Novel risk scoring system for immune checkpoint inhibitors treatment in non-small cell lung cancer
Immune checkpoint inhibitor (ICI)-based immunotherapy has improved the clinical outcome of non-small cell lung cancer (NSCLC). However, current indicators, such as programmed cell death-ligand 1 (PD-L1) expression in tumors or tumor mutational burden (TMB), are not considered ideal biomarkers for pr...
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| Veröffentlicht in: | Translational lung cancer research 2021-02, Vol.10 (2), p.776-789 |
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| container_title | Translational lung cancer research |
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| creator | Li, Chuling Shi, Meiqi Lin, Xinqing Zhang, Yongchang Yu, Shaorong Zhou, Chengzhi Yang, Nong Zhang, Jianya Zhang, Fang Lv, Tangfeng Liu, Hongbing Song, Yong |
| description | Immune checkpoint inhibitor (ICI)-based immunotherapy has improved the clinical outcome of non-small cell lung cancer (NSCLC). However, current indicators, such as programmed cell death-ligand 1 (PD-L1) expression in tumors or tumor mutational burden (TMB), are not considered ideal biomarkers for prognosis. Thus, there is an urgent requirement for a comprehensive risk scoring system.
In this study, we enrolled 464 NSCLC patients who received ICIs between March 2017 and January 2020 at four clinical centers. Univariate and multivariate (the logistic and the Cox regression) analyses were conducted to screen clinically relevant variables. Significant parameters (P |
| doi_str_mv | 10.21037/tlcr-20-832 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_crossref_primary_10_21037_tlcr_20_832</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>33718021</sourcerecordid><originalsourceid>FETCH-LOGICAL-c384t-91e6be864da54040bca43c0b8f8e9d7f53ae541e4977383bf9680449258d2f4b3</originalsourceid><addsrcrecordid>eNpVkE1LAzEQhoMotmhvniU_wGi-dpNcBCl-QdGLnkOSzbaxu5uSbAv9925bLXqZGWbeeWZ4Abgi-JYSzMRd37iEKEaS0RMwppSWiHMhTnc1kagUBRmBSc5fGGPCFS8KdQ5GjAkiMSVjYN_ixjcwhbyE2cUUujnM29z7FtYxwdC2685Dt_BuuYqh62HoFsGGPqYM--RN3_p9E3axQ7k1TQOdH0KzHkDOdM6nS3BWmyb7yU--AJ9Pjx_TFzR7f36dPsyQY5L3SBFfWi9LXpmCY46tM5w5bGUtvapEXTDjC048V0IwyWytSok5V7SQFa25ZRfg_sBdrW3rKzc8lkyjVym0Jm11NEH_n3Rhoedxo4XigmM1AG4OAJdizsnXx12C9d5uvbNbU6wHuwf59d97R_Gvuewb8j1-gQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Novel risk scoring system for immune checkpoint inhibitors treatment in non-small cell lung cancer</title><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Li, Chuling ; Shi, Meiqi ; Lin, Xinqing ; Zhang, Yongchang ; Yu, Shaorong ; Zhou, Chengzhi ; Yang, Nong ; Zhang, Jianya ; Zhang, Fang ; Lv, Tangfeng ; Liu, Hongbing ; Song, Yong</creator><creatorcontrib>Li, Chuling ; Shi, Meiqi ; Lin, Xinqing ; Zhang, Yongchang ; Yu, Shaorong ; Zhou, Chengzhi ; Yang, Nong ; Zhang, Jianya ; Zhang, Fang ; Lv, Tangfeng ; Liu, Hongbing ; Song, Yong</creatorcontrib><description>Immune checkpoint inhibitor (ICI)-based immunotherapy has improved the clinical outcome of non-small cell lung cancer (NSCLC). However, current indicators, such as programmed cell death-ligand 1 (PD-L1) expression in tumors or tumor mutational burden (TMB), are not considered ideal biomarkers for prognosis. Thus, there is an urgent requirement for a comprehensive risk scoring system.
