino
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| |
Collapse
|
8
|
Prelaj A, Ferrara R, Rebuzzi SE, Proto C, Signorelli D, Galli G, De Toma A, Randon G, Pagani F, Viscardi G, Brambilla M, Trevisan B, Ganzinelli M, Martinetti A, Gallucci R, Di Mauro RM, Molino G, Zilembo N, Torri V, de Braud FM, Garassino MC, Lo Russo G. EPSILoN: A Prognostic Score for Immunotherapy in Advanced Non-Small-Cell Lung Cancer: A Validation Cohort. Cancers (Basel) 2019; 11:E1954. [PMID: 31817541 PMCID: PMC6966664 DOI: 10.3390/cancers11121954] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Beyond programmed death ligand 1 (PD-L1), no other biomarkers for immunotherapy are used in daily practice. We previously created EPSILoN (Eastern Cooperative Oncology Group performance status (ECOG PS), smoking, liver metastases, lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR)) score, a clinical/biochemical prognostic score, in 154 patients treated with second/further-line immunotherapy. This study's aim was to validate EPSILoN score in a different population group. METHODS 193 patients were included at National Cancer Institute of Milan (second-line immunotherapy, 61%; further-line immunotherapy, 39%). Clinical/laboratory parameters such as neutrophil-to-lymphocyte ratio and lactate dehydrogenase levels were collected. Kaplan-Meier and Cox hazard methods were used for survival analysis. RESULTS Overall median progression-free survival and median overall survival were 2.3 and 7.6 months, respectively. Multivariate analyses for Progression-Free Survival (PFS) identified heavy smokers (hazard ratio (HR) 0.71, p = 0.036) and baseline LDH < 400 mg/dL (HR 0.66, p = 0.026) as independent positive factors and liver metastases (HR 1.48, p = 0.04) and NLR ≥ 4 (HR 1.49, p = 0.029) as negative prognostic factors. These five factors were included in the EPSILoN score which was able to stratify patients in three different prognostic groups, high, intermediate and low, with PFS of 6.0, 3.8 and 1.9 months, respectively (HR 1.94, p < 0.001); high, intermediate and low prognostic groups had overall survival (OS) of 24.5, 8.9 and 3.4 months, respectively (HR 2.40, p < 0.001). CONCLUSIONS EPSILoN, combining five baseline clinical/blood parameters (ECOG PS, smoking, liver metastases, LDH, NLR), may help to identify advanced non-small-cell lung cancer (aNSCLC) patients who most likely benefit from immune checkpoint inhibitors (ICIs).
Collapse
Affiliation(s)
- Arsela Prelaj
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Roberto Ferrara
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy;
| | - Claudia Proto
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Diego Signorelli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Giulia Galli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Alessandro De Toma
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Giovanni Randon
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Filippo Pagani
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Giuseppe Viscardi
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Marta Brambilla
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Benedetta Trevisan
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Monica Ganzinelli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Antonia Martinetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Rosaria Gallucci
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Rosa Maria Di Mauro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Giuliano Molino
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Nicoletta Zilembo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Valter Torri
- Pharmacological Research Institute IRCSS Mario Negri, Via La Masa 19, 20156 Milan, Italy;
| | - Filippo Maria de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Marina Chiara Garassino
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| | - Giuseppe Lo Russo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy; (R.F.); (C.P.); (D.S.); (G.G.); (A.D.T.); (G.R.); (F.P.); (G.V.); (M.B.); (B.T.); (M.G.); (A.M.); (R.G.); (R.M.D.M.); (G.M.); (N.Z.); (F.M.d.B.); (M.C.G.); (G.L.R.)
| |
Collapse
|
9
|
Yang Y, Xu H, Yang G, Yang L, Li J, Wang Y. The value of blood biomarkers of progression and prognosis in ALK-positive patients with non-small cell lung cancer treated with crizotinib. Asia Pac J Clin Oncol 2019; 16:63-69. [PMID: 31721468 DOI: 10.1111/ajco.13284] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 10/10/2019] [Indexed: 12/22/2022]
Abstract
AIM Valuable and convenient prognostic predictors are essential for targeted therapy of non-small cell lung cancer (NSCLC). Patients with early-stage cancer and EGFR mutations who's neutrophils-to-lymphocytes rate (NLR) could be prognostic factor to evaluate efficacy. However, the prognostic role of NLR in patients receiving ALK inhibitors has not been established. Additionally, the relation between the efficacy of ALK inhibitors and derived NLR (dNLR), platelets-to-lymphocytes rate (PLR), white blood cells (WBC) and hemoglobin (HGB) are still unknown. METHODS This is a retrospective single-center study and enrolled 113 staged IIIB-IV ALK-positive NSCLC patients who had received crizotinib treatment. Pretreatment NLR, dNLR, PLR, WBC, HGB were collected and calculated. Cox regression analysis were conducted to study the prognostic roles of NLR, dNLR, PLR, WBC, and HGB on progression-free survival (PFS) and overall survival (OS). Z-test was utilized to identify the difference among all predictive factors' receiver-operating characteristics (ROC) curves. RESULTS The median PFS and OS were 10.1 and 23.4 months. Elevated NLR, dNLR, PLR and decreased HGB were associated with worse PFS (95% confidence interval [CI], 1.078-2.304, P = 0.018; 95% CI, 1.043-2.222, P = 0.028; 95% CI, 1.257-2.757, P = 0.002; 95% CI, 0.368-0.843, P = 0.005, respectively) and OS (95% CI, 1.698-5.721, P < 0.001; 95% CI, 1.273-3.984, P = 0.005; 95% CI, 2.174-6.347, P < 0.001; 95% CI, 0.246-0.710, P = 0.001, respectively). Z-test revealed there were no significant differences between single factors or combination of them to predict the efficacy. CONCLUSIONS Trend of NLR, dNLR, PLR and WBC could be used to identify patients progress status in ALK-positive NSCLC patients receiving crizotinib. Combination of all biomarkers is no superior to single biomarker.
