Predictive Value of Modified Glasgow Prognostic Score and Persistent Inflammation among Patients with Non-Small Cell Lung Cancer Treated with Durvalumab Consolidation after Chemoradiotherapy: A Multicenter Retrospective Study

Background: Durvalumab consolidation after chemoradiotherapy (CRT) is a standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, studies on immunological and nutritional markers to predict progression-free survival (PFS) and overall survival (OS) are inadequate. Systemic...

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Published in:Cancers 2023-09, Vol.15 (17), p.4358
Main Authors: Tanimura, Keiko, Takeda, Takayuki, Yoshimura, Akihiro, Honda, Ryoichi, Goda, Shiho, Shiotsu, Shinsuke, Fukui, Mototaka, Chihara, Yusuke, Uryu, Kiyoaki, Takei, Shota, Katayama, Yuki, Hibino, Makoto, Yamada, Tadaaki, Takayama, Koichi
Format: Article
Language:English
Subjects:
Apoptosis
C-reactive protein
Cachexia
Cancer
Cancer therapies
Care and treatment
Cell death
Chemoradiotherapy
Cytokines
Development and progression
Health aspects
Immunology
Immunotherapy
Inflammation
Lung cancer
Lung cancer, Non-small cell
Lung cancer, Small cell
Lymphocytes
Medical prognosis
Neutrophils
Non-small cell lung carcinoma
Oncology, Experimental
Risk groups
Small cell lung carcinoma
Software
Survival analysis
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Summary:Background: Durvalumab consolidation after chemoradiotherapy (CRT) is a standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, studies on immunological and nutritional markers to predict progression-free survival (PFS) and overall survival (OS) are inadequate. Systemic inflammation causes cancer cachexia and negatively affects immunotherapy efficacy, which also reflects survival outcomes. Patients and Methods: We retrospectively investigated 126 patients from seven institutes in Japan. Results: The modified Glasgow Prognostic Score (mGPS) values, before and after CRT, were the essential predictors among the evaluated indices. A systemic inflammation-based prognostic risk classification was created by combining mGPS values before CRT, and C-reactive protein (CRP) levels after CRT, to distinguish tumor-derived inflammation from CRT-induced inflammation. Patients were classified into high-risk (n = 31) and low-risk (n = 95) groups, and the high-risk group had a significantly shorter median PFS of 7.2 months and an OS of 19.6 months compared with the low-risk group. The hazard ratios for PFS and OS were 2.47 (95% confidence interval [CI]: 1.46–4.19, p < 0.001) and 3.62 (95% CI: 1.79–7.33, p < 0.001), respectively. This association was also observed in the subgroup with programmed cell death ligand 1 expression of ≥50%, but not in the
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15174358