In this study, we enrolled 464 NSCLC patients who received ICIs between March 2017 and January 2020 at four clinical centers. Univariate and multivariate (the logistic and the Cox regression) analyses were conducted to screen clinically relevant variables. Significant parameters (P<0.05) including absolute lymphocyte count (ALC, L), Eastern Cooperative Oncology Group Performance Status (ECOG PS, E) and lung/pleural metastasis (M) were selected for LEM score. Weighted values based on odds ratio and hazard ratio of multiple analyses were assigned to each parameter. LEM score was the sum of weighted values of each variable (Good, 0-1; Intermediate, 2-3; Poor, 4-6). Kaplan-Meier curves were used to evaluate the association between LEM score and progression-free survival (PFS).
In total, 258 patients were pooled and stratified into three risk categories based on the LEM score. Objective response rate (ORR) was significantly higher in the good-risk group compared with the poor-risk group [55.9%
7.3%, odds ratio (OR), 0.023; 95% confidence interval (CI), 0.005-0.099; P<0.001]. Patients with good risk [hazard ratio (HR), 0.130; 95% CI, 0.084-0.203; median PFS, 12.5 months; P<0.001] or intermediate risk (HR, 0.330; 95% CI, 0.222-0.490; median PFS, 4.2 months; P<0.001) had longer PFS than those with poor risk (median PFS, 2.1 months). DNA sequencing was performed in 41 patients [no durable benefit (NDB): n=29; durable clinical benefit (DCB): n=12] and epidermal growth factor receptor (EGFR) mutations were enriched in samples of the NDB group
the DCB group (11/29
1/12; Fisher's exact P=0.073; OR, 6.722; 95% CI, 0.760-59.479). Additionally, patients with EGFR mutations had higher LEM scores than those with wild-type EGFR.
In conclusion, the LEM score provided a potential prognostic biomarker for NSCLC patients treated with ICIs.</description><identifier>ISSN: 2218-6751</identifier><identifier>EISSN: 2226-4477</identifier><identifier>DOI: 10.21037/tlcr-20-832</identifier><identifier>PMID: 33718021</identifier><language>eng</language><publisher>China: AME Publishing Company</publisher><subject>Original</subject><ispartof>Translational lung cancer research, 2021-02, Vol.10 (2), p.776-789</ispartof><rights>2021 Translational Lung Cancer Research. All rights reserved.</rights><rights>2021 Translational Lung Cancer Research. All rights reserved. 2021 Translational Lung Cancer Research.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-91e6be864da54040bca43c0b8f8e9d7f53ae541e4977383bf9680449258d2f4b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947409/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947409/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33718021$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Chuling</creatorcontrib><creatorcontrib>Shi, Meiqi</creatorcontrib><creatorcontrib>Lin, Xinqing</creatorcontrib><creatorcontrib>Zhang, Yongchang</creatorcontrib><creatorcontrib>Yu, Shaorong</creatorcontrib><creatorcontrib>Zhou, Chengzhi</creatorcontrib><creatorcontrib>Yang, Nong</creatorcontrib><creatorcontrib>Zhang, Jianya</creatorcontrib><creatorcontrib>Zhang, Fang</creatorcontrib><creatorcontrib>Lv, Tangfeng</creatorcontrib><creatorcontrib>Liu, Hongbing</creatorcontrib><creatorcontrib>Song, Yong</creatorcontrib><title>Novel risk scoring system for immune checkpoint inhibitors treatment in non-small cell lung cancer</title><title>Translational lung cancer research</title><addtitle>Transl Lung Cancer Res</addtitle><description>Immune checkpoint inhibitor (ICI)-based immunotherapy has improved the clinical outcome of non-small cell lung cancer (NSCLC). However, current indicators, such as programmed cell death-ligand 1 (PD-L1) expression in tumors or tumor mutational burden (TMB), are not considered ideal biomarkers for prognosis. Thus, there is an urgent requirement for a comprehensive risk scoring system.
