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Huemer, Florian; Lang, David; Westphal, Theresa; Gampenrieder, Simon Peter; Hutarew, Georg; Weiss, Lukas; Hackl, Hubert; Lamprecht, Bernd; Rinnerthaler, Gabriel; Greil, Richard
Journal of clinical medicine, 07/2019, Volume: 8, Issue: 7Journal Article
Immune-checkpoint blockade in front-line or second-line treatment improves survival in advanced non-small cell lung cancer (aNSCLC) when compared with chemotherapy alone. However, easily applicable predictive parameters are necessary to guide immune-checkpoint inhibition in clinical practice. In this retrospective bi-centric analysis, we investigated the impact of baseline patient and tumor characteristics on clinical outcome in aNSCLC patients treated with programmed cell death protein 1(PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors. Between May 2015 and January 2018, 142 unselected consecutive NSCLC patients received PD-1/PD-L1 inhibitors during the course of disease. In multivariate analysis, we identified the Eastern Cooperative Oncology Group (ECOG) performance status (ECOG > 1 versus ECOG ≤ 1, HR: 3.23, 95%CI: 1.58-6.60, = 0.001), baseline absolute lymphocyte count (ALC; high: >0.93 × 10 /L versus low: ≤ 0.93 × 10 /L, HR: 0.38, 95%CI: 0.23-0.62, < 0.001), prior or concomitant anti-vascular endothelial growth factor (VEGF) targeting therapy (yes versus no, HR: 2.18, 95%CI: 1.15-4.14, = 0.017) and TNM stage (IV versus III, HR: 4.18, 95%CI: 1.01-17.36, = 0.049) as the most relevant parameters for survival. Neither antibiotic exposure (antibiotic-positive versus antibiotic-negative, HR: 0.90, 95%CI: 0.56-1.45, = 0.675), nor PD-L1 expression on tumor cells (≥1% versus <1%, HR: 0.68, 95%CI: 0.41-1.13, = 0.140) was associated with survival. Baseline ECOG performance status and ALC were associated with survival in aNSCLC patients treated with PD-1/PD-L1 inhibitors and assessment of these parameters could be suitable in clinical practice.
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