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Prognostic Factors of Second-line Immune Checkpoint Inhibitors in Patients With Advanced-stage Non-Small Cell Lung
Jiyeon Roh1, Jung Seop Eom1, Min Ki Lee1
1Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital.
Objectives:
Immune checkpoint inhibitors (ICIs) targeting the programmed cell death receptor-1 and its ligand have achieved impressive success in treating patients with advanced-stage non-small cell lung cancer (NSCLC) after failed first-line cytotoxic chemotherapy. However, knowledge on clinical biomarkers that could help select patients who will respond well to second-line ICI therapy is limited.
Patients And Methods:
Medical records of patients with NSCLC treated with first-line platinum-based chemotherapy and subsequent second-line ICI were collected from 6 medical centers between January 2018 and June 2020. Clinical information, pathologic variables, and radiologic findings of the data collected were reviewed. The patients were followed up until the date of the last visit, the death of any cause, or the end of data recording (December 31, 2020).
Results:
A total of 181 patients with NSCLC were treated with second-line ICI following first-line platinum-based doublet chemotherapy. The median progression-free survival was 2.0 months (interquartile range, 1.0 to 5.5 mo), and the median overall survival was 12.0 months (interquartile range, 6.0 to 20.0 mo). Low body mass index (BMI) was independently associated with progression-free survival (odds ratio [OR], 0.826; 95% confidence interval [CI], 0.723-0.945; P=0.005). Similarly, a low BMI (OR, 0.839; 95% CI, 0.740-0.952; P=0.005) and a high number of metastatic organs (OR, 1.682; 95% CI, 1.156-2.448; P=0.007) were independently associated with the overall survival after second-line ICI therapy.
Conclusion:
BMI and the number of metastatic sites were significantly associated with second-line ICI therapy outcomes in patients with NSCLC receiving first-line platinum-based chemotherapy.
Insights
Low body mass index (BMI) and a higher number of metastatic sites are key predictors for treatment success in advanced non-small cell lung cancer (NSCLC) patients receiving second-line immune checkpoint inhibitors (ICIs). These factors influence both progression-free and overall survival.
Area of Science:
- Oncology
- Immunotherapy
- Biomarker Discovery
Background:
- Immune checkpoint inhibitors (ICIs) show efficacy in advanced non-small cell lung cancer (NSCLC) post-chemotherapy.
- Identifying predictive biomarkers for second-line ICI therapy in NSCLC remains a challenge.
Purpose of the Study:
- To investigate clinical biomarkers associated with outcomes in NSCLC patients receiving second-line ICI therapy.
- To evaluate the impact of patient characteristics on treatment response after first-line chemotherapy.
Main Methods:
- Retrospective analysis of 181 NSCLC patients treated with first-line platinum-based chemotherapy followed by second-line ICI.
- Data collection included clinical, pathological, and radiological variables.
- Statistical analysis identified independent predictors for progression-free and overall survival.
Main Results:
- Median progression-free survival was 2.0 months and median overall survival was 12.0 months.
- Low body mass index (BMI) was independently associated with improved progression-free survival (OR, 0.826; P=0.005).
- Low BMI (OR, 0.839; P=0.005) and a high number of metastatic organs (OR, 1.682; P=0.007) were associated with overall survival.
Conclusions:
- Body mass index and the number of metastatic sites are significant clinical biomarkers for predicting outcomes in NSCLC patients undergoing second-line ICI therapy.
- These findings can aid in patient selection for immunotherapy after initial chemotherapy failure.
