BMC Cancer (Dec 2023)
Baseline C-reactive protein predicts efficacy of the first-line immune checkpoint inhibitors plus chemotherapy in advanced lung squamous cell carcinoma: a retrospective, multicenter study
- Xinlong Zheng,
- Longfeng Zhang,
- Lin Wu,
- Jun Zhao,
- Jianguo Sun,
- Yong Fang,
- Jin Zhou,
- Qian Chu,
- Yihong Shen,
- Zhenzhou Yang,
- Lijin Chen,
- Meijuan Huang,
- Xiaoyan Lin,
- Zhenhua Liu,
- Peng Shen,
- Zhijie Wang,
- Xin Wang,
- Huijuan Wang,
- Zhengbo Han,
- Anwen Liu,
- Hongmei Zhang,
- Feng Ye,
- Wen Gao,
- Fang Wu,
- Zhengbo Song,
- Shengchi Chen,
- Chenzhi Zhou,
- Qian Wang,
- Chunwei Xu,
- Dingzhi Huang,
- Xiaobin Zheng,
- Qian Miao,
- Kan Jiang,
- Yiquan Xu,
- Shiwen Wu,
- Haibo Wang,
- Qiuyu Zhang,
- Shanshan Yang,
- Yujing Li,
- Sihui Chen,
- Gen Lin
Affiliations
- Xinlong Zheng
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Longfeng Zhang
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Lin Wu
- The Second Department of Thoracic Oncology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital
- Jun Zhao
- Department of Thoracic Medical Oncology, Peking University Cancer Hospital and Institute
- Jianguo Sun
- Cancer Institute, Xinqiao Hospital, Army Medical University
- Yong Fang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University
- Jin Zhou
- School of Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China
- Qian Chu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Yihong Shen
- Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University
- Zhenzhou Yang
- Department of Cancer Center, The Second Affiliated Hospital, Chongqing Medical University
- Lijin Chen
- Department of Oncology, Affiliated Quanzhou First Hospital of Fujian Medical University
- Meijuan Huang
- Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University
- Xiaoyan Lin
- Department of Oncology, Fujian Medical University Union Hospital
- Zhenhua Liu
- Department of Medical Oncology, Provincial Clinical College, Fujian Medical University, Fujian provincial hospital
- Peng Shen
- Department of Oncology, Nanfang Hospital, Southern Medical University
- Zhijie Wang
- Medical Oncology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College
- Xin Wang
- Department of Oncology, Zhongshan Hospital of Xiamen University
- Huijuan Wang
- Department of Respiratory Medicine, the Affiliated Cancer Hospital of Zhengzhou University
- Zhengbo Han
- Department of Oncology, Shengjing Hospital of China Medical University
- Anwen Liu
- Department of Oncology, The Second Affiliated Hospital of Nanchang University
- Hongmei Zhang
- Department of Oncology, Xijing Hospital, Airforce Military Medical University
- Feng Ye
- Department of Medical Oncology, Cancer Hospital, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University
- Wen Gao
- Department of Medical Oncology, The First Affiliated Hospital with Nanjing Medical University
- Fang Wu
- Department of Oncology, The Second Xiangya Hospital, Central South University
- Zhengbo Song
- Department of Clinical Trial, Cancer Hospital of the University of Chinese Academy of Sciences
- Shengchi Chen
- Department of Oncology, Nanping First Hospital Affiliated to Fujian Medical University
- Chenzhi Zhou
- Respiratory Medicine Department, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University
- Qian Wang
- Department of Respiratory Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine
- Chunwei Xu
- Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University Nanjing
- Dingzhi Huang
- Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital
- Xiaobin Zheng
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Qian Miao
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Kan Jiang
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Yiquan Xu
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Shiwen Wu
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Haibo Wang
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Qiuyu Zhang
- Institute of Immunotherapy, Fujian Medical University
- Shanshan Yang
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Yujing Li
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Sihui Chen
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- Gen Lin
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital
- DOI
- https://doi.org/10.1186/s12885-023-11737-x
- Journal volume & issue
-
Vol. 23,
no. 1
pp. 1 – 10
Abstract
Abstract Aims To investigate the predictive value of baseline C-reactive protein (CRP) levels on the efficacy of chemotherapy plus immune checkpoint inhibitors (ICI) in patients with advanced lung squamous cell carcinoma (LSCC). Materials and methods In this retrospective multicenter study spanning from January 2016 to December 2020, advanced LSCC patients initially treated with chemotherapy or a combination of chemotherapy and ICI were categorized into normal and elevated CRP subgroups. The relationship between CRP levels and treatment outcomes was analyzed using multivariate Cox proportional hazards models and multivariate logistic regression, focusing primarily on the progression-free survival (PFS) endpoint, and secondarily on overall survival (OS) and objective response rate (ORR) endpoints. Survival curves were generated using the Kaplan-Meier method, with the log-rank test used for comparison between groups. Results Of the 245 patients evaluated, the 105 who received a combination of chemotherapy and ICI with elevated baseline CRP levels exhibited a significant reduction in PFS (median 6.5 months vs. 11.8 months, HR, 1.78; 95% CI: 1.12–2.81; p = 0.013) compared to those with normal CRP levels. Elevated CRP was identified as an independent risk factor for poor PFS through multivariate-adjusted analysis. However, among the 140 patients receiving chemotherapy alone, baseline CRP levels did not significantly influence PFS. Furthermore, within the combination therapy group, there was a notable decrease in the ORR (51% vs. 71%, p = 0.035), coupled with a significantly shorter OS (median 20.9 months vs. 31.5 months, HR, 2.24; 95% CI: 1.13–4.44; p = 0.033). Conclusion In patients with advanced LSCC, elevated baseline CRP levels were identified as an independent predictive factor for the efficacy of combination therapy with chemotherapy and ICI, but not in chemotherapy alone. This suggests that CRP may be a valuable biomarker for guiding treatment strategies.
Keywords
