Prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumab
Abstract Background Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50% [1]. However, it is not effective in all patients, and the factors predicting responses among this popula...
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doaj-ebb39f92241d4468872f8907e1101a202021-02-07T12:50:12ZengBMCBMC Cancer1471-24072020-02-012011610.1186/s12885-020-6582-4Prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumabMitsunori Morita0Motohiro Tamiya1Daichi Fujimoto2Akihiro Tamiya3Hidekazu Suzuki4Katsuya Hirano5Yasushi Fukuda6Toshihide Yokoyama7Ryota Kominami8Masaki Kanazu9Junji Uchida10Satoshi Hara11Shuji Yamashita12Hiromi Tomioka13Department of Respiratory Medicine, Kobe City Medical Center West HospitalDepartment of Thoracic Oncology, Osaka International Cancer InstituteDepartment of Respiratory Medicine, Kobe City Medical Center General HospitalDepartment of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical CenterDepartment of Thoracic Oncology, Osaka Habikino Medical CenterDepartment of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical CenterDepartment of Respiratory Medicine, Kurashiki Central HospitalDepartment of Respiratory Medicine, Kurashiki Central HospitalDepartment of Respiratory Medicine, National Hospital Organization Himeji Medical CenterDepartment of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical CenterDepartment of Respiratory Medicine, Osaka General Medical CenterDepartment of Respiratory Medicine, Itami City HospitalDepartment of Respiratory Medicine, Kobe City Medical Center West HospitalDepartment of Respiratory Medicine, Kobe City Medical Center West HospitalAbstract Background Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50% [1]. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) > 50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N = 52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥ 2 (p = 0.0832), stage IV disease or recurrence (p = 0.0487), PD-L1 TPS 50–89% (p = 0.0657), use of steroids prior to the administration of pembrolizumab (p = 0.0243), malignant pleural effusion (p = 0.0032), and baseline C-reactive protein (CRP) levels > 1.0 mg/dL (p = 0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p = 0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p = 0.0228), and baseline CRP > 1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p = 0.0402) were significantly associated with non-response to treatment. Conclusion In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels > 1.0 mg/dL reduced the response of first-line monotherapy with pembrolizumab.https://doi.org/10.1186/s12885-020-6582-4Non-small cell lung cancerPembrolizumabFirst-line therapyEfficacyProgrammed death ligand-1 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mitsunori Morita Motohiro Tamiya Daichi Fujimoto Akihiro Tamiya Hidekazu Suzuki Katsuya Hirano Yasushi Fukuda Toshihide Yokoyama Ryota Kominami Masaki Kanazu Junji Uchida Satoshi Hara Shuji Yamashita Hiromi Tomioka |
spellingShingle |
Mitsunori Morita Motohiro Tamiya Daichi Fujimoto Akihiro Tamiya Hidekazu Suzuki Katsuya Hirano Yasushi Fukuda Toshihide Yokoyama Ryota Kominami Masaki Kanazu Junji Uchida Satoshi Hara Shuji Yamashita Hiromi Tomioka Prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumab BMC Cancer Non-small cell lung cancer Pembrolizumab First-line therapy Efficacy Programmed death ligand-1 |
author_facet |
Mitsunori Morita Motohiro Tamiya Daichi Fujimoto Akihiro Tamiya Hidekazu Suzuki Katsuya Hirano Yasushi Fukuda Toshihide Yokoyama Ryota Kominami Masaki Kanazu Junji Uchida Satoshi Hara Shuji Yamashita Hiromi Tomioka |
author_sort |
Mitsunori Morita |
title |
Prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumab |
title_short |
Prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumab |
title_full |
Prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumab |
title_fullStr |
Prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumab |
title_full_unstemmed |
Prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumab |
title_sort |
prediction of patients with a tumor proportion score > 50% who do not respond to first-line monotherapy with pembrolizumab |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2020-02-01 |
description |
Abstract Background Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50% [1]. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) > 50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N = 52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥ 2 (p = 0.0832), stage IV disease or recurrence (p = 0.0487), PD-L1 TPS 50–89% (p = 0.0657), use of steroids prior to the administration of pembrolizumab (p = 0.0243), malignant pleural effusion (p = 0.0032), and baseline C-reactive protein (CRP) levels > 1.0 mg/dL (p = 0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p = 0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p = 0.0228), and baseline CRP > 1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p = 0.0402) were significantly associated with non-response to treatment. Conclusion In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels > 1.0 mg/dL reduced the response of first-line monotherapy with pembrolizumab. |
topic |
Non-small cell lung cancer Pembrolizumab First-line therapy Efficacy Programmed death ligand-1 |
url |
https://doi.org/10.1186/s12885-020-6582-4 |
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