Immune Checkpoint Inhibitors With or Without Bone-Targeted Therapy in NSCLC Patients With Bone Metastases and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio
IntroductionBone metastases (BMs) are a negative prognostic factor in patients with non-small cell lung cancer (NSCLC). Although immune-checkpoint inhibitors (ICIs) have dramatically changed the therapeutic landscape of NSCLC, little information is available on BMs from NSCLC treated with ICIs alone...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:efaf44bda0a24525b2e67623d8a9d8992021-11-10T07:53:07ZImmune Checkpoint Inhibitors With or Without Bone-Targeted Therapy in NSCLC Patients With Bone Metastases and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio1664-322410.3389/fimmu.2021.697298https://doaj.org/article/efaf44bda0a24525b2e67623d8a9d8992021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.697298/fullhttps://doaj.org/toc/1664-3224IntroductionBone metastases (BMs) are a negative prognostic factor in patients with non-small cell lung cancer (NSCLC). Although immune-checkpoint inhibitors (ICIs) have dramatically changed the therapeutic landscape of NSCLC, little information is available on BMs from NSCLC treated with ICIs alone or in association with bone-targeted therapy (BTT) such as zoledronate or denosumab.MethodsFrom 2014 to 2020, 111 of the 142 patients with BMs secondary to NSCLC extrapolated from the prospective multicenter Italian BM Database were eligible for analysis. Information on blood count, comorbidities, and toxicity was retrospectively collected. The neutrophil-to-lymphocyte ratio (NLR) pre- and post-treatment was calculated. Survival was analyzed using the Kaplan–Meier method, with statistical significance of survival differences assessed using the log-rank test.ResultsMedian age was 66 (range, 42–84) years. Performance status (PS) Eastern Cooperative Oncology Group (ECOG) was 0–1 in 79/111 patients. The majority of patients (89.2%) had adenocarcinoma histology. At a median follow-up of 47.4 months, median progression-free (mPFS) and overall survival (mOS) was 4.9 (95%CI, 2.8–10.0) and 11.9 (95%CI, 8.2–14.4) months, respectively. Forty-six (43.4%) patients with BM NSCLC underwent first- or further-line therapy with ICIs: 28 (60.8%) received nivolumab, 9 (19.6%) pembrolizumab, and 9 (19.6%) atezolizumab. Of the 46 patients treated with ICIs, 30 (65.2%) underwent BTT: 24 (80.0%) with zoledronate and 6 (20.0%) with denosumab. The ICI-alone group had an mOS of 15.8 months [95%CI, 8.2–not evaluable (NE)] vs. 21.8 months (95%CI, 14.5–not evaluable) for the ICI plus BTT group and 7.5 (95%CI, 6.1–10.9) months for the group receiving other treatments (p < 0.001). NLR ≤5 had a positive impact on OS.ConclusionBTT appears to have a synergistic effect when used in combination with ICIs, improving patient survival.Alberto BongiovanniFlavia FocaJessica MenisJessica MenisJessica MenisStefania Luigia StucciFabrizio ArtioliValentina GuadalupiMaria Rosachiara ForcignanòManuela FantiniFederica RecineLaura MercataliChiara SpadazziMarco Angelo BurgioValentina FaustiAnna MiserocchiToni IbrahimFrontiers Media S.A.articleimmune checkpoint inhibitorsNSCLCbone metastaseszoledronatedenosumablung cancerImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021) |
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DOAJ |
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EN |
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immune checkpoint inhibitors NSCLC bone metastases zoledronate denosumab lung cancer Immunologic diseases. Allergy RC581-607 |
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immune checkpoint inhibitors NSCLC bone metastases zoledronate denosumab lung cancer Immunologic diseases. Allergy RC581-607 Alberto Bongiovanni Flavia Foca Jessica Menis Jessica Menis Jessica Menis Stefania Luigia Stucci Fabrizio Artioli Valentina Guadalupi Maria Rosachiara Forcignanò Manuela Fantini Federica Recine Laura Mercatali Chiara Spadazzi Marco Angelo Burgio Valentina Fausti Anna Miserocchi Toni Ibrahim Immune Checkpoint Inhibitors With or Without Bone-Targeted Therapy in NSCLC Patients With Bone Metastases and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio |
