Elevated CRP levels indicate poor progression-free and overall survival on cancer patients treated with PD-1 inhibitors

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dc.contributor University of Helsinki, HUS Comprehensive Cancer Center en
dc.contributor.author Iivanainen, Sanna
dc.contributor.author Ahvonen, Jarkko
dc.contributor.author Knuuttila, Aija
dc.contributor.author Tiainen, Satu
dc.contributor.author Koivunen, Jussi Pekka
dc.date.accessioned 2019-11-08T06:06:02Z
dc.date.available 2019-11-08T06:06:02Z
dc.date.issued 2019-07
dc.identifier.citation Iivanainen , S , Ahvonen , J , Knuuttila , A , Tiainen , S & Koivunen , J P 2019 , ' Elevated CRP levels indicate poor progression-free and overall survival on cancer patients treated with PD-1 inhibitors ' , ESMO open , vol. 4 , no. 4 , 000531 . https://doi.org/10.1136/esmoopen-2019-000531 en
dc.identifier.issn 2059-7029
dc.identifier.other PURE: 127982431
dc.identifier.other PURE UUID: e285506d-6f6a-4e78-ad86-84c6a5ae31f0
dc.identifier.other WOS: 000489068900006
dc.identifier.uri http://hdl.handle.net/10138/306819
dc.description.abstract Background Anti-PD-(L)1 agents are standard of care treatments in various cancers but predictive factors for therapy selection are limited. We hypothesised that markers of systemic inflammation would predict adverse outcomes in multiple cancers treated with anti-PD-(L)1 agents. Material and methods Discovery cohort consisted of patients who were treated with anti-programmed cell death protein-1 (PD-1) agents for advanced melanoma (MEL), non-small cell lung cancer (NSCLC) or renal and bladder cancers (GU) at Oulu University Hospital and had pretreatment C reactive protein (CRP), or neutrophil/lymphocyte values available. As a validation cohort, we collected patients treated with anti-PD-1 agents from three other hospitals in Finland. Results In the discovery cohort (n=56, MEL n=23, GU n=17, NSCLC n=16), elevated CRP over the upper limit of normal (ULN) (>10mg/mL) indicated poor progression-free (PFS; p=0.005) and overall survival (OS; p=0.000004) in the whole population and in MEL subgroup. Elevated neutrophil-to-lymphocyte ratio (>2.65) also indicated inferior PFS (p=0.02) and OS (p=0.009). In the validation cohort (n=107,MEL n=44, NSCLC n=42, GU n=17, other n=4), CRP over ULN also was a strong indicator for poor PFS (p=0.0000008), and OS (p=0.000006) in the whole population, and in MEL and NSCLC also. Conclusions Systemic inflammation suggested by elevated CRP is a very strong indicator for adverse prognosis on patients treated with anti-PD-(L)1 agents and has a potential negative predictive value for treatment with anti-PD-(L)1 agents. Prospective trials should investigate whether patients with elevated CRP gain any significant benefit from anti-PD-1 therapy. en
dc.format.extent 7
dc.language.iso eng
dc.relation.ispartof ESMO open
dc.rights en
dc.subject PD-1 en
dc.subject CRP en
dc.subject prognostic en
dc.subject predictive en
dc.subject survival en
dc.subject MUTATIONAL LANDSCAPE en
dc.subject CLINICAL-RESPONSE en
dc.subject NIVOLUMAB en
dc.subject PEMBROLIZUMAB en
dc.subject INFLAMMATION en
dc.subject IPILIMUMAB en
dc.subject DOCETAXEL en
dc.subject MELANOMA en
dc.subject ANTIBODY en
dc.subject THERAPY en
dc.subject 3122 Cancers en
dc.title Elevated CRP levels indicate poor progression-free and overall survival on cancer patients treated with PD-1 inhibitors en
dc.type Article
dc.description.version Peer reviewed
dc.identifier.doi https://doi.org/10.1136/esmoopen-2019-000531
dc.type.uri info:eu-repo/semantics/other
dc.type.uri info:eu-repo/semantics/publishedVersion
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