Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab

Background: Immune checkpoint inhibitors (ICIs) are currently the standard therapy in advanced non small cell lung cancer (NSCLC); however, there is no well-established prognostic biomarker. We investigated the relationship between survival outcomes and three peripheral blood biomarkers, including t...

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Autores: Sánchez-Gastaldo, Amparo, Muñoz-Fuentes, Miguel A., Molina Pinelo, Sonia, Alonso-García, Miriam, Boyero, Laura, Bernabé-Caro, Reyes
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/139512
Acceso en línea:https://hdl.handle.net/11441/139512
https://doi.org/10.21037/tlcr-21-156
Access Level:acceso abierto
Palabra clave:Pembrolizumab
Blood biomarkers
Non-small cell lung cancer (NSCLC)
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spelling Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumabSánchez-Gastaldo, AmparoMuñoz-Fuentes, Miguel A.Molina Pinelo, SoniaAlonso-García, MiriamBoyero, LauraBernabé-Caro, ReyesPembrolizumabBlood biomarkersNon-small cell lung cancer (NSCLC)Background: Immune checkpoint inhibitors (ICIs) are currently the standard therapy in advanced non small cell lung cancer (NSCLC); however, there is no well-established prognostic biomarker. We investigated the relationship between survival outcomes and three peripheral blood biomarkers, including the neutrophil to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR), as well as a new score termed the risk blood biomarker (RBB), calculated from the combination of the neutrophil-monocyte-to-lymphocyte ratio (NMLR) and white blood cell count (WBC). Methods: This study included patients with stage IV or recurrent NSCLC confirmed with programmed death ligand 1 (PD-L1) expression ≥50% who received pembrolizumab monotherapy as first-line treatment at the Virgen del Rocío University Hospital in Seville, Spain. To establish the relationship between baseline peripheral blood biomarkers and survival outcomes, progression free survival (PFS) and overall survival (OS), we used the Kaplan-Meier method and multivariable Cox regression models. Results: A total of 51 patients were included in this study. In multivariate analysis, baseline NLR and PLR showed a strong association with PFS [NLR hazard ratio (HR): 0.19, 95% confidence interval (CI): 0.09–0.44, P<0.001; PLR HR: 0.46, 95% CI: 0.23–0.92, P=0.03] and OS (NLR HR: 0.07, 95% CI: 0.02–0.19, P<0.001; PLR HR: 0.29, 95% CI: 0.13–0.67, P=0.004), and the MLR was associated with OS (MLR HR: 0.34, 95% CI: 0.15–0.76, P=0.01). According to the RBB score, groups with lower scores were associated with superior PFS (group 0: HR: 0.16, 95% CI: 0.06–0.41, P<0.001 and group 1: HR: 0.29, 95% CI: 0.12–0.73, P=0.01) and OS (group 0: HR: 0.04, 95% CI: 0.01–0.17, P<0.001 and group 1: HR: 0.15, 95% CI: 0.05–0.42, P<0.001). Conclusions: Low baseline NLR, MLR and PLR are significantly associated with better PFS, and low baseline NLR and PLR are associated with better OS. Additionally, we identified three subgroups of patients using the RBB score, and low scores were associated with improved survival outcomes and response to therapy.MedicinaMinisterio de Salud y Bienestar Social de la junta de Andalucia2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/139512https://doi.org/10.21037/tlcr-21-156reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésTranslational Lung Cancer Research, 10 (6), 2509-2522.PI-0046-2012RH-0051-2020OH-0022-2018RC-0004-2020https://tlcr.amegroups.com/article/view/53208/htmlinfo:eu-repo/semantics/openAccessoai:idus.us.es:11441/1395122026-06-17T12:51:07Z
dc.title.none.fl_str_mv Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab
title Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab
spellingShingle Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab
Sánchez-Gastaldo, Amparo
Pembrolizumab
Blood biomarkers
Non-small cell lung cancer (NSCLC)
title_short Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab
title_full Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab
title_fullStr Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab
title_full_unstemmed Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab
title_sort Correlation of peripheral blood biomarkers with clinical outcomes in NSCLC patients with high PD-L1 expression treated with pembrolizumab
dc.creator.none.fl_str_mv Sánchez-Gastaldo, Amparo
Muñoz-Fuentes, Miguel A.
Molina Pinelo, Sonia
Alonso-García, Miriam
Boyero, Laura
Bernabé-Caro, Reyes
author Sánchez-Gastaldo, Amparo
author_facet Sánchez-Gastaldo, Amparo
Muñoz-Fuentes, Miguel A.
Molina Pinelo, Sonia
Alonso-García, Miriam
Boyero, Laura
Bernabé-Caro, Reyes
author_role author
author2 Muñoz-Fuentes, Miguel A.
Molina Pinelo, Sonia
Alonso-García, Miriam
Boyero, Laura
Bernabé-Caro, Reyes
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Medicina
Ministerio de Salud y Bienestar Social de la junta de Andalucia
dc.subject.none.fl_str_mv Pembrolizumab
Blood biomarkers
Non-small cell lung cancer (NSCLC)
topic Pembrolizumab
Blood biomarkers
Non-small cell lung cancer (NSCLC)
description Background: Immune checkpoint inhibitors (ICIs) are currently the standard therapy in advanced non small cell lung cancer (NSCLC); however, there is no well-established prognostic biomarker. We investigated the relationship between survival outcomes and three peripheral blood biomarkers, including the neutrophil to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR), as well as a new score termed the risk blood biomarker (RBB), calculated from the combination of the neutrophil-monocyte-to-lymphocyte ratio (NMLR) and white blood cell count (WBC). Methods: This study included patients with stage IV or recurrent NSCLC confirmed with programmed death ligand 1 (PD-L1) expression ≥50% who received pembrolizumab monotherapy as first-line treatment at the Virgen del Rocío University Hospital in Seville, Spain. To establish the relationship between baseline peripheral blood biomarkers and survival outcomes, progression free survival (PFS) and overall survival (OS), we used the Kaplan-Meier method and multivariable Cox regression models. Results: A total of 51 patients were included in this study. In multivariate analysis, baseline NLR and PLR showed a strong association with PFS [NLR hazard ratio (HR): 0.19, 95% confidence interval (CI): 0.09–0.44, P<0.001; PLR HR: 0.46, 95% CI: 0.23–0.92, P=0.03] and OS (NLR HR: 0.07, 95% CI: 0.02–0.19, P<0.001; PLR HR: 0.29, 95% CI: 0.13–0.67, P=0.004), and the MLR was associated with OS (MLR HR: 0.34, 95% CI: 0.15–0.76, P=0.01). According to the RBB score, groups with lower scores were associated with superior PFS (group 0: HR: 0.16, 95% CI: 0.06–0.41, P<0.001 and group 1: HR: 0.29, 95% CI: 0.12–0.73, P=0.01) and OS (group 0: HR: 0.04, 95% CI: 0.01–0.17, P<0.001 and group 1: HR: 0.15, 95% CI: 0.05–0.42, P<0.001). Conclusions: Low baseline NLR, MLR and PLR are significantly associated with better PFS, and low baseline NLR and PLR are associated with better OS. Additionally, we identified three subgroups of patients using the RBB score, and low scores were associated with improved survival outcomes and response to therapy.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/139512
https://doi.org/10.21037/tlcr-21-156
url https://hdl.handle.net/11441/139512
https://doi.org/10.21037/tlcr-21-156
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Translational Lung Cancer Research, 10 (6), 2509-2522.
PI-0046-2012
RH-0051-2020
OH-0022-2018
RC-0004-2020
https://tlcr.amegroups.com/article/view/53208/html
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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