| description |
IntroductionBone metastases (BMs) are a negative prognostic factor in patients with non-small cell lung cancer (NSCLC). Although immune-checkpoint inhibitors (ICIs) have dramatically changed the therapeutic landscape of NSCLC, little information is available on BMs from NSCLC treated with ICIs alone or in association with bone-targeted therapy (BTT) such as zoledronate or denosumab.MethodsFrom 2014 to 2020, 111 of the 142 patients with BMs secondary to NSCLC extrapolated from the prospective multicenter Italian BM Database were eligible for analysis. Information on blood count, comorbidities, and toxicity was retrospectively collected. The neutrophil-to-lymphocyte ratio (NLR) pre- and post-treatment was calculated. Survival was analyzed using the Kaplan–Meier method, with statistical significance of survival differences assessed using the log-rank test.ResultsMedian age was 66 (range, 42–84) years. Performance status (PS) Eastern Cooperative Oncology Group (ECOG) was 0–1 in 79/111 patients. The majority of patients (89.2%) had adenocarcinoma histology. At a median follow-up of 47.4 months, median progression-free (mPFS) and overall survival (mOS) was 4.9 (95%CI, 2.8–10.0) and 11.9 (95%CI, 8.2–14.4) months, respectively. Forty-six (43.4%) patients with BM NSCLC underwent first- or further-line therapy with ICIs: 28 (60.8%) received nivolumab, 9 (19.6%) pembrolizumab, and 9 (19.6%) atezolizumab. Of the 46 patients treated with ICIs, 30 (65.2%) underwent BTT: 24 (80.0%) with zoledronate and 6 (20.0%) with denosumab. The ICI-alone group had an mOS of 15.8 months [95%CI, 8.2–not evaluable (NE)] vs. 21.8 months (95%CI, 14.5–not evaluable) for the ICI plus BTT group and 7.5 (95%CI, 6.1–10.9) months for the group receiving other treatments (p < 0.001). NLR ≤5 had a positive impact on OS.ConclusionBTT appears to have a synergistic effect when used in combination with ICIs, improving patient survival. |
| format |
article |
| author |
Alberto Bongiovanni Flavia Foca Jessica Menis Jessica Menis Jessica Menis Stefania Luigia Stucci Fabrizio Artioli Valentina Guadalupi Maria Rosachiara Forcignanò Manuela Fantini Federica Recine Laura Mercatali Chiara Spadazzi Marco Angelo Burgio Valentina Fausti Anna Miserocchi Toni Ibrahim |
| author_facet |
Alberto Bongiovanni Flavia Foca Jessica Menis Jessica Menis Jessica Menis Stefania Luigia Stucci Fabrizio Artioli Valentina Guadalupi Maria Rosachiara Forcignanò Manuela Fantini Federica Recine Laura Mercatali Chiara Spadazzi Marco Angelo Burgio Valentina Fausti Anna Miserocchi Toni Ibrahim |
| author_sort |
Alberto Bongiovanni |
| title |
Immune Checkpoint Inhibitors With or Without Bone-Targeted Therapy in NSCLC Patients With Bone Metastases and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio |
| title_short |
Immune Checkpoint Inhibitors With or Without Bone-Targeted Therapy in NSCLC Patients With Bone Metastases and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio |
| title_full |
Immune Checkpoint Inhibitors With or Without Bone-Targeted Therapy in NSCLC Patients With Bone Metastases and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio |
| title_fullStr |
Immune Checkpoint Inhibitors With or Without Bone-Targeted Therapy in NSCLC Patients With Bone Metastases and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio |
| title_full_unstemmed |
Immune Checkpoint Inhibitors With or Without Bone-Targeted Therapy in NSCLC Patients With Bone Metastases and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio |
| title_sort |
immune checkpoint inhibitors with or without bone-targeted therapy in nsclc patients with bone metastases and prognostic significance of neutrophil-to-lymphocyte ratio |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/efaf44bda0a24525b2e67623d8a9d899 |
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