Department of Medicine I & CCC, Division of Oncology, Medical University of Vienna, Wien, Austria.
Medical University of Vienna, Center for Medical Statistics, Informatics, and Intelligent Systems Institute of Clinical Biometrics, Wien, Austria.
Ann Med. 2022 Dec;54(1):1339-1349. doi: 10.1080/07853890.2022.2070660.
Immune checkpoint inhibitors (ICI) are regarded as a standard of care in multiple malignancies. We hypothesized that serum parameters are of prognostic value in ICI treated patients suffering from solid tumours.
Data from 114 patients treated with ICIs for solid malignancies from 2015 to 2019 at the Medical University of Vienna were collected retrospectively. Data included baseline characteristics, cancer type, serum parameters such as lactate dehydrogenase (LDH), C-reactive protein (CRP), albumin (Alb) and lymphocyte counts as well as overall survival (OS) and progression free survival. Additionally, the Gustave Roussy Immune Score (GRIm score) and the Glasgow prognostic score (GPS) were calculated. Cox regression models including time-dependent effects and strata for tumour type were used. Prognostic factors were pre-selected using a relaxed LASSO approach.
The majority of patients were male (64.9%). The most common cancer types were non-small cell lung cancer (30.7%) and renal cell carcinoma (21.9%). Increased LDH and CRP were associated with poor 6-month OS (Hazard ratios (HR)=1.16 and 1.06 per 20% LDH/CRP increase; 95% CI 1.07-1.26 and 95% CI 1.03-1.09, respectively; < .001). Both GRIm Score and GPS had a significant influence on OS (GRIm: HR = 2.84, 95% CI 1.72-4.69; < .001 for high vs. low; GPS HR 3.57, 95% CI 1.76-7.25; < .001 for poor vs. good). The proportion of explained variation (PEV) of our full multivariable model was significantly higher compared to the GRIm and GPS (PEV = 29.5% vs. 14.8% and 14.65%). When grouped into quartiles according to the individual 8-weeks change, both increased LDH and CRP correlated with poor OS (LDH (=.001) and CRP ( < .001)).
The results of this analysis suggest that serum parameters might have prognostic value for the outcome of cancer patients treated with ICI, regardless of the tumour type.Key messagesIn this retrospective analysis, 114 patients with solid tumours were included. The results of this analysis point out that pre-treatment LDH, CRP and albumin levels are strongly prognostic for a poor 6-month OS.In addition to that, a high GRIm-score and poor GPS were associated with a worse OS (GRIm: HR = 2.84, 95% CI 1.72-4.69; < .001 for high vs. low; GPS HR = 3.57, 95% CI 1.76-7.25; < .001 for poor vs. good).Pre-treatment serum parameters might have prognostic value for the outcome of cancer patients treated with ICI, regardless of the tumour type.
免疫检查点抑制剂（ICI）被认为是多种恶性肿瘤的标准治疗方法。我们假设血清参数对接受 ICI 治疗的实体瘤患者具有预后价值。
回顾性收集了 2015 年至 2019 年在维也纳医科大学接受 ICI 治疗的 114 例实体瘤患者的数据。数据包括基线特征、癌症类型、血清参数（如乳酸脱氢酶（LDH）、C 反应蛋白（CRP）、白蛋白（Alb）和淋巴细胞计数）以及总生存期（OS）和无进展生存期。此外，计算了 Gustave Roussy 免疫评分（GRIm 评分）和格拉斯哥预后评分（GPS）。使用包括时间依赖性效应和肿瘤类型分层的 Cox 回归模型。使用宽松的 LASSO 方法进行了预后因素的预筛选。
大多数患者为男性（64.9%）。最常见的癌症类型是非小细胞肺癌（30.7%）和肾细胞癌（21.9%）。升高的 LDH 和 CRP 与 6 个月 OS 不良相关（危险比（HR）=1.16 和 1.06/20% LDH/CRP 增加；95%CI 1.07-1.26 和 95%CI 1.03-1.09； < .001）。GRIm 评分和 GPS 对 OS 均有显著影响（GRIm：HR = 2.84，95%CI 1.72-4.69； < .001，高 vs. 低；GPS HR 3.57，95%CI 1.76-7.25； < .001，差 vs. 好）。我们的全多变量模型的解释变异比例（PEV）明显高于 GRIm 和 GPS（PEV = 29.5% vs. 14.8% 和 14.65%）。根据个体 8 周变化分为四分位数时，升高的 LDH 和 CRP 均与 OS 不良相关（LDH（= .001）和 CRP（ < .001））。
这项分析的结果表明，血清参数可能对接受 ICI 治疗的癌症患者的预后具有预测价值，无论肿瘤类型如何。
在这项回顾性分析中，纳入了 114 例实体瘤患者。该分析结果指出，治疗前 LDH、CRP 和白蛋白水平强烈预示着 6 个月 OS 不良。
此外，高 GRIm 评分和差 GPS 与较差的 OS 相关（GRIm：HR = 2.84，95%CI 1.72-4.69； < .001，高 vs. 低；GPS HR = 3.57，95%CI 1.76-7.25； < .001，差 vs. 好）。治疗前血清参数可能对接受 ICI 治疗的癌症患者的预后具有预测价值，无论肿瘤类型如何。
