Progression-Free Survival Under Immune Checkpoint Inhibitors for Metastatic Non-Small-Cell Lung Cancer: A Retrospective Cohort Study.

IF 3.2 Q2 ONCOLOGY

Oncology and Therapy Pub Date : 2025-09-01 Epub Date: 2025-08-04 DOI:10.1007/s40487-025-00362-2

Paul Boré, Margaux Geier, Loïc Campion, Jean-Luc Raoul, Ludovic Doucet, Sandrine Hiret, Frédéric Bigot, François Bocquet, Laura Mezquita, Teresa Gorria, Judith Raimbourg

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引用次数: 0

Abstract

Introduction: Immune checkpoint inhibitors (ICI) are the standard of care for non-small-cell lung cancer (NSCLC) regardless of program death ligand-1 (PDL1) expression. However, a majority of patients presented early progression, underlining the need for better patient selection. The aim of this study was to determine effective clinical and biological biomarkers of real-world progression-free survival (rwPFS) in addition to PDL1.

Methods: From January 2015 to January 2020, 173 patients with metastatic NSCLC were treated with second line or further nivolumab at the Institut de Cancérologie de l'Ouest (ICO). Using univariate and multivariate analyses, we screened clinical and biological parameters associated with rwPFS. From the independent prognostic variables, a prediction model of 9 and 12 months of median PFS was calculated using a nomogram. This model was validated in a second retrospective cohort of 253 patients with NSCLC from eight centers.

Results: In the first cohort, we found five independent prognostic biomarkers: bone and lung metastases, current smoking status, PFS in first line (PFS1), and neutrophil-to-lymphocyte ratio (NLR). The nomogram identified three distinct prognostic groups with respective median rwPFS values of 11.7, 3.9, and 1.6 months. This prediction model was confirmed in our second retrospective cohort.

Conclusions: We created a predictive model on the basis of five simple biomarkers that may predict the efficacy of ICI regardless of PDL1 status. The presence of lung metastases, prolonged PFS1, low NLR, and smoking status are good prognostic factors, whereas the presence of bone metastases was associated with worse prognosis.

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免疫检查点抑制剂治疗转移性非小细胞肺癌的无进展生存期：一项回顾性队列研究

免疫检查点抑制剂（ICI）是治疗非小细胞肺癌（NSCLC）的标准药物，与程序死亡配体-1 （PDL1）的表达无关。然而，大多数患者出现早期进展，强调需要更好的患者选择。本研究的目的是确定除PDL1外，真实世界无进展生存期（rwPFS）的有效临床和生物学生物标志物。方法：2015年1月至2020年1月，173例转移性NSCLC患者在法国癌症研究所（ICO）接受了二线或进一步的纳武单抗治疗。通过单因素和多因素分析，我们筛选了与rwPFS相关的临床和生物学参数。从独立的预后变量中，使用nomogram来计算9个月和12个月中位PFS的预测模型。该模型在来自8个中心的253例非小细胞肺癌患者的第二个回顾性队列中得到验证。结果：在第一个队列中，我们发现了5个独立的预后生物标志物：骨和肺转移、当前吸烟状况、一线PFS （PFS1）和中性粒细胞与淋巴细胞比率（NLR）。nomogram确定了三个不同的预后组，各自的中位rwPFS值分别为11.7、3.9和1.6个月。该预测模型在我们的第二个回顾性队列中得到了证实。结论：我们基于五种简单的生物标志物建立了一个预测模型，可以预测ICI的疗效，而不管PDL1状态如何。肺转移、PFS1延长、低NLR和吸烟是良好的预后因素，而骨转移的存在与预后较差相关。

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来源期刊

Oncology and Therapy ONCOLOGY-

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6 weeks

期刊介绍： Now indexed in PubMed Aims and Scope Oncology and Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Oncology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of clinical therapies. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts. Digital features and plain language summaries Oncology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Please see here for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case by case basis and should be sent to the journal editor. Copyright Oncology and Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. 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