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. 2022 Feb;13(3):483-488.
doi: 10.1111/1759-7714.14256. Epub 2021 Dec 22.

Host immune-inflammatory markers to unravel the heterogeneous outcome and assessment of patients with PD-L1 ≥50% metastatic non-small cell lung cancer and poor performance status receiving first-line immunotherapy

Giuseppe L Banna  1 , Marcello Tiseo  2   3 , Diego L Cortinovis  4 , Francesco Facchinetti  5 , Joachim G J V Aerts  6 , Cinzia Baldessari  7 , Raffaele Giusti  8 , Emilio Bria  9   10 , Francesco Grossi  11 , Rossana Berardi  12 , Alessandro Morabito  13 , Annamaria Catino  14 , Carlo Genova  15 , Francesca Mazzoni  16 , Alain Gelibter  17 , Francesca Rastelli  18 , Marianna Macerelli  19 , Rita Chiari  20 , Stefania Gori  21 , Giovanni Mansueto  22 , Fabrizio Citarella  23 , Luca Cantini  6   12 , Erika Rijavec  24 , Federica Bertolini  7 , Federico Cappuzzo  25 , Alessandro De Toma  26 , Alex Friedlaender  27 , Giulio Metro  28 , Maria Vittoria Pensieri  29 , Giampiero Porzio  30 , Corrado Ficorella  29   30 , David J Pinato  31   32 , Alessio Cortellini #  31 , Alfredo Addeo #  27
Affiliations

Host immune-inflammatory markers to unravel the heterogeneous outcome and assessment of patients with PD-L1 ≥50% metastatic non-small cell lung cancer and poor performance status receiving first-line immunotherapy

Giuseppe L Banna et al. Thorac Cancer. 2022 Feb.

Abstract

Background: Patients with programmed cell death-ligand 1 (PD-L1) ≥50% metastatic non-small cell lung cancer (mNSCLC) and ECOG performance status (PS) of 2 treated with first-line immunotherapy have heterogeneous clinical assessment and outcomes.

Methods: To explore the role of immune-inflammatory surrogates by the validated lung immuno-oncology prognostic score (LIPS) score, including the neutrophil-to-lymphocyte ratio (NLR) and the pretreatment use of steroids, alongside other prognostic variables. A retrospective analysis of 128 patients with PS2 and PD-L1 ≥50% mNSCLC treated between April 2018 and September 2019 with first-line pembrolizumab in a real-world setting was performed.

Results: With a median follow-up of 15.3 months, the 1-year overall survival (OS) and median progression-free survival (PFS) were 32.3% (95% CI: 30.9-33.9) and 3.3 months (95% CI: 1.8-4.7), respectively. The NLR, lactate dehydrogenase (LDH) and pretreatment steroids results were the only significant prognostic factors on the univariate analysis and independent prognostic factors by the multivariate analysis on both OS and PFS. The LIPS score, including the NLR and pretreatment steroids, identified 29 (23%) favourable-risk patients, with 0 factors, 1-year OS of 67.6% and median PFS of 8.2 months; 57 (45%) intermediate-risk patients, with 1 factor, 1-year OS 32.1% and median PFS 2.7 months; 42 (33%) poor-risk patients, with both factors, 1-year OS of 10.7% and median PFS of 1.2 months.

Conclusions: The assessment of pre-existing imbalance of the host immune response by combined blood and clinical immune-inflammatory markers may represent a way to unravel the heterogeneous outcome and assessment of patients with mNSCLC and poor PS in the immune-oncology setting.

Keywords: immunotherapy; inflammation; neutrophil-to-lymphocyte ratio (NLR); non-small cell lung cancer; performance status.

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Conflict of interest statement

Dr Marcello Tiseo received speakers' and consultants' fee from Astra‐Zeneca, Pfizer, Eli‐Lilly, BMS, Novartis, Roche, MSD, Boehringer Ingelheim, Otsuka, Takeda, Pierre Fabre. M.T. received institutional research grants from Astra‐Zeneca, Boehringer Ingelheim. Dr Diego Cortinovis received speaker fees/grant consultancies by Astra Zeneca, BMS, MSD, Boehringer Ingelheim, Novartis, Amgen, Roche, Eli Lilly. Dr Francesco Facchinetti has participated to editorial activities sponsored by BMS and Roche. Dr Emilio Bria received speaker and travel fees from MSD, Astra‐Zeneca, Pfizer, Helsinn, Eli‐Lilly, BMS, Novartis and Roche. Dr Emilio Bria received grant consultancies by Roche and Pfizer. Dr. Alessandro Morabito received speaker fees by Astra, Roche, BMS, MSD, Boehringer, Pfizer, Takeda. Dr Francesca Mazzoni received grant consultancies by MSD and Takeda. Dr Raffaele Giusti received speaker fees and grant consultancies by AstraZeneca and Roche. Dr Carlo Genova received speaker fees/grant consultancies by Astrazeneca, BMS, Boehringer‐Ingelheim. Dr Alex Friedlaender received grant consultancies by Roche, Pfizer, Astellas and BMS. Dr Rita Chiari received speaker fees by BMS, MSD, Takeda, Pfizer, Roche and AstraZeneca. Dr David J Pinato received lecture fees from ViiV Healthcare, Bayer Healthcare and travel expenses from BMS and Bayer Healthcare; consulting fees for Mina Therapeutics, EISAI, Roche, Astra Zeneca; received research funding (to institution) from MSD, BMS. Dr Alfredo Addeo received grant consultancies by Takeda, MSD, BMJ, AstraZeneca, Roche and Pfizer. Dr Alessio Cortellini received speaker fees and grant consultancies by AstraZeneca, MSD, BMS, Roche, Novartis, and Astellas. All other author declared no interests to disclose.

Figures

FIGURE 1
FIGURE 1
OS and PFS by risk categories based on NLR, pretreatment steroids use +/− LDH in patients with mNSCLC, PD‐L1 ≥50% and ECOG PS 2
See this image and copyright information in PMC

References

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