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
Genre
Journal articleDate
2021-11-15Author
Nardone, ValerioGiannicola, Rocco
Giannarelli, Diana
Saladino, Rita Emilena
Azzarello, Domenico
Romeo, Caterina
Bianco, Giovanna
Rosario Rizzo, Maria
Di Meo, Irene
Nesci, Antonio
Pastina, Pierpaolo
Falzea, Antonia Consuelo
Caracciolo, Daniele
Reginelli, Alfonso
Caraglia, Michele
Luce, Amalia
Mutti, Luciano
Giordano, Antonio
Cappabianca, Salvatore
Pirtoli, Luigi
Barbieri, Vito
Tassone, Pierfrancesco
Tagliaferri, Pierosandro
Correale, Pierpaolo
Group
Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University)Department
BiologySubject
Immune checkpoint blockadeMetastatic non-small-cell lung cancer
Real-world evidence study
Age
Inflammatory markers
Immunotherapy
Immunosenescence
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http://hdl.handle.net/20.500.12613/7605
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https://doi.org/10.3390/life11111235Abstract
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.Citation
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/life11111235Citation to related work
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http://dx.doi.org/10.34944/dspace/7583