scholarly journals C-reactive protein reduction post treatment is associated with improved survival in atezolizumab (anti-PD-L1) treated non-small cell lung cancer patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246486
Author(s):  
Namrata S. Patil ◽  
Wei Zou ◽  
Simonetta Mocci ◽  
Alan Sandler ◽  
Marcus Ballinger ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Post Treatment ◽  
Phase Iii ◽  
C Reactive Protein ◽  
Small Cell Lung ◽  
Reactive Protein ◽  
Pre Treatment ◽  
Serum Crp

Purpose Overall survival (OS) is the most significant endpoint for evaluation of treatment benefit with checkpoint inhibitors (CPI) in cancer. We evaluated serum C-reactive protein (CRP) in non-small cell lung cancer (NSCLC) trials with atezolizumab (anti-PD-L1) as an early OS surrogate. Methods Serum from patients enrolled in randomized Phase II (n = 240) and Phase III (n = 701) trials of NSCLC patients (POPLAR, OAK) who progressed on prior-platinum chemotherapy, were analyzed for CRP levels over time. Patients were grouped by changes in CRP levels post-treatment as either increased (≥ 1.5 fold), decreased (≤ 1.5 fold) or unchanged (within +1.5 fold) relative to pre-treatment levels to assess association with progression free survival (PFS) and OS. Results Decrease in serum CRP levels at 6 weeks relative to pre-treatment were observed in patients with RECIST1.1 based complete or partial responses (CR/PR) to atezolizumab whereas patients with disease progression (PD) demonstrated an increase in CRP levels in the Phase II POPLAR study, and confirmed in the Phase III OAK study. Decrease in serum CRP as early as six weeks post treatment predicted improved PFS and OS, even in patients who were determined as stable disease (SD) in their first scan. This effect was not observed in the chemotherapy arms. Conclusion Modulation of serum CRP correlates with clinical outcome post-atezolizumab treatment. This routine lab test may provide utility in informing OS signals as early as 6 weeks post-initiation of therapy with CPIs in NSCLC.

scholarly journals Pre-Treatment C-Reactive Protein Predicts Survival in Small Cell Lung Cancer Patients

Onco ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 114-123
Author(s):  
Anne Marie Stensvold ◽  
Ninna Aggerholm-Pedersen ◽  
Anne Winther-Larsen ◽  
Birgitte Sandfeld-Paulsen
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Prognostic Value ◽  
Small Cell ◽  
Cox Proportional Hazards Model ◽  
C Reactive Protein ◽  
Small Cell Lung ◽  
Reactive Protein ◽  
Pre Treatment

Improved prognostication of small cell lung cancer (SCLC) patients could strengthen the treatment strategy and, thereby, potentially improve the overall survival (OS) of these patients. C-reactive protein (CRP) has been proposed as a prognostic indicator of inferior survival, although so far, only based on data from smaller studies. Data on SCLC patients diagnosed from January 2009 to June 2018 were extracted from the Danish Lung Cancer Registry and the clinical laboratory information system. CRP measurements were divided at the clinical cut-off value of 8 mg/L or 75 nmol/L) and stratified into quartiles. Cox proportional hazards model assessed the prognostic value of the CRP level. C-statistics further evaluated the biomarker’s prognostic value. In total, 923 patients were included. A pre-treatment CRP level above the clinical cut-off significantly correlated to inferior OS (adjusted hazard ratio (HR) = 1.25 (95% confidence interval (CI): 1.08–1.46). When divided into quartiles, a level-dependent correlation was observed with only the highest quartiles significantly associated with OS (3rd quartile: adjusted HR = 1.26 (95% CI: 1.03–1.55) 4th quartile: adjusted HR = 1.44 (95% CI: 1.17–1.77)). Adding CRP level to already well-established prognostic factors improved the prognostication of SCLC patients. In conclusion, high pre-treatment CRP level is an independent prognostic factor in SCLC patients.

