TY - JOUR
T1 - Prognostic impact of the Controlling Nutritional Status score in patients with non-small cell lung cancer treated with pembrolizumab
AU - Ohba, Taro
AU - Takamori, Shinkichi
AU - Toyozawa, Ryo
AU - Nosaki, Kaname
AU - Umeyama, Yasuhiro
AU - Haratake, Naoki
AU - Miura, Naoko
AU - Yamaguchi, Masafumi
AU - Taguchi, Kenichi
AU - Seto, Takashi
AU - Shimokawa, Mototsugu
AU - Takenoyama, Mitsuhiro
N1 - Funding Information:
Japan, Kyowa Hakko Kirin, MSD, Nippon Boehringer Ingelheim, Nippon Kayaku, Ono Pharmaceutical, and Taiho Pharmaceutical. Dr. K Nosaki reports personal fees from AstraZeneca, Bristol-Myers Squibb, Chugai Pharmaceutical, Eli Lilly Japan, Kyowa Hakko Kirin, Nippon Boehringer Ingelheim, Nippon Kayaku, Ono Pharmaceutical, Pfizer Japan, Taiho Pharmaceutical, and grants and personal fees from MSD, and Novartis Pharma. Dr. Miura reports personal fees from Ono Pharmaceutical. Dr. M Yamaguchi reports personal fees from Astellas Pharma, AstraZeneca, Chugai Pharmaceutical, Covidien Japan, Daiichi Sankyo, Eli Lilly Japan, Johnson & Johnson, Kyowa Hakko Kirin, Nippon Boehringer Ingelheim, Ono Pharmaceutical, and Taiho Pharmaceutical. Dr. K Taguchi reports personal fees from AstraZeneca, MSD, Ono Pharmaceutical, and Taiho Pharmaceutical. Dr. T Seto reports grants and personal fees from Astellas Pharma, AstraZeneca, Chugai Pharmaceutica, Eli Lilly Japan, Kissei Pharmaceutical, MSD, Nippon Boehringer Ingelheim, Novartis Pharma, Pfizer Japan, Takeda Pharmaceutical, and personal fees from Bristol-Myers Squibb, Kyowa Hakko Kirin, Nippon Kayaku, Ono Pharmaceutical, Roche Singapore, Taiho Pharmaceutical, Thermo Fisher Scientific, YakultHonsha, and grants from Bayer Yakuhin, Daiichi Sankyo, Eisai, LOXO Oncology, and Merck Serono. Dr. M Shimokawa reports consulting fee from Sysmex. Dr. M Takenoyama reports grants and personal fees from AstraZeneca, Bristol-Myers Squibb, Chugai Pharmaceutical, Covidien Japan, Eli Lilly Japan, Kyowa Hakko Kirin, MSD, Nippon Boehringer Ingelheim, Novartis Pharma, Ono Pharmaceutical, Taiho Pharmaceutical, and grants from Johnson & Johnson, Kaketsuken, and personal fees from Pfizer Japan. The other authors have no conflicts of interest to declare.
Publisher Copyright:
© Journal of Thoracic Disease. All rights reserved.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background: Pembrolizumab, an anti-programmed cell death-1 (PD-1) monoclonal antibody, has been shown to yield a durable response and significant survival benefit in some non-small cell lung cancer (NSCLC) patients. Recent studies have shown that the Controlling Nutritional Status (CONUT) score, a novel nutritional index, can be useful for predicting the prognosis in some malignancies. However, its usefulness in predicting the clinical outcome of immune-checkpoint inhibitor (ICI) treatment in patients with NSCLC has not been clarified. The aim of this study was to investigate the clinical significance of the CONUT score in NSCLC patients treated with pembrolizumab. Methods: We conducted a retrospective analysis of the clinical data of 32 patients with advanced NSCLC who received pembrolizumab monotherapy. A cut-off CONUT score of 2 was used to categorize patients into low and high CONUT groups. We evaluated the relation between the clinicopathological factors including CONUT score and neutrophil-to-lymphocyte ratio (NLR) and the prognosis. Results: Twenty-two patients were classified into the low CONUT score group, while 10 were classified into the high CONUT score group. In the univariate and multivariate analyses, the number of prior treatments and the CONUT score were found to independently predict progression-free survival (PFS) (P<0.05), while the CONUT score as well as NLR was an independent prognostic factor for overall survival (P<0.05). In addition, in patients who received pembrolizumab as a first-line treatment, a high CONUT score was associated with a significantly worse PFS and overall survival in comparison to a low CONUT score. Conclusions: The CONUT score has potential application as a predictor of the therapeutic effect and the prognosis of NSCLC patients treated with pembrolizumab. Our findings suggest that in addition to the programmed cell death ligand 1 expression level, the CONUT may also be a useful indicator for selecting NSCLC patients who may benefit from ICI treatment.
AB - Background: Pembrolizumab, an anti-programmed cell death-1 (PD-1) monoclonal antibody, has been shown to yield a durable response and significant survival benefit in some non-small cell lung cancer (NSCLC) patients. Recent studies have shown that the Controlling Nutritional Status (CONUT) score, a novel nutritional index, can be useful for predicting the prognosis in some malignancies. However, its usefulness in predicting the clinical outcome of immune-checkpoint inhibitor (ICI) treatment in patients with NSCLC has not been clarified. The aim of this study was to investigate the clinical significance of the CONUT score in NSCLC patients treated with pembrolizumab. Methods: We conducted a retrospective analysis of the clinical data of 32 patients with advanced NSCLC who received pembrolizumab monotherapy. A cut-off CONUT score of 2 was used to categorize patients into low and high CONUT groups. We evaluated the relation between the clinicopathological factors including CONUT score and neutrophil-to-lymphocyte ratio (NLR) and the prognosis. Results: Twenty-two patients were classified into the low CONUT score group, while 10 were classified into the high CONUT score group. In the univariate and multivariate analyses, the number of prior treatments and the CONUT score were found to independently predict progression-free survival (PFS) (P<0.05), while the CONUT score as well as NLR was an independent prognostic factor for overall survival (P<0.05). In addition, in patients who received pembrolizumab as a first-line treatment, a high CONUT score was associated with a significantly worse PFS and overall survival in comparison to a low CONUT score. Conclusions: The CONUT score has potential application as a predictor of the therapeutic effect and the prognosis of NSCLC patients treated with pembrolizumab. Our findings suggest that in addition to the programmed cell death ligand 1 expression level, the CONUT may also be a useful indicator for selecting NSCLC patients who may benefit from ICI treatment.
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U2 - 10.21037/jtd.2019.09.29
DO - 10.21037/jtd.2019.09.29
M3 - Article
AN - SCOPUS:85073783766
SN - 2072-1439
VL - 11
SP - 3757
EP - 3768
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
IS - 9
ER -
