Impact of early inflammatory cytokine elevation after commencement of PD-1 inhibitors to predict efficacy in patients with non-small cell lung cancer

Journal Article · Mon Apr 15 04:00:00 EDT 2019 · Medical Oncology (Online)

DOI:https://doi.org/10.1007/S12032-019-1255-3· OSTI ID:22938433

Ozawa, Yuichi; Amano, Yusuke; Kanata, Kei; Hasegwa, Hirotsugu; Matsui, Takashi; Kakutani, Takuya; Koyauchi, Takafumi ^[1]; Tanahashi, Masayuki; Niwa, Hiroshi ^[2]; Yokomura, Koshi ^[1]; Suda, Takafumi ^[3]

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1. Seirei Mikatahara General Hospital, Department of Respiratory Medicine, Respiratory Disease Center (Japan)
2. Seirei Mikatahara General Hospital, Division of Thoracic Surgery, Respiratory Disease Center (Japan)
3. Hamamatsu University School of Medicine, Second Division, Department of Internal Medicine (Japan)

Early elevation of inflammatory cytokines, such as IL-6 or TNF-α, or CRP, which is a surrogate marker for IL-6, following commencement of PD-1/L1 inhibitors (PD1-I) may represent early activation of immune-cells. Serum IL-6 and TNF-α were measured in 10 non-small cell lung cancer patients who were evaluable within the 7 days before and after commencement of PD1-I. For CRP, medical records were reviewed and 34 patients with measured CRP within the 7 days before and after the treatment were evaluated. In the 10 patients analyzed for IL-6/TNF-α, the serum levels of IL-6/TNF-α were not significantly different between pre- and post-initial PD1-I [IL-6 20.3 (2.6–49.9) and 22.9 (3.6–96.1) pg/mL, p = 0.453; TNF-α 1.6 (0.7–6.3) and 3.3 (0.7–9.6) pg/mL, p = 0.329]; however, all four responses were observed among the 7 IL-6-elevated cases, resulting in a response rate of 57%. In the 34 patients analyzed for CRP, CRP was significantly increased after initial PD1-I [1.8 (0.1–17.8) mg/dL, 2.4 (0.0–27.8), p = 0.001]. Notably, in the 31 evaluable cases, all responses were again observed in either the IL-6 or CRP elevated groups and the response rate was 46% (11 of 24). The median overall survival time was not reached in the elevated group and was 112 days in the non-elevated group (p = 0.069). The early increase in inflammatory cytokines with PD1-I was indicated to be predictive for the efficacy in patients with non-small cell lung cancer.

• OSTI ID: 22938433
• Journal Information: Medical Oncology (Online), Journal Name: Medical Oncology (Online) Journal Issue: 4 Vol. 36; ISSN 1559-131X
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
INFLAMMATION
LUNGS
LYMPHOKINES
MEDICAL RECORDS
NEOPLASMS
PATIENTS
REVIEWS
SURVIVAL TIME