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A Cohort Study on Dual Predictive Markers of Immune Combination Therapy for Advanced Non-Small Cell Lung Cancer
Maike Zheng1, Mingming Hu2,3, Yanxia Liu2,3
1Department of Clinical Laboratory, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Tongzhou District, Beijing, China.
Background:
Immune checkpoint inhibitors (ICIs) hold a great promise in treatment of non-small cell lung cancer (NSCLC), while only a portion of patients benefited from the treatment, and others could not achieve optimal therapeutic effects from initial immunotherapy, even for those patients with PD-L1 (Programed cell death ligand 1) tested positive. However, the clinical markers for the selection of patients who will benefit from ICIs combination treatment beforehand are largely unknown.
Objectives:
The purpose of this study was to explore the non-invasive biomarkers that can predict the efficacy of immune combination therapy in advanced/metastatic NSCLC patients.
Design:
This study employed a retrospective cohort design to analyze dual predictive biomarkers in advanced non-small cell lung cancer (NSCLC) patients with immune combination therapy.
Method:
An analysis was conducted on baseline information of 144 patients with advanced/metastatic NSCLC who received ICIs treatment from the November of 2018 to the January of 2023 in Beijing Chest Hospital. We established a scoring group chart to make quantitative prediction for overall survival (OS) and progression-free survival (PFS) based on 4 variables, and set up the nomogram model as well as Decision curve analysis (DCA) to assess clinical benefits of ICIs combination in treatment of patients with advanced/metastatic NSCLC.
Results:
We found that serum globulin (GLB) >26.6 (g/L) (HR = 1.865, P = .002), absolute neutrophil counts (ANC) (109/L) > 5 (HR = 2.146, P < .001), and bone metastasis (HR = 2.148, P < .001) were independent factors affecting the PFS of NSCLC patients. GLB > 26.6 (g/L) (HR = 1.741, P = .018), ANC (109/L) >5 (HR = 1.807, P = .008), bone metastasis (HR = 1.651, P = .002), and PD-L1 Negative (HR = 2.432, P = .032) were independent factors affecting the OS of NSCLC patients. Same variables and cut-off value have good predictive efficacy in both PFS and OS.
Conclusion:
In patients with advanced/metastatic NSCLC receiving ICIs combination treatment, the GLB, ANC, bone metastasis, and PD-L1 may serve as useful predictive markers for the prognosis of NSCLC patients with ICIs combination treatment.
Insights
Serum globulin (GLB), absolute neutrophil count (ANC), bone metastasis, and PD-L1 status can predict treatment response in non-small cell lung cancer (NSCLC) patients receiving immune checkpoint inhibitors (ICIs). These markers help identify patients likely to benefit from combination immunotherapy.
Area of Science:
- Oncology
- Immunotherapy
- Biomarker Discovery
Background:
- Immune checkpoint inhibitors (ICIs) show promise for non-small cell lung cancer (NSCLC) but benefit only a subset of patients.
- Predictive markers for selecting patients who will respond to ICI combination therapy are largely unknown, even for PD-L1 positive cases.
Purpose of the Study:
- To identify non-invasive biomarkers for predicting the efficacy of immune combination therapy in advanced/metastatic NSCLC patients.
- To explore predictive factors for overall survival (OS) and progression-free survival (PFS) in NSCLC patients undergoing ICI treatment.
Main Methods:
- Retrospective cohort study of 144 advanced/metastatic NSCLC patients treated with ICIs.
- Development of a scoring system and nomogram model to predict OS and PFS.
- Utilized Decision Curve Analysis (DCA) to assess clinical benefits.
Main Results:
- Serum globulin (GLB) >26.6 g/L, absolute neutrophil count (ANC) >5 x 10^9/L, and bone metastasis were independent predictors of PFS.
- GLB >26.6 g/L, ANC >5 x 10^9/L, bone metastasis, and PD-L1 negative status were independent predictors of OS.
- Identified variables demonstrated consistent predictive efficacy for both PFS and OS.
Conclusions:
- Serum globulin (GLB), absolute neutrophil count (ANC), bone metastasis, and PD-L1 status are potential predictive markers for NSCLC prognosis in patients receiving ICI combination therapy.
- These biomarkers can aid in selecting patients likely to benefit from advanced NSCLC immunotherapy.
