Wasamoto Satoshi, Imai Hisao, Tsuda Takeshi, Nagai Yoshiaki, Minemura Hiroyuki, Yamada Yutaka, Umeda Yukihiro, Kishikawa Takayuki, Shiono Ayako, Kozu Yuki, Shiihara Jun, Yamaguchi Ou, Mouri Atsuto, Kaira Kyoichi, Kanazawa Kenya, Taniguchi Hirokazu, Kaburagi Takayuki, Minato Koichi, Kagamu Hiroshi
Division of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Nagano, Japan.
Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan.
Front Oncol. 2023 Jan 20;12:1080729. doi: 10.3389/fonc.2022.1080729. eCollection 2022.
There are no established predictive biomarkers for the effectiveness of first-line atezolizumab plus carboplatin and etoposide therapy in patients with small-cell lung cancer (SCLC). Therefore, the current study aimed to investigate whether the Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio (NLR), and body mass index (BMI) can predict the effectiveness of first-line atezolizumab plus carboplatin and etoposide therapy in patients with extensive-disease SCLC.
We reviewed data from 84 patients who received first-line atezolizumab plus carboplatin and etoposide therapy for SCLC at nine Japanese institutions between August 2019 and May 2021. Further, we evaluated the prognostic value of the GPS, NLR, and BMI. The Kaplan-Meier and Cox proportional hazard models were used to examine differences in progression-free survival (PFS) and overall survival (OS). Moreover, the GPS, NLR, and BMI consisted of C-reactive protein and albumin concentrations, neutrophil and lymphocyte counts, and body weight and height, respectively.
The response rate was 72.6% (95% confidence interval: 63.0-82.1%). The median PFS and OS from the initiation of treatment were 5.4 (95% CI: 4.9-5.9) months and 15.4 (95% CI: 11.4-16.8) months, respectively. The GPS independently predicted the effectiveness of first-line atezolizumab plus carboplatin and etoposide treatment, as a favorable GPS (GPS 0-1) was correlated with significantly better PFS and OS rates compared to a poor GPS (GPS 2) (PFS: 5.8 vs. 3.8 months, = 0.0005; OS: 16.5 vs. 8.4 months, <0.0001).
This is the first analysis to evaluate the association between the GPS, NLR, and BMI and the treatment effectiveness of survival among patients receiving first-line atezolizumab plus carboplatin and etoposide therapy for SCLC. Among patients receiving this treatment for SCLC, GPS was significantly associated with the PFS and OS rates, suggesting that GPS might be useful for evaluating therapeutic outcomes in these patients.
对于小细胞肺癌（SCLC）患者，目前尚无已确立的预测一线阿替利珠单抗联合卡铂和依托泊苷治疗疗效的生物标志物。因此，本研究旨在探讨格拉斯哥预后评分（GPS）、中性粒细胞与淋巴细胞比值（NLR）和体重指数（BMI）能否预测广泛期SCLC患者一线阿替利珠单抗联合卡铂和依托泊苷治疗的疗效。
我们回顾了2019年8月至2021年5月期间在日本9家机构接受一线阿替利珠单抗联合卡铂和依托泊苷治疗SCLC的84例患者的数据。此外，我们评估了GPS、NLR和BMI的预后价值。采用Kaplan-Meier法和Cox比例风险模型来检验无进展生存期（PFS）和总生存期（OS）的差异。此外，GPS、NLR和BMI分别由C反应蛋白和白蛋白浓度、中性粒细胞和淋巴细胞计数以及体重和身高组成。
缓解率为72.6%（95%置信区间：63.0 - 82.1%）。从治疗开始的中位PFS和OS分别为5.4（95%CI：4.9 - 5.9）个月和15.4（95%CI：11.4 - 16.8）个月。GPS独立预测一线阿替利珠单抗联合卡铂和依托泊苷治疗的疗效，因为良好的GPS（GPS 0 - 1）与较差的GPS（GPS 2）相比，PFS和OS率显著更好（PFS：5.8个月对3.8个月， = 0.0005；OS：16.5个月对8.4个月，<0.0001）。
这是首次分析评估GPS、NLR和BMI与接受一线阿替利珠单抗联合卡铂和依托泊苷治疗SCLC患者的生存治疗疗效之间的关联。在接受该治疗的SCLC患者中，GPS与PFS和OS率显著相关，表明GPS可能有助于评估这些患者的治疗结果。
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