Collapse
Affiliation(s)
- Yaning Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haiyan Xu
- Department of Comprehensive, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guangjian Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lu Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junling Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
10
|
Kanaji N, Tadokoro A, Watanabe N, Inoue T, Kadowaki N, Ishii T. Association of specific metastatic organs with the prognosis and chemotherapeutic response in patients with advanced lung cancer. Respir Investig 2019; 57:472-480. [PMID: 31327681 DOI: 10.1016/j.resinv.2019.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/22/2019] [Accepted: 06/12/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND This study was performed to investigate the influence of specific metastatic organs on the prognosis and therapeutic effect in patients with advanced lung cancer. METHODS We retrospectively analyzed 400 patients with pathologically diagnosed advanced lung cancer to determine the association of the patients' metastatic status with their prognoses and responses to first-line therapy. Metastases within the chest cavity (pulmonary metastasis, pleural effusion, and pericardial effusion) were counted as one organ. RESULTS The numbers of metastatic organs in the patients were as follows: one (n=199 patients), two (n=99), three (n=61), and four or more (n=41). A multivariate analysis showed that liver and muscle metastases were independently associated with shorter overall survival (median of 207 and 120 days, respectively) and shorter progression-free survival (median of 125 and 53 days, respectively). Chest cavity, bone, brain, and lymph node metastases were not associated with survival. The presence of either muscle or skin metastasis was associated with a lower response rate to first-line therapy than was the absence of each metastasis (14.3% vs. 49.4% and 11.1% vs. 48.9% in patients with vs. without muscle or skin metastasis, respectively). CONCLUSIONS Muscle and liver metastases were associated with poor outcomes. Muscle and skin metastases were associated with a lower response rate to treatment. For patients with advanced lung cancer, oncologists should select treatment strategies considering the patients' metastatic statuses as well as other clinical characteristics.
Collapse
Affiliation(s)
- Nobuhiro Kanaji
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
| | - Akira Tadokoro
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
| | - Naoki Watanabe
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
| | - Takuya Inoue
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
| | - Norimitsu Kadowaki
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
| | - Tomoya Ishii
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
| |
Collapse
|
11
|
Wang Z, Zhan P, Lv Y, Shen K, Wei Y, Liu H, Song Y. Prognostic role of pretreatment neutrophil-to-lymphocyte ratio in non-small cell lung cancer patients treated with systemic therapy: a meta-analysis. Transl Lung Cancer Res 2019; 8:214-226. [PMID: 31367535 DOI: 10.21037/tlcr.2019.06.10] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Neutrophil-to-lymphocyte ratio (NLR) is related to prognosis in non-small cell lung cancer (NSCLC). However, no consensus on the relationship of pretreatment NLR and survival outcomes of systemic therapy in NSCLC exists. This meta-analysis investigated the prognostic role of pretreatment NLR during systemic therapy for NSCLC, including chemotherapy, immunotherapy and targeted therapy. Methods PubMed, Web of Science and Cochrane Library databases were systematically searched up to April 09, 2019. Hazard ratios (HRs) with their 95% confidence intervals (CIs) were pooled to investigate the association of pretreatment NLR with progression-free survival (PFS) and overall survival (OS). Results In total, 27 articles with 4,298 participants were selected. The pooled results showed that elevated pretreatment NLR was associated with inferior PFS (HR, 1.45, 95% CI, 1.28-1.66) and OS (HR, 1.63, 95% CI, 1.43-1.84) during systemic therapy. Subgroup analyses according to the treatment strategy suggested that higher pretreatment NLR was significantly associated with shorter survival in all therapies, including chemotherapy (PFS HR, 1.74, 95% CI, 1.39-2.17; OS HR, 1.73, 95% CI, 1.26-2.36), immunotherapy (PFS HR, 1.53, 95% CI, 1.27-1.84; OS HR, 2.50, 95% CI, 1.60-3.89) and targeted therapy (PFS HR, 1.53, 95% CI, 1.04-2.25; OS HR, 1.92, 95% CI, 1.14-3.24). Conclusions Pretreatment NLR is a promising prognostic indicator for NSCLC patients receiving systemic therapy, including chemotherapy, immunotherapy and targeted therapy.
Collapse
Affiliation(s)
- Zimu Wang
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Ping Zhan
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Yanling Lv
- Department of Respiratory Medicine, Jinling Clinical Medical College of Nanjing Medical University, Nanjing 210002, China
| | - Kaikai Shen
- Department of Respiratory Medicine, Wannan Medical College, Wuhu 241000, China
| | - Yuqing Wei
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Hongbing Liu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Yong Song
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| |
Collapse
|