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The Prognostic Nutritional Index before durvalumab after chemoradiation predict the overall survival in patients with stage III non-small cell lung cancer

BACKGROUND: Adjuvant durvalumab after chemoradiation has become the standard of care for patients with stage III NSCLC, according to the PACIFIC trial. Whether biomarkers before durvalumab for patients with stage III NSCLC showed predictive and prognostic effects remains unknown. METHODS: This is a...

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Autores principales: Matsuura, Shun, Serizawa, Sayaka, Yamashita, Ryoma, Morikawa, Keisuke, Ito, Yutaro, Hiramatsu, Toshiya, Mochizuki, Eisuke, Tanaka, Kazuki, Akiyama, Norimichi, Tsukui, Masaru, Koshimizu, Naoki, Kosugi, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10101664/
https://www.ncbi.nlm.nih.gov/pubmed/37043179
http://dx.doi.org/10.1080/07853890.2023.2196089
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author Matsuura, Shun
Serizawa, Sayaka
Yamashita, Ryoma
Morikawa, Keisuke
Ito, Yutaro
Hiramatsu, Toshiya
Mochizuki, Eisuke
Tanaka, Kazuki
Akiyama, Norimichi
Tsukui, Masaru
Koshimizu, Naoki
Kosugi, Takashi
author_facet Matsuura, Shun
Serizawa, Sayaka
Yamashita, Ryoma
Morikawa, Keisuke
Ito, Yutaro
Hiramatsu, Toshiya
Mochizuki, Eisuke
Tanaka, Kazuki
Akiyama, Norimichi
Tsukui, Masaru
Koshimizu, Naoki
Kosugi, Takashi
author_sort Matsuura, Shun
collection PubMed
description BACKGROUND: Adjuvant durvalumab after chemoradiation has become the standard of care for patients with stage III NSCLC, according to the PACIFIC trial. Whether biomarkers before durvalumab for patients with stage III NSCLC showed predictive and prognostic effects remains unknown. METHODS: This is a retrospective study in the Fujieda Municipal General Hospital between October 2018 and March 2022. We assessed the predictive value of the Prognostic Nutritional Index (PNI) in stage III non-small cell lung cancer (NSCLC) patients treated with durvalumab after chemoradiation. RESULTS: After applying the inclusion and exclusion criteria, the study included 56 patients for further analysis. The median follow-up period was 17.6 months (range, 3.0–45.4 months). According to receiver operating characteristic curve results, the PNI cutoff value to predict overall survival (OS) was 37.9, with sensitivity and specificity at 67.9% and 67.9%. Accordingly, the patients were divided into low- and high-PNI groups. Patients with the low-PNI group had a significantly shorter progression-free survival compared to the high-PNI group (median, 9.1 vs. 21.3 months, p = 0.032). OS was also shorter in the low-PNI group (median, 19.0 months vs. not reached, p < 0.001). In the multivariate Cox hazards regression analyses, the high-PNI was an independent prognostic factor for OS (hazard ratio, 0.187; 95% confidence interval, 0.046–0.760; p = 0.019). CONCLUSIONS: It seems that PNI could be used as a predictor for OS in patients with stage III NSCLC treated with durvalumab after chemoradiation. KEY MESSAGES: Inadequate immunocompetence and nutritional status after chemoradiation therapy may result in poor antitumor efficacy of ICIs. Pretreatment immune and nutritional assessment using PNI could be considered an independent predictor for the survival of stage III NSCLC patients treated with durvalumab after chemoradiation therapy.
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spelling pubmed-101016642023-04-14 The Prognostic Nutritional Index before durvalumab after chemoradiation predict the overall survival in patients with stage III non-small cell lung cancer Matsuura, Shun Serizawa, Sayaka Yamashita, Ryoma Morikawa, Keisuke Ito, Yutaro Hiramatsu, Toshiya Mochizuki, Eisuke Tanaka, Kazuki Akiyama, Norimichi Tsukui, Masaru Koshimizu, Naoki Kosugi, Takashi Ann Med Oncology BACKGROUND: Adjuvant durvalumab after chemoradiation has become the standard of care for patients with stage III NSCLC, according to the PACIFIC trial. Whether biomarkers before durvalumab for patients with stage III NSCLC showed predictive and prognostic effects remains unknown. METHODS: This is a retrospective study in the Fujieda Municipal General Hospital between October 2018 and March 2022. We assessed the predictive value of the Prognostic Nutritional Index (PNI) in stage III non-small cell lung cancer (NSCLC) patients treated with durvalumab after chemoradiation. RESULTS: After applying the inclusion and exclusion criteria, the study included 56 patients for further analysis. The median follow-up period was 17.6 months (range, 3.0–45.4 months). According to receiver operating characteristic curve results, the PNI cutoff value to predict overall survival (OS) was 37.9, with sensitivity and specificity at 67.9% and 67.9%. Accordingly, the patients were divided into low- and high-PNI groups. Patients with the low-PNI group had a significantly shorter progression-free survival compared to the high-PNI group (median, 9.1 vs. 21.3 months, p = 0.032). OS was also shorter in the low-PNI group (median, 19.0 months vs. not reached, p < 0.001). In the multivariate Cox hazards regression analyses, the high-PNI was an independent prognostic factor for OS (hazard ratio, 0.187; 95% confidence interval, 0.046–0.760; p = 0.019). CONCLUSIONS: It seems that PNI could be used as a predictor for OS in patients with stage III NSCLC treated with durvalumab after chemoradiation. KEY MESSAGES: Inadequate immunocompetence and nutritional status after chemoradiation therapy may result in poor antitumor efficacy of ICIs. Pretreatment immune and nutritional assessment using PNI could be considered an independent predictor for the survival of stage III NSCLC patients treated with durvalumab after chemoradiation therapy. Taylor & Francis 2023-04-12 /pmc/articles/PMC10101664/ /pubmed/37043179 http://dx.doi.org/10.1080/07853890.2023.2196089 Text en © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
spellingShingle Oncology
Matsuura, Shun
Serizawa, Sayaka
Yamashita, Ryoma
Morikawa, Keisuke
Ito, Yutaro
Hiramatsu, Toshiya
Mochizuki, Eisuke
Tanaka, Kazuki
Akiyama, Norimichi
Tsukui, Masaru
Koshimizu, Naoki
Kosugi, Takashi
The Prognostic Nutritional Index before durvalumab after chemoradiation predict the overall survival in patients with stage III non-small cell lung cancer
title The Prognostic Nutritional Index before durvalumab after chemoradiation predict the overall survival in patients with stage III non-small cell lung cancer
title_full The Prognostic Nutritional Index before durvalumab after chemoradiation predict the overall survival in patients with stage III non-small cell lung cancer
title_fullStr The Prognostic Nutritional Index before durvalumab after chemoradiation predict the overall survival in patients with stage III non-small cell lung cancer
title_full_unstemmed The Prognostic Nutritional Index before durvalumab after chemoradiation predict the overall survival in patients with stage III non-small cell lung cancer
title_short The Prognostic Nutritional Index before durvalumab after chemoradiation predict the overall survival in patients with stage III non-small cell lung cancer
title_sort prognostic nutritional index before durvalumab after chemoradiation predict the overall survival in patients with stage iii non-small cell lung cancer
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10101664/
https://www.ncbi.nlm.nih.gov/pubmed/37043179
http://dx.doi.org/10.1080/07853890.2023.2196089
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