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Article

Baseline Absolute Lymphocyte Count and ECOG Performance Score Are Associated with Survival in Advanced Non-Small Cell Lung Cancer Undergoing PD-1/PD-L1 Blockade

1
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria
2
Department of Pulmonology, Kepler University Hospital, Med Campus III, 4020 Linz, Austria
3
Institute of Pathology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
4
Division of Bioinformatics, Biocenter, Medical University of Innsbruck, 6020 Innsbruck, Austria
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2019, 8(7), 1014; https://doi.org/10.3390/jcm8071014
Received: 28 May 2019 / Revised: 4 July 2019 / Accepted: 8 July 2019 / Published: 10 July 2019
Immune-checkpoint blockade in front-line or second-line treatment improves survival in advanced non-small cell lung cancer (aNSCLC) when compared with chemotherapy alone. However, easily applicable predictive parameters are necessary to guide immune-checkpoint inhibition in clinical practice. In this retrospective bi-centric analysis, we investigated the impact of baseline patient and tumor characteristics on clinical outcome in aNSCLC patients treated with programmed cell death protein 1(PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors. Between May 2015 and January 2018, 142 unselected consecutive NSCLC patients received PD-1/PD-L1 inhibitors during the course of disease. In multivariate analysis, we identified the Eastern Cooperative Oncology Group (ECOG) performance status (ECOG > 1 versus ECOG ≤ 1, HR: 3.23, 95%CI: 1.58–6.60, P = 0.001), baseline absolute lymphocyte count (ALC; high: >0.93 × 109/L versus low: ≤ 0.93 × 109/L, HR: 0.38, 95%CI: 0.23–0.62, P < 0.001), prior or concomitant anti-vascular endothelial growth factor (VEGF) targeting therapy (yes versus no, HR: 2.18, 95%CI: 1.15–4.14, P = 0.017) and TNM stage (IV versus III, HR: 4.18, 95%CI: 1.01–17.36, P = 0.049) as the most relevant parameters for survival. Neither antibiotic exposure (antibiotic-positive versus antibiotic-negative, HR: 0.90, 95%CI: 0.56–1.45, P = 0.675), nor PD-L1 expression on tumor cells (≥1% versus <1%, HR: 0.68, 95%CI: 0.41–1.13, P = 0.140) was associated with survival. Baseline ECOG performance status and ALC were associated with survival in aNSCLC patients treated with PD-1/PD-L1 inhibitors and assessment of these parameters could be suitable in clinical practice. View Full-Text
Keywords: absolute lymphocyte count; ECOG performance status; immune-checkpoint inhibitor; antibiotics; PD-1/PD-L1; immune-checkpoint blockade; RANK; VEGF; denosumab absolute lymphocyte count; ECOG performance status; immune-checkpoint inhibitor; antibiotics; PD-1/PD-L1; immune-checkpoint blockade; RANK; VEGF; denosumab
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MDPI and ACS Style

Huemer, F.; Lang, D.; Westphal, T.; Gampenrieder, S.P.; Hutarew, G.; Weiss, L.; Hackl, H.; Lamprecht, B.; Rinnerthaler, G.; Greil, R. Baseline Absolute Lymphocyte Count and ECOG Performance Score Are Associated with Survival in Advanced Non-Small Cell Lung Cancer Undergoing PD-1/PD-L1 Blockade. J. Clin. Med. 2019, 8, 1014. https://doi.org/10.3390/jcm8071014

AMA Style

Huemer F, Lang D, Westphal T, Gampenrieder SP, Hutarew G, Weiss L, Hackl H, Lamprecht B, Rinnerthaler G, Greil R. Baseline Absolute Lymphocyte Count and ECOG Performance Score Are Associated with Survival in Advanced Non-Small Cell Lung Cancer Undergoing PD-1/PD-L1 Blockade. Journal of Clinical Medicine. 2019; 8(7):1014. https://doi.org/10.3390/jcm8071014

Chicago/Turabian Style

Huemer, Florian, David Lang, Theresa Westphal, Simon P. Gampenrieder, Georg Hutarew, Lukas Weiss, Hubert Hackl, Bernd Lamprecht, Gabriel Rinnerthaler, and Richard Greil. 2019. "Baseline Absolute Lymphocyte Count and ECOG Performance Score Are Associated with Survival in Advanced Non-Small Cell Lung Cancer Undergoing PD-1/PD-L1 Blockade" Journal of Clinical Medicine 8, no. 7: 1014. https://doi.org/10.3390/jcm8071014

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