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Cancer Immunology, Immunotherapy

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01-02-2021 | NSCLC | Original Article

Development of nomograms to predict therapeutic response and prognosis of non-small cell lung cancer patients treated with anti-PD-1 antibody

Authors: Shijin Yuan, Yan Xia, Lihong Shen, Liuqing Ye, Lisha Li, Lifen Chen, Xinyou Xie, Haizhou Lou, Jun Zhang

Published in: Cancer Immunology, Immunotherapy | Issue 2/2021

Abstract

Background

Anti-programmed death-1 (PD-1) antibody changed the treatment of non-small cell lung cancer (NSCLC), however, reliable predictive markers were lacking. We aimed to explore factors associated with response and survival, and develop predictive models.

Methods

This multicenter retrospective study included a training cohort (n = 92) and validation cohort (n = 111) with NSCLC patients received anti-PD-1 antibody monotherapy in eight Chinese hospitals, and a control cohort (n = 124) with NSCLC patients received chemotherapy. Logistic and Cox models were used to identify factors associated with response and survival respectively. Nomograms were developed based on significant factors, and evaluated by Concordance-index (C-index), area under the curve (AUC) and calibration curve.

Result

In training cohort, smoking history (P = 0.027) and higher absolute lymphocyte count (P = 0.038) were associated with response. Female (P < 0.001), age ≥ 65 years (P = 0.004) and higher lactate dehydrogenase (LDH, P < 0.001) were associated with shorter progression-free survival (PFS). Higher LDH (P < 0.001) and derived neutrophil-to-lymphocyte ratio (P = 0.035) were associated with poorer overall survival (OS). While these factors were nonsignificant in chemotherapy cohort. Three nomograms to predict response at 6-week after treatment, PFS and OS at 6-, 12- and 18-months were developed, and validated in validation cohort. The C-indices of each nomogram in both cohorts were as follow (training vs validation): 0.706 vs 0.701; 0.728 vs 0.701; 0.741 vs 0.709; respectively. AUC showed a good discriminative ability. Calibration curves demonstrated a consistence between actual results and predictions.

Conclusion

We developed predictive nomograms based on easily available factors to help clinicians early assess response and prognosis for NSCLC patients received anti-PD-1 antibody.

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Title: Development of nomograms to predict therapeutic response and prognosis of non-small cell lung cancer patients treated with anti-PD-1 antibody
Authors: Shijin Yuan
Yan Xia
Lihong Shen
Liuqing Ye
Lisha Li
Lifen Chen
Xinyou Xie
Haizhou Lou
Jun Zhang
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: NSCLC
NSCLC
Published in: Cancer Immunology, Immunotherapy / Issue 2/2021
Print ISSN: 0340-7004
Electronic ISSN: 1432-0851
DOI: https://doi.org/10.1007/s00262-020-02710-9

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Abstract

Background

Methods

Result

Conclusion

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