Prognostic Significance of Perioperative C-Reactive Protein in Resected Non-Small Cell Lung Cancer

2020 ◽  
Vol 32 (4) ◽  
pp. 1046-1055 ◽  
Author(s):  
Satoru Okada ◽  
Masanori Shimomura ◽  
Hiroaki Tsunezuka ◽  
Satoshi Teramukai ◽  
Shunta Ishihara ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Prognostic Significance ◽  
Small Cell ◽  
C Reactive Protein ◽  
Small Cell Lung ◽  
Reactive Protein

scholarly journals Preresection serum C-reactive protein measurement and survival among patients with resectable non–small cell lung cancer

2011 ◽  
Vol 142 (5) ◽  
pp. 1161-1167 ◽  
Author(s):  
Marco Alifano ◽  
Pierre E. Falcoz ◽  
Valérie Seegers ◽  
Nicolas Roche ◽  
Olivier Schussler ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
C Reactive Protein ◽  
Small Cell Lung ◽  
Reactive Protein ◽  
Protein Measurement

Monitoring C-reactive protein facilitates early discontinuation of immune oncology without compromising outcomes in stage IV non-small cell lung cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21107-e21107
Author(s):  
Tyler Fugere ◽  
Ples Spradley ◽  
Ahmad Mazen Safar
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Small Cell ◽  
C Reactive Protein ◽  
Small Cell Lung ◽  
Free Survival ◽  
Reactive Protein

e21107 Background: C-Reactive Protein (CRP) is a non-specific inflammatory marker and reflects tissue destruction seen in metastatic cancer (ca). We have observed a tight correlation with CRP trends mirroring ca activity, hence it may prove to be a valuable marker to monitor response to Immuno-Oncology (IO) in non-small cell lung cancer (NSCLC) patients (pts). Once CRP levels stabilized, IO discontinuation was offered, and consenting pts were closely observed. This strategy resulted in shortened IO duration and impressive treatment-free progression-free survival (tf-PFS). We sought to examine the validity of this strategy using the rate of return to any form of ca therapy within 6 months after stopping IO. Methods: We analyzed all pts of a single provider since 2016 with stage IV NSCLC who had CRP checked while on IO, totaling 23 pts. We excluded pts who stopped IO for reasons besides stable CRP values (5 progressed on IO, 3 died while on IO, 1 had side effects, 1 stopped for a clinical trial, 1 opted to complete 2 years of IO, and 2 are still on IO). Of the remaining 10 patient cohort, all pts were males treated at the VA with ages between 56-75 years at diagnosis. 50% of the cohort had adenocarcinoma and 50% had squamous cell carcinoma. Results: Using the CRP trend to shorten the duration of IO resulted in durable drug-free holidays with none of the cohort returning to any form of ca therapy within 6 months and comparable rates of overall survival (OS) despite shorter IO duration. In KEYNOTE-042, the median OS for pts on the pembrolizumab arm was 16.7 months in the overall population and 20 months in the TPS ≥50% subgroup. Pts were treated for up to 35 months. In our cohort, median OS was 38 months, with all pts currently still alive, and median number of doses of IO was 9 cycles, or approximately 7 months. Our pts had ongoing progression free survival (PFS) after stopping treatment, which we report as tf-PFS. The median tf-PFS of our cohort was 23.5 months. Conclusions: In pts with stage IV NSCLC treated with IO, CRP appears promising as a marker to tailor IO therapy addressing tumor and clinical heterogeneity. Responding pts with stable CRP levels can be safely taken off IO. CRP should be monitored with stable values indicating continued PFS. tf-PFS rather than PFS may serve as a surrogate for cure and carries significant impact for pts financially, socially, and psychologically. [Table: see text]

Postoperative C-reactive Protein Is a Predictive Biomarker for Survival After Non-small Cell Lung Cancer Resection

