Efficacy outcomes and prognostic factors from real-world patients with advanced non-small-cell lung cancer treated with first-line chemoimmunotherapy: The Spinnaker retrospective study. in International immunopharmacology / Int Immunopharmacol. 2022 Sep;110:108985. doi: 10.1016/j.intimp.2022.108985. Epub 2022 Jun 28.
2022
ASL Torino 4
AOU San Luigi di Orbassano
Tipo pubblicazione
Journal Article
Autori/Collaboratori (17)Vedi tutti...
Barone G
United Lincolnshire Hospitals NHS Trust, Lincoln, UK.
Addeo A
University Hospital Geneva, Geneva, Switzerland.
Signori A
University of Genoa, Genoa, Italy.
et alii...
Abstract
BACKGROUND: Efficacy outcomes and prognostic factors of real-world patients with advanced non-small cell lung cancer (aNSCLC) treated with first-line chemoimmunotherapy are still limited. PATIENTS AND METHODS: In the retrospective Spinnaker study, data was collected from patients in six United Kingdom and one Swiss oncology centres with first-line pembrolizumab plus platinum-based chemotherapy. Efficacy outcomes and potential prognostic factors were estimated aiming at developing a prognostic model. RESULTS: Three-hundred-eight patients were included, 32% ? 70 years, with ? 3 metastatic sites in 33%, brain or liver metastases in 10% and 12%, respectively. With a median follow-up of 18.0 months (mo.) (range, 15.9-20.1), median overall survival (OS) and progression-free survival (PFS) were 12.7 mo. (range, 10.2-15.2), and 8.0 mo. (range, 7.1-8.8), respectively. The neutrophils-to-lymphocytes ratio (NLR) and systemic immune-inflammatory index (SII) (i.e., NLR × platelet count) were both significantly higher in ECOG PS 1 (p = 0.0147 and p = 0.0018, respectively), underweight or normal body mass index (p = 0.0456 and p = 0.0062, respectively), ?3 metastatic sites (p = 0.0069 and p = 0.112), pretreatment steroids (p = 0.0019 and p = 0.0017). By MVA, the number of metastatic sites ? 3 (p < 0.001 and p = 0.002), squamous histology (p = 0.033 and p = 0.013) and SII ? 1444 (p = 0.031 and p = 0.009, respectively) were associated with both worse OS and PFS and led to a highly discriminating three-class risk prognostic model. CONCLUSION: Real-world PFS with chemoimmunotherapy in aNSCLC patients is similar to that reported in clinical trials. A high number of metastatic sites, squamous histology and high SII are adverse prognostic factors that might contribute to a clinically useful prognostic model.
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PMID : 35777264
DOI : 10.1016/j.intimp.2022.108985
Keywords
Prognostic; Non-small-cell lung cancer; NLR prognostic; Inflammatory index; Chemoimmunotherapy; Retrospective Studies; Prognosis; Neutrophils/pathology; Lymphocytes/pathology; Humans; Lung Neoplasms; Carcinoma, Squamous Cell/pathology; Carcinoma, Non-Small-Cell Lung;