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Integrating clinical and biological prognostic biomarkers in patients with advanced NSCLC treated with immunotherapy: the DEMo score system
BACKGROUND: Several biomarkers have been separately described to select patients for immunotherapy (IO), but few studies integrate these markers. Di Maio, EPSILoN and the plasma microRNA signature classifier (MSC), are three different clinico, biochemical and molecular markers able to independently...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354114/ https://www.ncbi.nlm.nih.gov/pubmed/32676324 http://dx.doi.org/10.21037/tlcr-20-231 |
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author | Prelaj, Arsela Proto, Claudia Lo Russo, Giuseppe Signorelli, Diego Ferrara, Roberto Mensah, Mavis Galli, Giulia De Toma, Alessandro Viscardi, Giuseppe Brambilla, Marta Lobefaro, Riccardo Trevisan, Benedetta Trovò, Francesco Torri, Valter Sozzi, Gabriella Garassino, Marina Chiara Boeri, Mattia |
author_facet | Prelaj, Arsela Proto, Claudia Lo Russo, Giuseppe Signorelli, Diego Ferrara, Roberto Mensah, Mavis Galli, Giulia De Toma, Alessandro Viscardi, Giuseppe Brambilla, Marta Lobefaro, Riccardo Trevisan, Benedetta Trovò, Francesco Torri, Valter Sozzi, Gabriella Garassino, Marina Chiara Boeri, Mattia |
author_sort | Prelaj, Arsela |
collection | PubMed |
description | BACKGROUND: Several biomarkers have been separately described to select patients for immunotherapy (IO), but few studies integrate these markers. Di Maio, EPSILoN and the plasma microRNA signature classifier (MSC), are three different clinico, biochemical and molecular markers able to independently predict prognosis in non-small cell lung cancer (NSCLC). METHODS: Complete data such as sex, histology, ECOG-PS, stage, smoking status, presence of liver metastasis, LDH and neutrophils-to-lymphocyte ratio were collected to generate Di Maio and EPSILoN. The MSC risk level was prospectively assessed in plasma samples collected at baseline IO. The 3 markers were integrated into the DEMo score system prospectively tested in a cohort of 200 advanced NSCLC patients treated with IO. Endpoints were overall survival (OS), progression-free survival (PFS) and overall response rate (ORR). RESULTS: DEMo separated patients in 7-risk groups whose median OS had a trend ranging from 29.7 to 1.5 months (P<0.0001). When comparing patients with the lowest (n=29) and the highest (n=35) DEMo scores ORR was 45% and 3%, respectively (P<0.0001). Considering the 53 PD-L1 ≥50% patients, DEMo identified a group of 13 (25%) patients who benefit less from IO in terms of both OS (HR: 8.81; 95% CI: 2.87–20.01) and PFS (HR: 6.82; 95% CI: 2.57–18.10). Twelve out of 111 (11%) patients who most benefit from IO according to OS (HR: 0.21; 95% CI: 0.07–0.62) and PFS (HR: 0.28; 95% CI: 0.12–0.65) were identified by DEMo in the PD-L1 <50% group. CONCLUSIONS: The DEMo prognostic score system stratified NSCLC patients treated with IO better than each single marker. The proper use of DEMo according to PD-L1 could improve selection in IO regimens. |
format | Online Article Text |
id | pubmed-7354114 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-73541142020-07-15 Integrating clinical and biological prognostic biomarkers in patients with advanced NSCLC treated with immunotherapy: the DEMo score system Prelaj, Arsela Proto, Claudia Lo Russo, Giuseppe Signorelli, Diego Ferrara, Roberto Mensah, Mavis Galli, Giulia De Toma, Alessandro Viscardi, Giuseppe Brambilla, Marta Lobefaro, Riccardo Trevisan, Benedetta Trovò, Francesco Torri, Valter Sozzi, Gabriella Garassino, Marina Chiara Boeri, Mattia Transl Lung Cancer Res Original Article BACKGROUND: Several biomarkers have been separately described to select patients for immunotherapy (IO), but few studies integrate these markers. Di Maio, EPSILoN and the plasma microRNA signature classifier (MSC), are three different clinico, biochemical and molecular markers able to independently predict prognosis in non-small cell lung cancer (NSCLC). METHODS: Complete data such as sex, histology, ECOG-PS, stage, smoking status, presence of liver metastasis, LDH and neutrophils-to-lymphocyte ratio were collected to generate Di Maio and EPSILoN. The MSC risk level was prospectively assessed in plasma samples collected at baseline IO. The 3 markers were integrated into the DEMo score system prospectively tested in a cohort of 200 advanced NSCLC patients treated with IO. Endpoints were overall survival (OS), progression-free survival (PFS) and overall response rate (ORR). RESULTS: DEMo separated patients in 7-risk groups whose median OS had a trend ranging from 29.7 to 1.5 months (P<0.0001). When comparing patients with the lowest (n=29) and the highest (n=35) DEMo scores ORR was 45% and 3%, respectively (P<0.0001). Considering the 53 PD-L1 ≥50% patients, DEMo identified a group of 13 (25%) patients who benefit less from IO in terms of both OS (HR: 8.81; 95% CI: 2.87–20.01) and PFS (HR: 6.82; 95% CI: 2.57–18.10). Twelve out of 111 (11%) patients who most benefit from IO according to OS (HR: 0.21; 95% CI: 0.07–0.62) and PFS (HR: 0.28; 95% CI: 0.12–0.65) were identified by DEMo in the PD-L1 <50% group. CONCLUSIONS: The DEMo prognostic score system stratified NSCLC patients treated with IO better than each single marker. The proper use of DEMo according to PD-L1 could improve selection in IO regimens. AME Publishing Company 2020-06 /pmc/articles/PMC7354114/ /pubmed/32676324 http://dx.doi.org/10.21037/tlcr-20-231 Text en 2020 Translational Lung Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Prelaj, Arsela Proto, Claudia Lo Russo, Giuseppe Signorelli, Diego Ferrara, Roberto Mensah, Mavis Galli, Giulia De Toma, Alessandro Viscardi, Giuseppe Brambilla, Marta Lobefaro, Riccardo Trevisan, Benedetta Trovò, Francesco Torri, Valter Sozzi, Gabriella Garassino, Marina Chiara Boeri, Mattia Integrating clinical and biological prognostic biomarkers in patients with advanced NSCLC treated with immunotherapy: the DEMo score system |
title | Integrating clinical and biological prognostic biomarkers in patients with advanced NSCLC treated with immunotherapy: the DEMo score system |
title_full | Integrating clinical and biological prognostic biomarkers in patients with advanced NSCLC treated with immunotherapy: the DEMo score system |
title_fullStr | Integrating clinical and biological prognostic biomarkers in patients with advanced NSCLC treated with immunotherapy: the DEMo score system |
title_full_unstemmed | Integrating clinical and biological prognostic biomarkers in patients with advanced NSCLC treated with immunotherapy: the DEMo score system |
title_short | Integrating clinical and biological prognostic biomarkers in patients with advanced NSCLC treated with immunotherapy: the DEMo score system |
title_sort | integrating clinical and biological prognostic biomarkers in patients with advanced nsclc treated with immunotherapy: the demo score system |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354114/ https://www.ncbi.nlm.nih.gov/pubmed/32676324 http://dx.doi.org/10.21037/tlcr-20-231 |
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