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.
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.
Authors: Giuseppe Luigi Banna; Alex Friedlaender; Marco Tagliamento; Veronica Mollica; Alessio Cortellini; Sara Elena Rebuzzi; Arsela Prelaj; Abdul Rafeh Naqash; Edouard Auclin; Lucia Garetto; Laura Mezquita; Alfredo Addeo Journal: Curr Oncol Rep Date: 2022-10-18 Impact factor: 5.945
Authors: Kristin L Ayers; Meng Ma; Gaspard Debussche; David Corrigan; Jonathan McCafferty; Kyeryoung Lee; Scott Newman; Xiang Zhou; Fred R Hirsch; Philip C Mack; Jane J Liu; Eric E Schadt; Rong Chen; Shuyu D Li Journal: BMC Cancer Date: 2021-04-21 Impact factor: 4.430
Authors: Charlotte Pilard; Marie Ancion; Philippe Delvenne; Guy Jerusalem; Pascale Hubert; Michael Herfs Journal: Br J Cancer Date: 2021-06-10 Impact factor: 9.075
Authors: Sara Elena Rebuzzi; Alessio Signori; Giuseppe Luigi Banna; Marco Maruzzo; Ugo De Giorgi; Paolo Pedrazzoli; Andrea Sbrana; Paolo Andrea Zucali; Cristina Masini; Emanuele Naglieri; Giuseppe Procopio; Sara Merler; Laura Tomasello; Lucia Fratino; Cinzia Baldessari; Riccardo Ricotta; Stefano Panni; Veronica Mollica; Maria Sorarù; Matteo Santoni; Alessio Cortellini; Veronica Prati; Hector Josè Soto Parra; Marco Stellato; Francesco Atzori; Sandro Pignata; Carlo Messina; Marco Messina; Franco Morelli; Giuseppe Prati; Franco Nolè; Francesca Vignani; Alessia Cavo; Giandomenico Roviello; Francesco Pierantoni; Chiara Casadei; Melissa Bersanelli; Silvia Chiellino; Federico Paolieri; Matteo Perrino; Matteo Brunelli; Roberto Iacovelli; Camillo Porta; Sebastiano Buti; Giuseppe Fornarini Journal: Ther Adv Med Oncol Date: 2021-05-18 Impact factor: 8.168