In this study, we enrolled 464 NSCLC patients who received ICIs between March 2017 and January 2020 at four clinical centers. Univariate and multivariate (the logistic and the Cox regression) analyses were conducted to screen clinically relevant variables. Significant parameters (P<0.05) including absolute lymphocyte count (ALC, L), Eastern Cooperative Oncology Group Performance Status (ECOG PS, E) and lung/pleural metastasis (M) were selected for LEM score. Weighted values based on odds ratio and hazard ratio of multiple analyses were assigned to each parameter. LEM score was the sum of weighted values of each variable (Good, 0-1; Intermediate, 2-3; Poor, 4-6). Kaplan-Meier curves were used to evaluate the association between LEM score and progression-free survival (PFS).
In total, 258 patients were pooled and stratified into three risk categories based on the LEM score. Objective response rate (ORR) was significantly higher in the good-risk group compared with the poor-risk group [55.9%
7.3%, odds ratio (OR), 0.023; 95% confidence interval (CI), 0.005-0.099; P<0.001]. Patients with good risk [hazard ratio (HR), 0.130; 95% CI, 0.084-0.203; median PFS, 12.5 months; P<0.001] or intermediate risk (HR, 0.330; 95% CI, 0.222-0.490; median PFS, 4.2 months; P<0.001) had longer PFS than those with poor risk (median PFS, 2.1 months). DNA sequencing was performed in 41 patients [no durable benefit (NDB): n=29; durable clinical benefit (DCB): n=12] and epidermal growth factor receptor (EGFR) mutations were enriched in samples of the NDB group
the DCB group (11/29
1/12; Fisher's exact P=0.073; OR, 6.722; 95% CI, 0.760-59.479). Additionally, patients with EGFR mutations had higher LEM scores than those with wild-type EGFR.
In conclusion, the LEM score provided a potential prognostic biomarker for NSCLC patients treated with ICIs.</description><subject>Original</subject><issn>2218-6751</issn><issn>2226-4477</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpVkE1LAzEQhoMotmhvniU_wGi-dpNcBCl-QdGLnkOSzbaxu5uSbAv9925bLXqZGWbeeWZ4Abgi-JYSzMRd37iEKEaS0RMwppSWiHMhTnc1kagUBRmBSc5fGGPCFS8KdQ5GjAkiMSVjYN_ixjcwhbyE2cUUujnM29z7FtYxwdC2685Dt_BuuYqh62HoFsGGPqYM--RN3_p9E3axQ7k1TQOdH0KzHkDOdM6nS3BWmyb7yU--AJ9Pjx_TFzR7f36dPsyQY5L3SBFfWi9LXpmCY46tM5w5bGUtvapEXTDjC048V0IwyWytSok5V7SQFa25ZRfg_sBdrW3rKzc8lkyjVym0Jm11NEH_n3Rhoedxo4XigmM1AG4OAJdizsnXx12C9d5uvbNbU6wHuwf59d97R_Gvuewb8j1-gQ</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Li, Chuling</creator><creator>Shi, Meiqi</creator><creator>Lin, Xinqing</creator><creator>Zhang, Yongchang</creator><creator>Yu, Shaorong</creator><creator>Zhou, Chengzhi</creator><creator>Yang, Nong</creator><creator>Zhang, Jianya</creator><creator>Zhang, Fang</creator><creator>Lv, Tangfeng</creator><creator>Liu, Hongbing</creator><creator>Song, Yong</creator><general>AME Publishing Company</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>202102</creationdate><title>Novel risk scoring system for immune checkpoint inhibitors treatment in non-small cell lung cancer</title><author>Li, Chuling ; Shi, Meiqi ; Lin, Xinqing ; Zhang, Yongchang ; Yu, Shaorong ; Zhou, Chengzhi ; Yang, Nong ; Zhang, Jianya ; Zhang, Fang ; Lv, Tangfeng ; Liu, Hongbing ; Song, Yong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-91e6be864da54040bca43c0b8f8e9d7f53ae541e4977383bf9680449258d2f4b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Original</topic><toplevel>online_resources</toplevel><creatorcontrib>Li, Chuling</creatorcontrib><creatorcontrib>Shi, Meiqi</creatorcontrib><creatorcontrib>Lin, Xinqing</creatorcontrib><creatorcontrib>Zhang, Yongchang</creatorcontrib><creatorcontrib>Yu, Shaorong</creatorcontrib><creatorcontrib>Zhou, Chengzhi</creatorcontrib><creatorcontrib>Yang, Nong</creatorcontrib><creatorcontrib>Zhang, Jianya</creatorcontrib><creatorcontrib>Zhang, Fang</creatorcontrib><creatorcontrib>Lv, Tangfeng</creatorcontrib><creatorcontrib>Liu, Hongbing</creatorcontrib><creatorcontrib>Song, Yong</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Translational