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Archive > Volume 29 Issue 4 > 2022,29(4):308-316. DOI:10.3872/j.issn.1007-385X.2022.04.006 Prev Next
Clinical Research
The role of inflammatorymarkersinpredictingtheefficacyandsafety of anti-PD-1 therapy for advanced non-small cell lung cancer
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Abstract:
Objective: To explore the value of inflammatory markers in predicting the efficacy and safety of anti-PD-1 therapy in patients with advanced NSCLC. Methods: Dynamically monitored the serum inflammatory markers of 222 patients with advanced NSCLC who accepted anti-PD-1 treatment at the First Affiliated Hospital of Navy Medical University between January 2018 and December 2020. The ROC curve was used to calculate the optimal cut-off value and the inflammatory indexes were divided into two groups: high and low levels. Log-Rank test and Kaplan-Meier method were used to analyze the relationship between patients’ clinicopathological characteristics , their levels of inflammatory markers and patients’prognosis. Univariate and multivariate Cox regression analysis were used to estimate hazard ratios for PFS and OS. Fisher's exact test was used to analyze the correlation between the baseline levels of inflammatory markers for the high and low level groups and irAE. The Wilcoxon rank test was used to compare the differences between the levels of inflammatory markers before treatment (baseline) and those at the time of the first PR or the first PD and those at the occurrence of irAE. Results: Elevated baseline levels of NLR, MLR, PLR, LDH, CRP and IL-6 were associated with significantly shorter PFS and OS (P<0.01). The results of multivariate analysis showed that elevated baseline levels of PLR, MLR and LDH were independent risk factors for PFS and OS (P<0.05 or P<0.01). The levels of NLR, LDH, CRP and IL-6 decreased significantly when the patients first obtained PR (P<0.05 or P<0.01), and the levels of LDH, CRP, IL-6 and TNF- αincreased significantly when PD occurred (P<0.05 or P<0.01). Compared with the baseline levels, the levels of LDH, CRP, IL-6, IL-10 and TNF-α at the occurrence of irAE increased significantly (P<0.05 or P<0.01). Conclusion: In NSCLC anti-PD-1 therapy, a decrease in the levels of inflammatory markers indicated an improvement of the patient's disease, while an increase indicated progression of the disease and was associated with the occurrence of irAE. Dynamic monitoring of inflammatory markers can predict the efficacy and safety of anti-PD-1 therapy and may contribute to selecting the most eligible advanced NSCLC patients for anti-PD-1 therapy.
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Clc Number:
R734.2; R730.54
