Real‐world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy
Abstract Background Patient survival in advanced/metastatic melanoma, non‐small cell lung cancer (NSCLC), and renal cell carcinoma (RCC) has improved with immune checkpoint inhibitors (ICI). Biomarkers' role in prognosis and treatment has been limited by conflicting trial results. Methods This...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6645 |
| _version_ | 1797398924531597312 |
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| author | Jerome H. Goldschmidt Lin‐Na Chou Philip K. Chan Liwei Chen Nicholas Robert Joyce Kinsey Katherine Pitts Matt Nestor Edwin P. Rock Hillard M. Lazarus |
| author_facet | Jerome H. Goldschmidt Lin‐Na Chou Philip K. Chan Liwei Chen Nicholas Robert Joyce Kinsey Katherine Pitts Matt Nestor Edwin P. Rock Hillard M. Lazarus |
| author_sort | Jerome H. Goldschmidt |
| collection | DOAJ |
| description | Abstract Background Patient survival in advanced/metastatic melanoma, non‐small cell lung cancer (NSCLC), and renal cell carcinoma (RCC) has improved with immune checkpoint inhibitors (ICI). Biomarkers' role in prognosis and treatment has been limited by conflicting trial results. Methods This retrospective, observational study analyzed baseline demographic, clinical, laboratory, and treatment data versus outcomes of The US Oncology Network adult outpatients. Patients with advanced/metastatic melanoma, NSCLC, or RCC treated between January 1, 2015 and November 30, 2020 were given ICI monotherapy or combination therapy with ipilimumab, pembrolizumab, nivolumab, or atezolizumab. Treatment outcomes (overall survival [OS], time to treatment discontinuation, time to next treatment) were followed longitudinally until May 31, 2021, last patient record, or date of death. Baseline blood cell counts, including absolute monocyte count (AMC), absolute lymphocyte count (ALC), monocyte‐to‐lymphocyte ratio (MLR), absolute neutrophil count (ANC), and eosinophil count, were subdivided into quintiles for univariate and multivariable Cox regression analyses. Results Data from 18,186 patients with advanced/metastatic melanoma (n = 3314), NSCLC (n = 12,416), and RCC (n = 2456) were analyzed. Better OS correlated with increased baseline serum albumin concentration, increased eosinophil and lymphocyte counts, and Western United States physician practice location. Decreased OS correlated with increased AMC, MLR, ANC, age, and worse Eastern Cooperative Oncology Group performance status. Conclusions To our knowledge, this study is the largest to date to associate baseline survival indicators and outcomes in outpatients with advanced/metastatic melanoma, NSCLC, or RCC and receiving ICIs. Results may inform disease‐specific prognostic models and help providers identify patients most likely to benefit from ICI therapy. |
| first_indexed | 2024-03-09T01:32:34Z |
| format | Article |
| id | doaj.art-bcd408a5dd8c4136bb20c543a07474f6 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-09T01:32:34Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-bcd408a5dd8c4136bb20c543a07474f62023-12-09T07:52:05ZengWileyCancer Medicine2045-76342023-11-011222207832079710.1002/cam4.6645Real‐world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapyJerome H. Goldschmidt0Lin‐Na Chou1Philip K. Chan2Liwei Chen3Nicholas Robert4Joyce Kinsey5Katherine Pitts6Matt Nestor7Edwin P. Rock8Hillard M. Lazarus9US Oncology, Inc The Woodlands Texas USAOntada Irving Texas USAOntada Irving Texas USAOntada Irving Texas USAOntada Irving Texas USAPartner Therapeutics, Inc Lexington Massachusetts USAPartner Therapeutics, Inc Lexington Massachusetts USAPartner Therapeutics, Inc Lexington Massachusetts USAPartner Therapeutics, Inc Lexington Massachusetts USADepartment of Medicine, Division of Hematology and Oncology Case Western Reserve University Cleveland Ohio USAAbstract Background Patient survival in advanced/metastatic melanoma, non‐small cell lung cancer (NSCLC), and renal cell carcinoma (RCC) has improved with immune checkpoint inhibitors (ICI). Biomarkers' role in prognosis and treatment has been limited by conflicting trial results. Methods This retrospective, observational study analyzed baseline demographic, clinical, laboratory, and treatment data versus outcomes of The US Oncology Network adult outpatients. Patients with advanced/metastatic melanoma, NSCLC, or RCC treated between January 1, 2015 and November 30, 2020 were given ICI monotherapy or combination therapy with ipilimumab, pembrolizumab, nivolumab, or atezolizumab. Treatment outcomes (overall survival [OS], time to treatment discontinuation, time to next treatment) were followed longitudinally until May 31, 2021, last patient record, or date of death. Baseline blood cell counts, including absolute monocyte count (AMC), absolute lymphocyte count (ALC), monocyte‐to‐lymphocyte ratio (MLR), absolute neutrophil count (ANC), and eosinophil count, were subdivided into quintiles for univariate and multivariable Cox regression analyses. Results Data from 18,186 patients with advanced/metastatic melanoma (n = 3314), NSCLC (n = 12,416), and RCC (n = 2456) were analyzed. Better OS correlated with increased baseline serum albumin concentration, increased eosinophil and lymphocyte counts, and Western United States physician practice location. Decreased OS correlated with increased AMC, MLR, ANC, age, and worse Eastern Cooperative Oncology Group performance status. Conclusions To our knowledge, this study is the largest to date to associate baseline survival indicators and outcomes in outpatients with advanced/metastatic melanoma, NSCLC, or RCC and receiving ICIs. Results may inform disease‐specific prognostic models and help providers identify patients most likely to benefit from ICI therapy.https://doi.org/10.1002/cam4.6645biomarkerscheck point controlmedical oncologymelanomanon small cell lung cancerrenal cancer |
| spellingShingle | Jerome H. Goldschmidt Lin‐Na Chou Philip K. Chan Liwei Chen Nicholas Robert Joyce Kinsey Katherine Pitts Matt Nestor Edwin P. Rock Hillard M. Lazarus Real‐world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy Cancer Medicine biomarkers check point control medical oncology melanoma non small cell lung cancer renal cancer |
| title | Real‐world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy |
| title_full | Real‐world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy |
| title_fullStr | Real‐world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy |
| title_full_unstemmed | Real‐world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy |
| title_short | Real‐world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy |
| title_sort | real world outcomes of 18 186 metastatic solid tumor outpatients baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy |
| topic | biomarkers check point control medical oncology melanoma non small cell lung cancer renal cancer |
| url | https://doi.org/10.1002/cam4.6645 |
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