Identification of C-PLAN index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitors
ObjectiveIncreasing studies have highlighted the potential utility of non-invasive prognostic biomarkers in advanced lung cancer patients receiving immune checkpoint inhibitor (ICI) based anti-cancer therapies. Here, a novel prognostic predictor named as C-PLAN integrating C-reactive protein (CRP),...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1339729/full |
| _version_ | 1797319679170052096 |
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| author | Jiaxin Wang Huaijuan Guo Jingjing Yang Jingxian Mao Ying Wang Xuebing Yan Hong Guo |
| author_facet | Jiaxin Wang Huaijuan Guo Jingjing Yang Jingxian Mao Ying Wang Xuebing Yan Hong Guo |
| author_sort | Jiaxin Wang |
| collection | DOAJ |
| description | ObjectiveIncreasing studies have highlighted the potential utility of non-invasive prognostic biomarkers in advanced lung cancer patients receiving immune checkpoint inhibitor (ICI) based anti-cancer therapies. Here, a novel prognostic predictor named as C-PLAN integrating C-reactive protein (CRP), Performance status (PS), Lactate dehydrogenase (LDH), Albumin (ALB), and derived Neutrophil-to-lymphocyte ratio (dNLR) was identified and validated in a single-center retrospective cohort.MethodsThe clinical data of 192 ICI-treated lung cancer patients was retrospectively analyzed. The pretreatment levels of CRP, PS, LDH, ALB and dNLR were scored respectively and then their scores were added up to form C-PLAN index. The correlation of C-PLAN index with the progression-free survival (PFS) or overall survival (OS) was analyzed by a Kaplan–Meier model. The multivariate analysis was used to identify whether C-PLAN index was an independent prognostic predictor.ResultsA total of 88 and 104 patients were included in the low and high C-PLAN index group respectively. High C-PLAN index was significantly correlated with worse PFS and OS in ICI-treated lung cancer patients (both p<0.001). The multivariate analysis revealed high C-PLAN index was an independent unfavorable factor affecting PFS (hazard ratio (HR)=1.821; 95%confidence interval (CI)=1.291-2.568) and OS (HR=2.058, 95%CI=1.431-2.959). The high C-PLAN index group had a significantly lower disease control rate than the low C-PLAN index group (p=0.024), while no significant difference was found for objective response rate (p=0.172). The subgroup analysis based on clinical features (pathological type, therapy strategy, TNM stage and age) confirmed the prognostic value of C-PLAN index, except for patients receiving ICI monotherapy or with age ranging from 18 to 65 years old. Finally, a nomogram was constructed based on C-PLAN index, age, gender, TNM stage and smoking status, which could predict well the 1-, 2- and 3-year survival of ICI-treated lung cancer patients.ConclusionThe C-PLAN index has great potential to be utilized as a non-invasive, inexpensive and reliable prognostic predictor for advanced lung cancer patients receiving ICI-based anti-cancer therapies. |
| first_indexed | 2024-03-08T04:10:26Z |
| format | Article |
| id | doaj.art-517e8de216a14aca85f6dea0bb43cb7c |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T04:10:26Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-517e8de216a14aca85f6dea0bb43cb7c2024-02-08T19:00:43ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-02-011410.3389/fonc.2024.13397291339729Identification of C-PLAN index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitorsJiaxin Wang0Huaijuan Guo1Jingjing Yang2Jingxian Mao3Ying Wang4Xuebing Yan5Hong Guo6Department of Oncology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, ChinaDepartment of Oncology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, ChinaDepartment of Oncology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, ChinaDepartment of Oncology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, ChinaDepartment of Oncology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, ChinaDepartment of Oncology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, ChinaDepartment of Thoracic Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, ChinaObjectiveIncreasing studies have highlighted the potential utility of non-invasive prognostic biomarkers in advanced lung cancer patients receiving immune checkpoint inhibitor (ICI) based anti-cancer therapies. Here, a novel prognostic predictor named as C-PLAN integrating C-reactive protein (CRP), Performance status (PS), Lactate dehydrogenase (LDH), Albumin (ALB), and derived Neutrophil-to-lymphocyte ratio (dNLR) was identified and validated in a single-center retrospective cohort.MethodsThe clinical data of 192 ICI-treated lung cancer patients was retrospectively analyzed. The pretreatment levels of CRP, PS, LDH, ALB and dNLR were scored respectively and then their scores were added up to form C-PLAN index. The correlation of C-PLAN index with the progression-free survival (PFS) or overall survival (OS) was analyzed by a Kaplan–Meier model. The multivariate analysis was used to identify whether C-PLAN index was an independent prognostic predictor.ResultsA total of 88 and 104 patients were included in the low and high C-PLAN index group respectively. High C-PLAN index was significantly correlated with worse PFS and OS in ICI-treated lung cancer patients (both p<0.001). The multivariate analysis revealed high C-PLAN index was an independent unfavorable factor affecting PFS (hazard ratio (HR)=1.821; 95%confidence interval (CI)=1.291-2.568) and OS (HR=2.058, 95%CI=1.431-2.959). The high C-PLAN index group had a significantly lower disease control rate than the low C-PLAN index group (p=0.024), while no significant difference was found for objective response rate (p=0.172). The subgroup analysis based on clinical features (pathological type, therapy strategy, TNM stage and age) confirmed the prognostic value of C-PLAN index, except for patients receiving ICI monotherapy or with age ranging from 18 to 65 years old. Finally, a nomogram was constructed based on C-PLAN index, age, gender, TNM stage and smoking status, which could predict well the 1-, 2- and 3-year survival of ICI-treated lung cancer patients.ConclusionThe C-PLAN index has great potential to be utilized as a non-invasive, inexpensive and reliable prognostic predictor for advanced lung cancer patients receiving ICI-based anti-cancer therapies.https://www.frontiersin.org/articles/10.3389/fonc.2024.1339729/fullimmune checkpoint inhibitorlung cancerC-PLANprognosisbiomarker |
| spellingShingle | Jiaxin Wang Huaijuan Guo Jingjing Yang Jingxian Mao Ying Wang Xuebing Yan Hong Guo Identification of C-PLAN index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitors Frontiers in Oncology immune checkpoint inhibitor lung cancer C-PLAN prognosis biomarker |
| title | Identification of C-PLAN index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitors |
| title_full | Identification of C-PLAN index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitors |
| title_fullStr | Identification of C-PLAN index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitors |
| title_full_unstemmed | Identification of C-PLAN index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitors |
| title_short | Identification of C-PLAN index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitors |
| title_sort | identification of c plan index as a novel prognostic predictor for advanced lung cancer patients receiving immune checkpoint inhibitors |
| topic | immune checkpoint inhibitor lung cancer C-PLAN prognosis biomarker |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1339729/full |
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