"Baseline C-reactive protein predicts efficacy of the first-line immune checkpoint inhibitors plus chemotherapy in advanced lung squamous cell carcinoma: a retrospective, multicenter study"

作者全名："Zheng, Xinlong; Zhang, Longfeng; Wu, Lin; Zhao, Jun; Sun, Jianguo; Fang, Yong; Zhou, Jin; Chu, Qian; Shen, Yihong; Yang, Zhenzhou; Chen, Lijin; Huang, Meijuan; Lin, Xiaoyan; Liu, Zhenhua; Shen, Peng; Wang, Zhijie; Wang, Xin; Wang, Huijuan; Han, Zhengbo; Liu, Anwen; Zhang, Hongmei; Ye, Feng; Gao, Wen; Wu, Fang; Song, Zhengbo; Chen, Shengchi; Zhou, Chenzhi; Wang, Qian; Xu, Chunwei; Huang, Dingzhi; Zheng, Xiaobin; Miao, Qian; Jiang, Kan; Xu, Yiquan; Wu, Shiwen; Wang, Haibo; Zhang, Qiuyu; Yang, Shanshan; Li, Yujing; Chen, Sihui; Lin, Gen"

作者地址："[Zheng, Xinlong; Zhang, Longfeng; Zheng, Xiaobin; Miao, Qian; Jiang, Kan; Xu, Yiquan; Wu, Shiwen; Wang, Haibo; Yang, Shanshan; Li, Yujing; Chen, Sihui; Lin, Gen] Fujian Med Univ, Fujian Canc Hosp, Clin Oncol Sch, Dept Thorac Oncol, Fuzhou, Peoples R China; [Lin, Gen] Key Lab Adv Technol Canc Screening & Early Diag, Fuzhou 350014, Fujian, Peoples R China; [Wu, Lin] Cent South Univ, Hunan Canc Hosp, Dept Thorac Oncol 2, Affiliated Canc Hosp,Xiangya Sch Med, Changsha, Peoples R China; [Zhao, Jun] Peking Univ Canc Hosp & Inst, Dept Thorac Med Oncol, Beijing, Peoples R China; [Sun, Jianguo] Army Med Univ, Xinqiao Hosp, Canc Inst, Chongqing, Peoples R China; [Fang, Yong] Zhejiang Univ, Sir Run Run Shaw Hosp, Dept Med Oncol, Hangzhou 310016, Zhejiang, Peoples R China; [Zhou, Jin] Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Canc Ctr, Sch Med, Chengdu, Sichuan, Peoples R China; [Chu, Qian] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Oncol, Wuhan, Peoples R China; [Shen, Yihong] Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Resp Dis, Hangzhou, Peoples R China; [Yang, Zhenzhou] Chongqing Med Univ, Affiliated Hosp 2, Dept Canc Ctr, Chongqing, Peoples R China; [Chen, Lijin] First Hosp Quanzhou Affiliated Fujian Med Univ, Dept Urol, Quanzhou 362000, Fujian, Peoples R China; [Huang, Meijuan] Sichuan Univ, West China Hosp, Dept Thorac Oncol, Canc Ctr & State Key Lab Biotherapy, Chengdu, Peoples R China; [Lin, Xiaoyan] Fujian Med Univ, Union Hosp, Dept Radiat Oncol, Fuzhou, Peoples R China; [Liu, Zhenhua] Fujian Med Univ, Fujian Prov Hosp, Fujian Prov Clin Coll, Dept Med Oncol, Fuzhou 350001, Peoples R China; [Shen, Peng] Southern Med Univ, Nanfang Hosp, Dept Oncol, Guangzhou, Peoples R China; [Wang, Zhijie] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Dept Med Oncol, Natl Clin Res Ctr Canc,Canc Hosp, Beijing, Peoples R China; [Wang, Xin] Xiamen Univ, Zhongshan Hosp, Dept Orthopaed, Xiamen, Peoples R China; [Wang, Huijuan] Zhengzhou Univ, Henan Canc Hosp, Affiliated Canc Hosp, Dept Resp Med, Zhengzhou, Peoples R China; [Han, Zhengbo] Shengjing Hosp China Med Univ, Dept Oncol, Shenyang, Peoples R China; [Liu, Anwen] Second Affiliated Hosp Nanchang Univ, Dept Oncol, Nanchang, Jiangxi, Peoples R China; [Zhang, Hongmei] Airforce Mil Med Univ, Xijing Hosp, Dept Radiat Oncol, Xian, Peoples R China; [Ye, Feng] Fujian Med Univ, Teaching Hosp, Xiamen Univ, Dept Nucl Med,Xiamen Canc Ctr,Affiliated Hosp 1, Xiamen, Peoples R China; [Gao, Wen] First Affiliated Hosp Nanjing Med Univ, Dept Vasc Surg, Nanjing, Jiangsu, Peoples R China; [Wu, Fang] Cent South Univ, Xiangya Hosp 2, Dept Oncol, Changsha, Hunan, Peoples R China; [Song, Zhengbo] Univ Chinese Acad Sci, Zhejiang Canc Hosp, Canc Hosp, Dept Clin Trial, Hangzhou, Peoples R China; [Chen, Shengchi] Fujian Med Univ, Dept Radiol, Nanping First Hosp 1, Nanping, Peoples R China; [Zhou, Chenzhi] First Affiliated Hosp Guangzhou Med Univ, Guangzhou Inst Resp Hlth, Natl Clin Res Ctr Resp Dis, State Key Lab Resp Dis, Guangzhou, Peoples R China; [Wang, Qian] Nanjing Univ Chinese Med, Affiliated Hosp, Dept Resp Med, Nanjing, Jiangsu, Peoples R China; [Xu, Chunwei] Nanjing Univ, Jinling Hosp, Dept Resp Med, Sch Med, Nanjing, Jiangsu, Peoples R China; [Huang, Dingzhi] Tianjin Med Univ Canc Inst & Hosp, Dept Biotherapy, Tianjin, Peoples R China; [Zhang, Qiuyu] Fujian Med Univ, Inst Immunotherapy, Fuzhou, Peoples R China; [Lin, Gen] Fuzhou Univ, Fuzhou, Peoples R China"

