Epsilon: A prognostic score for immunotherapy in advanced non-small-cell lung cancer: A validation cohort
| Autor: | Benedetta Trevisan, Diego Signorelli, Marta Brambilla, Arsela Prelaj, Rosa Maria Di Mauro, Giulia Galli, Rosaria Gallucci, Giuseppe Viscardi, Sara Elena Rebuzzi, Claudia Proto, Valter Torri, Filippo Pagani, Antonia Martinetti, Giuliano Molino, Alessandro De Toma, Marina Chiara Garassino, Giuseppe Lo Russo, Roberto Ferrara, Nicoletta Zilembo, Filippo Maria de Braud, Giovanni Randon, Monica Ganzinelli |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty Multivariate analysis medicine.medical_treatment Population NSCLC Predictive Prognostic Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Lactate dehydrogenase medicine Lung cancer education Survival analysis education.field_of_study business.industry Hazard ratio Score Cancer Immunotherapy medicine.disease 030104 developmental biology chemistry 030220 oncology & carcinogenesis business |
| Zdroj: | Cancers Volume 11 Issue 12 |
| Popis: | Background: Beyond programmed death ligand 1 (PD-L1), no other biomarkers for immunotherapy are used in daily practice. We previously created EPSILoN (Eastern Cooperative Oncology Group performance status (ECOG PS), smoking, liver metastases, lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR)) score, a clinical/biochemical prognostic score, in 154 patients treated with second/further-line immunotherapy. This study&rsquo s aim was to validate EPSILoN score in a different population group. Methods: 193 patients were included at National Cancer Institute of Milan (second-line immunotherapy, 61% further-line immunotherapy, 39%). Clinical/laboratory parameters such as neutrophil-to-lymphocyte ratio and lactate dehydrogenase levels were collected. Kaplan&ndash Meier and Cox hazard methods were used for survival analysis. Results: Overall median progression-free survival and median overall survival were 2.3 and 7.6 months, respectively. Multivariate analyses for Progression-Free Survival (PFS) identified heavy smokers (hazard ratio (HR) 0.71, p = 0.036) and baseline LDH < 400 mg/dL (HR 0.66, p = 0.026) as independent positive factors and liver metastases (HR 1.48, p = 0.04) and NLR &ge 4 (HR 1.49, p = 0.029) as negative prognostic factors. These five factors were included in the EPSILoN score which was able to stratify patients in three different prognostic groups, high, intermediate and low, with PFS of 6.0, 3.8 and 1.9 months, respectively (HR 1.94, p < 0.001) high, intermediate and low prognostic groups had overall survival (OS) of 24.5, 8.9 and 3.4 months, respectively (HR 2.40, p < 0.001). Conclusions: EPSILoN, combining five baseline clinical/blood parameters (ECOG PS, smoking, liver metastases, LDH, NLR), may help to identify advanced non-small-cell lung cancer (aNSCLC) patients who most likely benefit from immune checkpoint inhibitors (ICIs). |
| Databáze: | OpenAIRE |
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