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Distinctive Role of the Systemic Inflammatory Profile in Non-Small-Cell Lung Cancer Younger and Elderly Patients Treated with a PD-1 Immune Checkpoint Blockade: A Real-World Retrospective Multi-Institutional Analysis

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Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
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Medical Oncology Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy
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Biostatistical Unit, National Cancer Institute “Regina Elena”, IRCCS, 00161 Rome, Italy
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Tissue typing Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy
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Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Unit of Pharmacy, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy
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Section of Radiation Oncology, Medical School, University of Siena, 53100 Siena, Italy
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Medical and Translational Oncology Unit, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
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BiogemScarl, Institute of Genetic Research, Precision and Molecular Oncology Laboratory, Ariano Irpino, 83031 Avellino, Italy
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Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
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Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: Kwong Tsang, Massimo Fantini, Philip M Arlen, Christina M. Annunziata, Takuya Tsunoda and Nicola Smania
Life 2021, 11(11), 1235; https://doi.org/10.3390/life11111235
Received: 29 September 2021 / Revised: 1 November 2021 / Accepted: 12 November 2021 / Published: 15 November 2021
(This article belongs to the Special Issue Immuno-Monitoring of Cancer Immunotherapy)
An immune checkpoint blockade with mAbs to PD-1 and PD-L1 is an expanding therapeutic option for mNSCLC patients. This treatment strategy is based on the use of mAbs able to restore the anti-tumor activity of intratumoral T cells inhibited by PD-1 binding to PD-L1/2 on tumor and inflammatory cells. It has been speculated that a chronic status of systemic inflammation as well as the immunosenescence physiologically occurring in elderly patients may affect the efficacy of the treatment and the occurrence of irAEs. We performed a multi-institutional retrospective study aimed at evaluating the effects of these mAbs (nivolumab or atezolizumab) in 117 mNSCLC patients younger (90 cases) and older (27 cases) than 75 years in correlation with multiple inflammatory parameters (NLR, CRP, ESR, LDH and PCT). No differences were observed when the cohorts were compared in terms of the frequency of PFS, OS, inflammatory markers and immune-related adverse events (irAEs). Similarly, the occurrence of irAEs was strictly correlated with a prolonged OS survival in both groups. On the contrary, a negative correlation between the high baseline levels of inflammatory markers and OS could be demonstrated in the younger cohort only. Overall, PD-1/PD-L1-blocking mAbs were equally effective in young and elderly mNSCLC patients; however, the detrimental influence of a systemic inflammation at the baseline was only observed in young patients, suggesting different aging-related inflammation immunoregulative effects. View Full-Text
Keywords: immune checkpoint blockade; metastatic non-small-cell lung cancer; real-world evidence study; age; inflammatory markers; immunotherapy; immunosenescence immune checkpoint blockade; metastatic non-small-cell lung cancer; real-world evidence study; age; inflammatory markers; immunotherapy; immunosenescence
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MDPI and ACS Style

Nardone, V.; Giannicola, R.; Giannarelli, D.; Saladino, R.E.; Azzarello, D.; Romeo, C.; Bianco, G.; Rizzo, M.R.; Di Meo, I.; Nesci, A.; Pastina, P.; Falzea, A.C.; Caracciolo, D.; Reginelli, A.; Caraglia, M.; Luce, A.; Mutti, L.; Giordano, A.; Cappabianca, S.; Pirtoli, L.; Barbieri, V.; Tassone, P.; Tagliaferri, P.; Correale, P. Distinctive Role of the Systemic Inflammatory Profile in Non-Small-Cell Lung Cancer Younger and Elderly Patients Treated with a PD-1 Immune Checkpoint Blockade: A Real-World Retrospective Multi-Institutional Analysis. Life 2021, 11, 1235. https://doi.org/10.3390/life11111235

AMA Style

Nardone V, Giannicola R, Giannarelli D, Saladino RE, Azzarello D, Romeo C, Bianco G, Rizzo MR, Di Meo I, Nesci A, Pastina P, Falzea AC, Caracciolo D, Reginelli A, Caraglia M, Luce A, Mutti L, Giordano A, Cappabianca S, Pirtoli L, Barbieri V, Tassone P, Tagliaferri P, Correale P. Distinctive Role of the Systemic Inflammatory Profile in Non-Small-Cell Lung Cancer Younger and Elderly Patients Treated with a PD-1 Immune Checkpoint Blockade: A Real-World Retrospective Multi-Institutional Analysis. Life. 2021; 11(11):1235. https://doi.org/10.3390/life11111235

Chicago/Turabian Style

Nardone, Valerio, Rocco Giannicola, Diana Giannarelli, Rita E. Saladino, Domenico Azzarello, Caterina Romeo, Giovanna Bianco, Maria R. Rizzo, Irene Di Meo, Antonio Nesci, Pierpaolo Pastina, Antonia C. Falzea, Daniele Caracciolo, Alfonso Reginelli, Michele Caraglia, Amalia Luce, Luciano Mutti, Antonio Giordano, Salvatore Cappabianca, Luigi Pirtoli, Vito Barbieri, Pierfrancesco Tassone, Pierosandro Tagliaferri, and Pierpaolo Correale. 2021. "Distinctive Role of the Systemic Inflammatory Profile in Non-Small-Cell Lung Cancer Younger and Elderly Patients Treated with a PD-1 Immune Checkpoint Blockade: A Real-World Retrospective Multi-Institutional Analysis" Life 11, no. 11: 1235. https://doi.org/10.3390/life11111235

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