scholarly journals Body composition and inflammation impact in non-small cell lung cancer patients treated by first-line immunotherapy

Immunotherapy ◽  
2021 ◽  
Author(s):  
Cinzia Baldessari ◽  
Annarita Pecchi ◽  
Raffaella Marcheselli ◽  
Giorgia Guaitoli ◽  
Riccardo Bonacini ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Body Composition ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Prognostic Impact ◽  
Small Cell Lung ◽  
First Line ◽  
Risk Of Death ◽  
Inflammatory Status

Background: Immunotherapy changed the landscape of non-small cell lung cancer (NSCLC). Efforts were made to implement its action. This study aims to describe body composition, nutritional and inflammatory status in NSCLC patients treated by first-line immunotherapy, their correlation, variation and impact. Patients and methods: We retrospectively analyzed 44 consecutive patients who received pembrolizumab treatment. Results: During the therapy, inflammation and visceral fat increased, whereas muscle and subcutaneous fat decreased. Parameters related to inflammation had an interesting prognostic impact. High numbers of white blood cells remained significantly correlated with a high risk of death in multivariate model. Conclusion: For the best treatment choice, a combination of clinical and biological factors will be most likely be necessary. Prospective and larger studies with a multidimensional approach are needed.

scholarly journals Risk of SARS-CoV2-related Mortality in Non-small Cell Lung Cancer Patients Treated With First-line Immunotherapy Alone or in Combination With Chemotherapy

2021 ◽  
Author(s):  
Giuseppe Luigi Banna ◽  
Ornella Cantale ◽  
Alex Friedlaender ◽  
Harliana Yusof ◽  
Alfredo Addeo
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Smoking History ◽  
Small Cell Lung ◽  
First Line ◽  
Risk Of Death ◽  
The Impact ◽  
Related Mortality

Abstract Background: Patients with cancer are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), although the impact of solid cancer types and systemic anticancer treatments on its related mortality is still debatable.Methods: To weigh the real impact of immune-checkpoint inhibitors (ICIs) by exploring the risk of SARS-CoV-2-related mortality in a retrospective analysis of patients with non-small-cell lung cancer (NSCLC) treated with first-line Pembrolizumab or in combination with chemotherapy (ChT) during the first surge of the pandemic. Results: The risk of death was significantly higher in the group of patients treated with ChT+Pembrolizumab than with Pembrolizumab alone (OR 2.43 (1.23-4.82, p=0.01). The SARS-CoV-2-related mortality rate was 8% and significantly associated with ChT+Pembrolizumab as compared to Pembrolizumab alone (18% vs. 0%, respectively, p=0.03). Patients dead because of SARS-CoV-2 were older than 70 years (100 vs. 34%, respectively, p=0.03) and tended to have a heavier smoking history (67 vs. 29% of current smokers, respectively, p=0.17). Higher baseline values of neutrophil-to-lymphocyte ratio (NLR) (with 67 vs. 50% ≥ 4.0, p=0.58) and systemic immune-inflammation index (SII) (with 67 vs. 50% ≥ 1236, p=0.58) were observed in patients dead due to the SARS-CoV-2.Conclusions: Immunotherapy might not impact the risk of SARS-CoV-2-related mortality, whilst the addition of ChT was either associated with an overall increased risk of mortality and to the risk of SARS-CoV-2-related mortality. The co-existence of other clinical factors may have contributed to the latter.

Low level of complement factor H increases the risk of cancer-related death in patients with small-cell lung cancer

2021 ◽  
pp. postgradmedj-2021-141186
Author(s):  
Mengqi Xiang ◽  
Huachuan Zhang ◽  
Lingna Kou ◽  
Jing Chen ◽  
Zhihua Xu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Factor H ◽  
Complement Factor H ◽  
Prognostic Impact ◽  
Complement Factor ◽  
Small Cell Lung ◽  
Risk Of Death

IntroductionPulmonary cancer is a kind of deeply invasive tumour which is difficult to treat, and its mortality rate is high. Previous research has shown that activation of complement could contribute to the progression of non-small-cell lung cancer (SCLC). However, little research has been done on SCLC.MethodsComplement factor H (CFH), complements C3 as well as C4 were measured in patients, and the prognostic impact of different parameters was assessed by log-rank function analysis and Cox multifactor models. Besides, we constructed a predictive model based on complement fractions and validated the accuracy of the model.ResultsAmong these 242 patients, 200 (82.6%) died. The median survival time was 18.3 months. We found by multifactorial analysis that high levels of CFH decreased the risk of death (HR 0.23, 95% CI 0.10 to 0.57, p<0.001), while elevated complement C4 displayed poor prognosis (HR 2.28, 95% CI 1.66 to 3.13, p<0.001). We screened variables by Cox models and constructed CFH-based prediction models to plot a nomogram by internal validation. The nomogram showed excellent accuracy in assessing the probability of death, yielding an adjusted C-statistics of 0.905.ConclusionsCFH can be recognised as a biomarker to predict the risk of death in SCLC. The prediction model established based on CFH, C3 and C4 levels has good accuracy in patients’ prognostic assessment.

The Prognostic Impact of Pericardial Fat Volumes in Resected Non-small Cell Lung Cancer

2019 ◽  
Vol 27 (2) ◽  
pp. 481-489 ◽  
Author(s):  
Shuichi Shinohara ◽  
Ryo Otsuki ◽  
Kenichi Kobayashi ◽  
Masaki Matsuo ◽  
Ken Harada ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Prognostic Impact ◽  
Small Cell Lung ◽  
Pericardial Fat

scholarly journals Biomarkers and Gene Signatures to Predict Durable Response to Pembrolizumab in Non-Small Cell Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3828
Author(s):  
Anello Marcello Poma ◽  
Rossella Bruno ◽  
Iacopo Pietrini ◽  
Greta Alì ◽  
Giulia Pasquini ◽  
...  
Keyword(s):  
Lung Cancer ◽  
T Cells ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Immune Cell ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Durable Response ◽  
Nsclc Patients

Pembrolizumab has been approved as first-line treatment for advanced Non-small cell lung cancer (NSCLC) patients with tumors expressing PD-L1 and in the absence of other targetable alterations. However, not all patients that meet these criteria have a durable benefit. In this monocentric study, we aimed at refining the selection of patients based on the expression of immune genes. Forty-six consecutive advanced NSCLC patients treated with pembrolizumab in first-line setting were enrolled. The expression levels of 770 genes involved in the regulation of the immune system was analysed by the nanoString system. PD-L1 expression was evaluated by immunohistochemistry. Patients with durable clinical benefit had a greater infiltration of cytotoxic cells, exhausted CD8, B-cells, CD45, T-cells, CD8 T-cells and NK cells. Immune cell scores such as CD8 T-cell and NK cell were good predictors of durable response with an AUC of 0.82. Among the immune cell markers, XCL1/2 showed the better performance in predicting durable benefit to pembrolizumab, with an AUC of 0.85. Additionally, CD8A, CD8B and EOMES showed a high specificity (>0.86) in identifying patients with a good response to treatment. In the same series, PD-L1 expression levels had an AUC of 0.61. The characterization of tumor microenvironment, even with the use of single markers, can improve patients’ selection for pembrolizumab treatment.

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