通信作者："Lin, G (通讯作者)，Fujian Med Univ, Fujian Canc Hosp, Clin Oncol Sch, Dept Thorac Oncol, Fuzhou, Peoples R China.; Lin, G (通讯作者)，Key Lab Adv Technol Canc Screening & Early Diag, Fuzhou 350014, Fujian, Peoples R China.; Lin, G (通讯作者)，Fuzhou Univ, Fuzhou, Peoples R China."

来源：BMC CANCER

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001125600900003

JCR分区：Q2

影响因子：3.4

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Lung squamous cell carcinoma; Immune checkpoint inhibitors; C-reactive protein; Predictive biomarker

摘要："AimsTo investigate the predictive value of baseline C-reactive protein (CRP) levels on the efficacy of chemotherapy plus immune checkpoint inhibitors (ICI) in patients with advanced lung squamous cell carcinoma (LSCC).Materials and methodsIn this retrospective multicenter study spanning from January 2016 to December 2020, advanced LSCC patients initially treated with chemotherapy or a combination of chemotherapy and ICI were categorized into normal and elevated CRP subgroups. The relationship between CRP levels and treatment outcomes was analyzed using multivariate Cox proportional hazards models and multivariate logistic regression, focusing primarily on the progression-free survival (PFS) endpoint, and secondarily on overall survival (OS) and objective response rate (ORR) endpoints. Survival curves were generated using the Kaplan-Meier method, with the log-rank test used for comparison between groups.ResultsOf the 245 patients evaluated, the 105 who received a combination of chemotherapy and ICI with elevated baseline CRP levels exhibited a significant reduction in PFS (median 6.5 months vs. 11.8 months, HR, 1.78; 95% CI: 1.12-2.81; p = 0.013) compared to those with normal CRP levels. Elevated CRP was identified as an independent risk factor for poor PFS through multivariate-adjusted analysis. However, among the 140 patients receiving chemotherapy alone, baseline CRP levels did not significantly influence PFS. Furthermore, within the combination therapy group, there was a notable decrease in the ORR (51% vs. 71%, p = 0.035), coupled with a significantly shorter OS (median 20.9 months vs. 31.5 months, HR, 2.24; 95% CI: 1.13-4.44; p = 0.033).ConclusionIn patients with advanced LSCC, elevated baseline CRP levels were identified as an independent predictive factor for the efficacy of combination therapy with chemotherapy and ICI, but not in chemotherapy alone. This suggests that CRP may be a valuable biomarker for guiding treatment strategies."

基金机构："National Natural Science Foundation of China [82372954, 82072565]; Fujian Provincial Health Systemic Innovation Project [2020CXA010]; Fujian provincial health technology project [2020QNA014]; Scientific and technological innovation joint capital projects of Fujian Province [2020Y9038]; Beijing Xisike Clinical Oncology Research Foundation [Y-2019AZZD-0386]"

基金资助正文："This work was supported by the National Natural Science Foundation of China [grant number 82372954], National Natural Science Foundation of China [grant number 82072565], Fujian Provincial Health Systemic Innovation Project [grant number 2020CXA010], the Fujian provincial health technology project [grant number 2020QNA014], Scientific and technological innovation joint capital projects of Fujian Province [grant number 2020Y9038], and Beijing Xisike Clinical Oncology Research Foundation [grant number Y-2019AZZD-0386]."