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Prediction of outcome in patients with non-small cell lung cancer treated with second line PD-1/PDL-1 inhibitors based on clinical parameters: Results from a prospective, single institution study.
- Source :
-
PloS one [PLoS One] 2021 Jun 01; Vol. 16 (6), pp. e0252537. Date of Electronic Publication: 2021 Jun 01 (Print Publication: 2021). - Publication Year :
- 2021
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Abstract
- Objective: We prospectively recorded clinical and laboratory parameters from patients with metastatic non-small cell lung cancer (NSCLC) treated with 2nd line PD-1/PD-L1 inhibitors in order to address their effect on treatment outcomes.<br />Materials and Methods: Clinicopathological information (age, performance status, smoking, body mass index, histology, organs with metastases), use and duration of proton pump inhibitors, steroids and antibiotics (ATB) and laboratory values [neutrophil/lymphocyte ratio, LDH, albumin] were prospectively collected. Steroid administration was defined as the use of > 10 mg prednisone equivalent for ≥ 10 days. Prolonged ATB administration was defined as ATB ≥ 14 days 30 days before or within the first 3 months of treatment. JADBio, a machine learning pipeline was applied for further multivariate analysis.<br />Results: Data from 66 pts with non-oncogenic driven metastatic NSCLC were analyzed; 15.2% experienced partial response (PR), 34.8% stable disease (SD) and 50% progressive disease (PD). Median overall survival (OS) was 6.77 months. ATB administration did not affect patient OS [HR = 1.35 (CI: 0.761-2.406, p = 0.304)], however, prolonged ATBs [HR = 2.95 (CI: 1.62-5.36, p = 0.0001)] and the presence of bone metastases [HR = 1.89 (CI: 1.02-3.51, p = 0.049)] independently predicted for shorter survival. Prolonged ATB administration, bone metastases, liver metastases and BMI < 25 kg/m2 were selected by JADbio as the important features that were associated with increased probability of developing disease progression as response to treatment. The resulting algorithm that was created was able to predict the probability of disease stabilization (PR or SD) in a single individual with an AUC = 0.806 [95% CI:0.714-0.889].<br />Conclusions: Our results demonstrate an adverse effect of prolonged ATBs on response and survival and underscore their importance along with the presence of bone metastases, liver metastases and low BMI in the individual prediction of outcomes in patients treated with immunotherapy.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung mortality
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Lung Neoplasms mortality
Machine Learning
Male
Middle Aged
Prognosis
Progression-Free Survival
Prospective Studies
Anti-Bacterial Agents adverse effects
B7-H1 Antigen antagonists & inhibitors
Bone Neoplasms secondary
Carcinoma, Non-Small-Cell Lung drug therapy
Carcinoma, Non-Small-Cell Lung pathology
Immune Checkpoint Inhibitors administration & dosage
Immunotherapy methods
Liver Neoplasms secondary
Lung Neoplasms drug therapy
Lung Neoplasms pathology
Programmed Cell Death 1 Receptor antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 16
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 34061904
- Full Text :
- https://doi.org/10.1371/journal.pone.0252537