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Biomarker role of thyroid irAE and PD-L1 positivity in predicting PD-1 blockade efficacy in patients with non-small cell lung cancer.
- Source :
-
Cancer immunology, immunotherapy : CII [Cancer Immunol Immunother] 2024 Oct 09; Vol. 73 (12), pp. 260. Date of Electronic Publication: 2024 Oct 09. - Publication Year :
- 2024
-
Abstract
- Thyroid immune-related adverse events (irAEs) are associated with programmed cell death protein 1 (PD-1) blockade efficacy in non-small cell lung cancer (NSCLC). However, their independence from PD-L1 expression and quantitative impact on predicting PD-1 blockade efficacy remain unexplored. This multicenter, retrospective, longitudinal study from Korea included 71 metastatic NSCLC patients who underwent PD-L1 expression and thyroid function testing during PD-1 blockade. Disease progression by the Response Evaluation Criteria for Solid Tumors was the main outcome. Three-stage analyses were performed: (1) multivariate Cox regression models adjusted for PD-L1 expression according to thyroid irAEs; (2) subgroup analyses; (3) regrouping and comparing predictivity of current and alternative staging. Patients with thyroid irAE + exhibited a longer progression-free survival [7/20 vs. 34/51, adjusted HR 0.19 (0.07-0.47); P < 0.001] than those with thyroid irAE-, independent of PD-L1 expression; the results remained across most subgroups without interaction. The three groups showed different adjusted HR for disease progression (Group 1: PD L1 + and thyroid irAE + ; Group 2: PD-L1 + or thyroid irAE + : 5.08 [1.48-17.34]; Group 3: PD-L1- and thyroid irAE- : 30.49 [6.60-140.78]). Alternative staging (Group 1 in stage IVB → stage IVA; Group 3 in stage IVA → stage IVB) improved the prognostic value (PVE: 21.7% vs. 6.44%; C-index: 0.706 vs. 0.617) compared with the 8th Tumor-Node-Metastasis staging. Our study suggests thyroid irAEs and PD-L1 expression are independent biomarkers that improve predicting PD-1 blockade efficacy in NSCLC. Thyroid irAEs would be helpful to identify NSCLC patients who benefit from PD-1 blockade in early course of treatment.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Retrospective Studies
Programmed Cell Death 1 Receptor antagonists & inhibitors
Programmed Cell Death 1 Receptor metabolism
Thyroid Gland pathology
Thyroid Gland metabolism
Longitudinal Studies
Prognosis
Adult
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung drug therapy
Carcinoma, Non-Small-Cell Lung metabolism
Carcinoma, Non-Small-Cell Lung pathology
B7-H1 Antigen antagonists & inhibitors
B7-H1 Antigen metabolism
Lung Neoplasms drug therapy
Lung Neoplasms metabolism
Lung Neoplasms pathology
Biomarkers, Tumor metabolism
Immune Checkpoint Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0851
- Volume :
- 73
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Cancer immunology, immunotherapy : CII
- Publication Type :
- Academic Journal
- Accession number :
- 39382668
- Full Text :
- https://doi.org/10.1007/s00262-024-03852-w