Efficacy outcomes and prognostic factors from real-world patients with advanced non-small-cell lung cancer treated with first-line chemoimmunotherapy: The Spinnaker retrospective study


Banna, Giuseppe L, Cantale, Ornella, Muthuramalingam, Sethupathi, Cave, Judith, Comins, Charles, Cortellini, Alessio, Addeo, Alfredo, Signori, Alessio, McKenzie, Hayley, Escriu, Carles ORCID: 0000-0003-3638-3202 et al (show 7 more authors) (2022) Efficacy outcomes and prognostic factors from real-world patients with advanced non-small-cell lung cancer treated with first-line chemoimmunotherapy: The Spinnaker retrospective study. INTERNATIONAL IMMUNOPHARMACOLOGY, 110. 108985-.

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Abstract

<h4>Background</h4>Efficacy outcomes and prognostic factors of real-world patients with advanced non-small cell lung cancer (aNSCLC) treated with first-line chemoimmunotherapy are still limited.<h4>Patients and methods</h4>In the retrospective Spinnaker study, data was collected from patients in six United Kingdom and one Swiss oncology centres with first-line pembrolizumab plus platinum-based chemotherapy. Efficacy outcomes and potential prognostic factors were estimated aiming at developing a prognostic model.<h4>Results</h4>Three-hundred-eight patients were included, 32% ≥ 70 years, with ≥ 3 metastatic sites in 33%, brain or liver metastases in 10% and 12%, respectively. With a median follow-up of 18.0 months (mo.) (range, 15.9-20.1), median overall survival (OS) and progression-free survival (PFS) were 12.7 mo. (range, 10.2-15.2), and 8.0 mo. (range, 7.1-8.8), respectively. The neutrophils-to-lymphocytes ratio (NLR) and systemic immune-inflammatory index (SII) (i.e., NLR × platelet count) were both significantly higher in ECOG PS 1 (p = 0.0147 and p = 0.0018, respectively), underweight or normal body mass index (p = 0.0456 and p = 0.0062, respectively), ≥3 metastatic sites (p = 0.0069 and p = 0.112), pretreatment steroids (p = 0.0019 and p = 0.0017). By MVA, the number of metastatic sites ≥ 3 (p < 0.001 and p = 0.002), squamous histology (p = 0.033 and p = 0.013) and SII ≥ 1444 (p = 0.031 and p = 0.009, respectively) were associated with both worse OS and PFS and led to a highly discriminating three-class risk prognostic model.<h4>Conclusion</h4>Real-world PFS with chemoimmunotherapy in aNSCLC patients is similar to that reported in clinical trials. A high number of metastatic sites, squamous histology and high SII are adverse prognostic factors that might contribute to a clinically useful prognostic model.

Item Type: Article
Uncontrolled Keywords: Non-small-cell lung cancer, Chemoimmunotherapy, Prognostic, Inflammatory index, NLR prognostic
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Faculty Management Office
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 18 Oct 2022 13:47
Last Modified: 18 Jan 2023 19:49
DOI: 10.1016/j.intimp.2022.108985
Open Access URL: https://doi.org/10.1016/j.intimp.2022.108985
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3165601
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