Prognostic value of hematologic parameters in advanced non-small cell lung cancer patients receiving anti-PD-1 inhibitors

• Published in: Frontiers in immunology 2022-10, Vol.13, p.1003581-1003581
• Main Authors: Zhao, Xinmin, Wu, Xianghua, Yu, Hui, Wang, Huijie, Sun, Si, Hu, Zhihuang, Liu, Cuicui, Zhang, Junli, Shao, Yang, Wang, Jialei
• Format: Article
• Language: English
• Subjects: Antineoplastic Agents, Immunological - therapeutic use; Biomarkers; Carcinoma, Non-Small-Cell Lung - pathology; first-line pembrolizumab; hematologic parameters; Humans; Immunology; Lung Neoplasms - pathology; Middle Aged; nivolumab; Nivolumab - therapeutic use; NSCLC; Prognosis; subsequent-line
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2022.1003581

The association between hematologic parameters and anti-programmed death-1 (PD-1) inhibitors was generally examined without considering therapy lines and medicine types. The study was aimed to identify potential hematologic biomarkers associated with clinical outcome in patients with non-small cell lung cancer (NSCLC) treated with first-line pembrolizumab and subsequent-line nivolumab. 161 NSCLC patients were categorized into first-line pembrolizumab group (pembrolizumab group) and subsequent-line nivolumab group (nivolumab group). Univariate and multivariate Cox regression analyses were used to evaluate the prognostic value of hematologic parameters for clinical outcomes. The median progression-free survival (mPFS) was 9.6 months in the pembrolizumab group and 4.1 months in the nivolumab group (HR =1.61; P = 0.012); the median overall survival (mOS) was not reached in the pembrolizumab group and 17.7 months in the nivolumab group (HR =1.37; P = 0.23). Of the 79 patients in the pembrolizumab group, baseline PD-L1 tumor proportion score (TPS)≥1% was an independent factor of longer PFS and OS. Age≥60 years, absolute platelet count (APC)≥220×10 /L and platelet-to-lymphocyte ratio (PLR)≥120 were associated with inferior PFS. Of the 82 patients in the nivolumab group, absolute neutrophil count (ANC)≥3×10 /L was associated with longer PFS, while LDH (lactate dehydrogenase)≥160 U/L was associated with inferior PFS and derived neutrophil-to-lymphocyte ratio (dNLR)≥1.2 was associated with longer OS. Our study identified multiple clinically accessible prognostic biomarkers in the peripheral blood in both the pembrolizumab and nivolumab subgroups.