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Review
. 2023 Jan;61(1):74-81.
doi: 10.1016/j.resinv.2022.10.003. Epub 2022 Nov 29.

Prognostic role of modified Glasgow Prognostic score in elderly non-small cell lung cancer patients treated with anti-PD-1 antibodies

Tomohiro Tanaka  1 , Tatsuya Yoshida  2 , Ken Masuda  2 , Yuki Takeyasu  2 , Yuki Shinno  2 , Yuji Matsumoto  2 , Yusuke Okuma  2 , Yasushi Goto  2 , Hidehito Horinouchi  2 , Noboru Yamamoto  3 , Yuichiro Ohe  2
Affiliations
Review

Prognostic role of modified Glasgow Prognostic score in elderly non-small cell lung cancer patients treated with anti-PD-1 antibodies

Tomohiro Tanaka et al. Respir Investig. 2023 Jan.

Abstract

Background: This study aimed to investigate whether the immunosenescence-related score is a critical prognostic predictor of anti-programmed cell death protein 1 (PD-1) axis inhibitors in elderly patients with advanced non-small cell lung cancer (NSCLC).

Methods: We reviewed 51 patients with advanced NSCLC aged ≥75 years, who were treated with nivolumab or pembrolizumab at the National Cancer Center Hospital between December 2015 and April 2019. Factors such as modified Glasgow prognostic score (mGPS), Neutrophil-to-lymphocyte ratio (NLR), and Charlson comorbidity index (CCI) were used to assess immunosenescence.

Results: The objective response rate (ORR) and disease control rate (DCR) of all patients were 25.4% (95% confidence interval [CI]: 14.3-39.6) and 52.9% (95% CI: 38.5-67.1), respectively. High mGPS (score of 2) was associated with low DCR compared to low mGPS (score of 0-1) (26.0% vs. 54.0%, p = 0.03). However, none of these scores were significantly related to the ORR. High mGPS was significantly linked to shorter median progression-free survival (mPFS) (4.2 mos. vs. 12.7 mos, p < 0.01), and median overall survival (mOS) (4.8 mos. vs. 28.1 mos, p = 0.03). However, neither CCI nor NLR was associated with prognosis. Multivariate regression analysis identified high mGPS as a significant prognostic factor for mOS (hazard ratio, HR: 0.31 [95% CI: 0.13-0.71], p < 0.01).

Conclusions: High mGPS scores significantly impaired DCR, mPFS, and mOS in patients with advanced NSCLC treated with anti-PD-1 antibodies.

Keywords: Elderly; Immuno-checkpoint inhibitors; Immunosenescence; Modified Glasgow prognostic score; Non-small cell lung cancer.

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Conflict of interest statement

Conflict of Interest Yuichiro Ohe received honoraria (lecture fees) from AstraZeneca, Chugai pharmaceutical Co Ltd; Hidehito Horinouchi received honoraria (lecture fees) from AstraZeneca, Eli Lilly Japan K.K, ONO pharmaceutical Co Ltd, Bristol Myers Squibb; Yasushi Goto received honoraria (lecture fees) from AstraZeneca, Pfizer, Novartis, Eli Lilly Japan K·K; Tatshuya Yoshida received honoraria (lecture fees) from AstraZeneca, Chugai pharmaceutical Co Ltd, Eli Lilly Japan K·K, Takeda, ONO pharmaceutical Co Ltd; Yusuke Okuma received honoraria (lecture fees) from AstraZeneca, Eli Lilly Japan K·K, Chugai pharmaceutical Co Ltd; Tomohiro Tanaka, Yuki Takeyasu, Ken Masuda, Yuki Shinnno, Yuji Matsumoto and Noboru Yamamoto have no conflict of interest.