1. Interrelations between Patients’ Clinicopathological Characteristics and Their Association with Response to Immunotherapy in a Real-World Cohort of NSCLC Patients
- Author
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Joan Frigola, Caterina Carbonell, Enriqueta Felip, Alejandro Navarro, P. Iranzo, Alex Martinez-Marti, A. Callejo, Nely Diaz, D. Marmolejo, Ramon Amat, Susana Cedres, J.D. Assaf, N. Pardo, Institut Català de la Salut, [Callejo A, Iranzo P, Diaz N, Assaf JD, Cedrés S, Martinez-Marti A, Navarro A, Pardo N] Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Frigola J, Carbonell C, Amat R] Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Marmolejo D] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Felip E] Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,LDH ,medicine.medical_treatment ,Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] ,ECOG Performance Status ,Other subheadings::Other subheadings::/drug therapy [Other subheadings] ,NSCLC ,Article ,immune checkpoint inhibitors ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Other subheadings::/therapeutic use [Other subheadings] ,Adverse effect ,Survival analysis ,RC254-282 ,Medicaments antineoplàstics - Ús terapèutic - Eficàcia ,Otros calificadores::/uso terapéutico [Otros calificadores] ,business.industry ,Hazard ratio ,acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antineoplásicos [COMPUESTOS QUÍMICOS Y DROGAS] ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,biomarkers ,Retrospective cohort study ,Immunotherapy ,Neoplasms::Neoplasms by Site::Thoracic Neoplasms::Respiratory Tract Neoplasms::Lung Neoplasms::Bronchial Neoplasms::Carcinoma, Bronchogenic::Carcinoma, Non-Small-Cell Lung [DISEASES] ,neoplasias::neoplasias por localización::neoplasias torácicas::neoplasias del tracto respiratorio::neoplasias pulmonares::neoplasias de los bronquios::carcinoma broncogénico::carcinoma de pulmón de células no pequeñas [ENFERMEDADES] ,immune related adverse events ,030104 developmental biology ,030220 oncology & carcinogenesis ,Cohort ,immunotherapy ,Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents [CHEMICALS AND DRUGS] ,business ,Pulmons - Càncer - Tractament - Abstract
Immune checkpoint inhibitors (ICIs) have transformed non-small cell lung cancer (NSCLC) treatment. Unfortunately, only some patients benefit from these therapies. Thus, certain clinicopathological characteristics of the patients have been proposed as biomarkers of ICIs response. We assembled a retrospective cohort of 262 NSCLC patients treated with ICIs, compiled relevant clinicopathological characteristics, and studied their associations with treatment outcome using Cox proportional-hazards survival models. Additionally, we investigated the interrelations between clinicopathological features and devised a method to create a compendium associated with ICIs response by selecting those that provide non-redundant information. In multivariate analyses, ECOG performance status (hazard ratio (HR) 1.37 (95% CI 1.11 to 1.68), p <, 0.005), LDH (HR 1.24 (95% CI 1.03 to 1.48), p = 0.02)) and PD-L1 negativity were associated with decreased PFS (HR 1.92 (95% CI 1.03 to 3.58), p <, 0.04), whereas presentation of immune-related adverse events (irAEs) (HR 0.35 (95% CI 0.22 to 0.55, p <, 0.005) or females (HR 0.52 (95% CI 0.33 to 0.80, p <, 0.005) had longer progression-free survival. Additionally, numerous clinicopathological indicators were found to be interrelated. Thus, we searched for features that provide non-redundant information, and found the combination of LDH levels, irAEs, and gender to have a better association with ICIs treatment response (cross-validated c-index = 0.66). We concluded that several clinicopathological features showed prognostic value in our real-world cohort. However, some are interrelated, and compendiums of features should therefore consider these interactions. Joint assessment of LDH, irAEs, and gender may be a good prognostic compendium.
- Published
- 2021
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