古斯塔夫·鲁西免疫（GRIm）评分变化是一线帕博利珠单抗治疗的晚期非小细胞肺癌（NSCLC）患者治疗早期的预后生物标志物。
The Gustave Roussy Immune (GRIm)-Score Variation Is an Early-on-Treatment Biomarker of Outcome in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients Treated with First-Line Pembrolizumab.
作者信息
Lenci Edoardo, Cantini Luca, Pecci Federica, Cognigni Valeria, Agostinelli Veronica, Mentrasti Giulia, Lupi Alessio, Ranallo Nicoletta, Paoloni Francesco, Rinaldi Silvia, Nicolardi Linda, Caglio Andrea, Aerts Sophie, Cortellini Alessio, Ficorella Corrado, Chiari Rita, Di Maio Massimo, Dingemans Anne-Marie C, Aerts Joachim G J V, Berardi Rossana
机构信息
Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti Ancona, 60126 Ancona, Italy.
Department of Pulmonary Medicine, Erasmus MC Rotterdam, 3015 GD Rotterdam, The Netherlands.
出版信息
J Clin Med. 2021 Mar 2;10(5):1005. doi: 10.3390/jcm10051005.
BACKGROUND
The Gustave Roussy Immune (GRIm)-Score takes into account neutrophil-to-lymphocyte ratio (NLR), serum albumin concentration and lactate dehydrogenase (LDH) and its prognostic value has been investigated in patients treated with immune check-point inhibitors (ICIs). To further assess the prognostic and predictive value of baseline GRIm-Score (GRImT0) in advanced non-small cell lung cancer (aNSCLC) patients, we separately investigated two cohorts of patients treated with first-line pembrolizumab or chemotherapy. We also investigated whether GRIm-Score at 45 days since treatment initiation (GRImT1) and GRIm-Score difference between the two timepoints may better predict clinical outcomes (GRImΔ = GRImT0 - GRImT1).
METHODS
We retrospectively evaluated 222 aNSCLC patients: 135 treated with pembrolizumab and 87 treated with chemotherapy as the first-line regimen. NLR, serum albumin and LDH concentrations were assessed at T0 and at T1. According to the GRIm-Score, patients were assigned 1 point if they had NLR > 6, LDH > upper limit normal or albumin < 3.5 g/dL. Patients with a GRIm-Score < 2 were considered as having a low Score.
RESULTS
In both cohorts, no difference in terms of overall survival (OS) between patients with low and high GRImT0 was found. Otherwise, median OS and progression free survival (PFS) of the low GRImT1 group were significantly longer than those of the high GRImT1 group in pembrolizumab-treated patients, but not in the CHT cohort (pembrolizumab cohort: low vs. high; median OS not reached vs. 9.2 months, = 0.004; median PFS 10.8 vs. 2.3 months, = 0.002). Patients receiving pembrolizumab with stable/positive GRImΔ had better OS (median OS not reached vs. 12.0 months, < 0.001), PFS (median PFS 20.6 vs. 2.6 months, < 0.001) and objective response rate (58.2% vs. 7.6%, = 0.003) compared to patients with negative GRImΔ.
CONCLUSION
Our data shown that GRImT1 and GRImΔ are more reliable peripheral blood biomarkers of outcome compared to GRImT0 in aNSCLC patients treated with pembrolizumab and might represent useful biomarkers to drive clinical decisions in this setting.
背景
古斯塔夫·鲁西免疫（GRIm）评分综合考虑了中性粒细胞与淋巴细胞比值（NLR）、血清白蛋白浓度和乳酸脱氢酶（LDH），其预后价值已在接受免疫检查点抑制剂（ICI）治疗的患者中进行了研究。为了进一步评估基线GRIm评分（GRImT0）在晚期非小细胞肺癌（aNSCLC）患者中的预后和预测价值，我们分别对两组接受一线派姆单抗或化疗的患者进行了研究。我们还研究了治疗开始后45天的GRIm评分（GRImT1）以及两个时间点之间的GRIm评分差异是否能更好地预测临床结局（GRImΔ = GRImT0 - GRImT1）。
方法
我们回顾性评估了222例aNSCLC患者：135例接受派姆单抗治疗，87例接受化疗作为一线治疗方案。在T0和T1时评估NLR、血清白蛋白和LDH浓度。根据GRIm评分，如果患者的NLR > 6、LDH > 正常上限或白蛋白 < 3.5 g/dL，则给予1分。GRIm评分 < 2的患者被认为评分较低。
结果
在两个队列中，GRImT0低分组和高分组患者的总生存期（OS）均无差异。否则，在接受派姆单抗治疗的患者中，GRImT1低分组的中位OS和无进展生存期（PFS）显著长于高分组，但在化疗队列中并非如此（派姆单抗队列：低分组与高分组；中位OS未达到 vs. 9.2个月，P = 0.004；中位PFS 10.8 vs. 2.3个月，P = 0.002）。与GRImΔ为阴性的患者相比，接受派姆单抗治疗且GRImΔ稳定/为阳性的患者具有更好的OS（中位OS未达到 vs. 12.0个月，P < 0.001）、PFS（中位PFS 20.6 vs. 2.6个月，P < 0.001）和客观缓解率（58.2% vs. 7.6%，P = 0.003）。
结论
我们的数据表明，在接受派姆单抗治疗的aNSCLC患者中，与GRImT0相比，GRImT1和GRImΔ是更可靠的外周血结局生物标志物，可能代表在这种情况下有助于指导临床决策的有用生物标志物。
Zotero 插件