2019 ◽  
Vol 39 (4) ◽  
pp. 2193-2198 ◽  
Author(s):  
SHUICHI SHINOHARA ◽  
RYO OTSUKI ◽  
TAKAMITSU ONITSUKA ◽  
KAZUHIKO MACHIDA ◽  
MASAKI MATSUO ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Predictive Biomarker ◽  
Small Cell ◽  
C Reactive Protein ◽  
Small Cell Lung ◽  
Cancer Resection ◽  
Reactive Protein

scholarly journals Flexible modeling improves assessment of prognostic value of C-reactive protein in advanced non-small cell lung cancer

2010 ◽  
Vol 102 (7) ◽  
pp. 1113-1122 ◽  
Author(s):  
B Gagnon ◽  
M Abrahamowicz ◽  
Y Xiao ◽  
M-E Beauchamp ◽  
N MacDonald ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Prognostic Value ◽  
Small Cell ◽  
C Reactive Protein ◽  
Small Cell Lung ◽  
Reactive Protein ◽  
Flexible Modeling

Clinical Significance of Pretreatment C-Reactive Protein in Patients with Advanced Nonsquamous, Non-Small Cell Lung Cancer Who Received Gefitinib

Oncology ◽  
2010 ◽  
Vol 79 (5-6) ◽  
pp. 355-362 ◽  
Author(s):  
Katsuhiro Masago ◽  
Shiro Fujita ◽  
Yosuke Togashi ◽  
Young Hak Kim ◽  
Yukimasa Hatachi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Clinical Significance ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
C Reactive Protein ◽  
Small Cell Lung ◽  
Reactive Protein

Association of PFS with levels of pretreatment lactate dehydrogenase in patients with EML4-ALK rearrangement non-small cell lung cancer treated with ALK tyrosine kinase inhibitor.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20513-e20513
Author(s):  
Hongge Liang ◽  
Di Ma ◽  
Yan Xu ◽  
Jing Zhao ◽  
Minjiang Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lactate Dehydrogenase ◽  
Small Cell Lung Cancer ◽  
Progression Free Survival ◽  
Small Cell ◽  
Post Treatment ◽  
Small Cell Lung ◽  
Alk Rearrangement ◽  
Free Survival ◽  
Pre Treatment

e20513 Background: We performed a retrospective analysis to investigate the association between the lactate dehydrogenase (LDH) levels and progression-free survival (PFS) in patients with echinoderm microtubule-associated protein-like 4-anaplasticlymphoma kinase (EML4-ALK) rearrangement non-small cell lung cancer (NSCLC) receiving treatment with crizotinib. Methods: Advanced NSCLC patients with EML4-ALK rearrangement receiving treatment with crizotinib were enrolled at Peking Union Medical College and Cancer Hospital Chinese Academy of Medical Sciences between January 2007 and January 2016. Pre-treatment or post-treatment serum LDH levels were analyzed with progression-free survival (PFS) and patients’ clinical parameters. Results: Overall, 212 patients were studied. Kaplan-Meier univariate analysis showed that elevated pre-treatment LDH level (7.9 vs. 14.1 months, P = 0.004) were associated with PFS, while the mean value of post-treatment LDH level (14.3 vs. 13.3 months, P = 0.970) were not associated with PFS. Coxproportional hazards model also identified that pre-treatment LDH level (hazard ratio [HR] = 1.841, 95% confidence interval [CI] 1.062-3.190, P = 0.030) was associated with the PFS. Logistic regression analysis showed that post-treatment LDH level was associated with creatine kinase(OR = 6.712, 95% CI 3.395-13.273, P < 0.01), CKMB (OR = 6.297, 95% CI 2.953-13.427, P < 0.01), and hemoglobin(OR = 4.163, 1.741-9.956, P = 0.001). Conclusions: An elevated pre-treatment serum LDH level ( > 250U/L) is significantly associated with shorter PFS in patients with EML4-ALK rearrangement NSCLC. Post-treatment elevated serum LDH level is associated with multiple factors including muscle damage and anemia, rather than PFS.

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