lung cancer research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Chuling</au><au>Shi, Meiqi</au><au>Lin, Xinqing</au><au>Zhang, Yongchang</au><au>Yu, Shaorong</au><au>Zhou, Chengzhi</au><au>Yang, Nong</au><au>Zhang, Jianya</au><au>Zhang, Fang</au><au>Lv, Tangfeng</au><au>Liu, Hongbing</au><au>Song, Yong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Novel risk scoring system for immune checkpoint inhibitors treatment in non-small cell lung cancer</atitle><jtitle>Translational lung cancer research</jtitle><addtitle>Transl Lung Cancer Res</addtitle><date>2021-02</date><risdate>2021</risdate><volume>10</volume><issue>2</issue><spage>776</spage><epage>789</epage><pages>776-789</pages><issn>2218-6751</issn><eissn>2226-4477</eissn><abstract>Immune checkpoint inhibitor (ICI)-based immunotherapy has improved the clinical outcome of non-small cell lung cancer (NSCLC). However, current indicators, such as programmed cell death-ligand 1 (PD-L1) expression in tumors or tumor mutational burden (TMB), are not considered ideal biomarkers for prognosis. Thus, there is an urgent requirement for a comprehensive risk scoring system.
In this study, we enrolled 464 NSCLC patients who received ICIs between March 2017 and January 2020 at four clinical centers. Univariate and multivariate (the logistic and the Cox regression) analyses were conducted to screen clinically relevant variables. Significant parameters (P<0.05) including absolute lymphocyte count (ALC, L), Eastern Cooperative Oncology Group Performance Status (ECOG PS, E) and lung/pleural metastasis (M) were selected for LEM score. Weighted values based on odds ratio and hazard ratio of multiple analyses were assigned to each parameter. LEM score was the sum of weighted values of each variable (Good, 0-1; Intermediate, 2-3; Poor, 4-6). Kaplan-Meier curves were used to evaluate the association between LEM score and progression-free survival (PFS).
In total, 258 patients were pooled and stratified into three risk categories based on the LEM score. Objective response rate (ORR) was significantly higher in the good-risk group compared with the poor-risk group [55.9%
7.3%, odds ratio (OR), 0.023; 95% confidence interval (CI), 0.005-0.099; P<0.001]. Patients with good risk [hazard ratio (HR), 0.130; 95% CI, 0.084-0.203; median PFS, 12.5 months; P<0.001] or intermediate risk (HR, 0.330; 95% CI, 0.222-0.490; median PFS, 4.2 months; P<0.001) had longer PFS than those with poor risk (median PFS, 2.1 months). DNA sequencing was performed in 41 patients [no durable benefit (NDB): n=29; durable clinical benefit (DCB): n=12] and epidermal growth factor receptor (EGFR) mutations were enriched in samples of the NDB group
the DCB group (11/29
1/12; Fisher's exact P=0.073; OR, 6.722; 95% CI, 0.760-59.479). Additionally, patients with EGFR mutations had higher LEM scores than those with wild-type EGFR.
In conclusion, the LEM score provided a potential prognostic biomarker for NSCLC patients treated with ICIs.</abstract><cop>China</cop><pub>AME Publishing Company</pub><pmid>33718021</pmid><doi>10.21037/tlcr-20-832</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| title | Novel risk scoring system for immune checkpoint inhibitors treatment in non-small cell lung cancer |
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