Dynamics of Serum Tumor Markers Can Serve as a Prognostic Biomarker for Chinese Advanced Non-small Cell Lung Cancer Patients Treated With Immune Checkpoint Inhibitors

作者：Zhibo Zhang, Fang Yuan, Runzhe Chen, Ye Li, Junxun Ma, Xiang Yan, Lijie Wang, Fan Zhang, Haitao Tao, Dong Guo, Zhiyue Huang, Sujie Zhang, Xiaoyan Li, Xiaoyu Zhi, Xiangwei Ge, Yi Hu, Jinliang Wang · 发表于：Frontiers in Immunology · 年份：2020 · DOI：10.3389/fimmu.2020.01173 · 被引用次数：55 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Research Studies、Lung Cancer Treatments and Mutations

Background: Serum tumor markers carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cytokeratin 19 fragment (CYFRA21-1) and squamous-cell carcinoma-related antigen (SCC-Ag) are routinely used for monitoring the response to chemotherapy or targeted therapy in advanced-stage non-small cell lung cancer (NSCLC), however their role in immunotherapy remains unclear. The aim of this study was to investigate whether dynamics of these serum markers could predict prognosis of patients with late-stage NSCLC treated by programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors. Methods: We initiated a longitudinal study on advanced NSCLC patients treated by PD-1/PD-L1 inhibitors. Blood samples of baseline and after 6 weeks' treatment were collected. At least 20% decreases of the biomarkers from baseline were considered as meaningful improvements after 6 weeks of treatment. Optimization-based method was used to balance baseline covariates between different groups. Results: A total of 308 patients with advanced NSCLC were enrolled in the study. After balancing the baseline covariates between different groups, patients with meaningful improvements in less than 2 out of 4 biomarkers was ended up with lower ORR (0.08 vs 0.35, p < 0.001), shorten PFS (5.4 vs 12.5 months, p < 0.001) and OS (11.7 vs 25.6 months, p < 0.001) in the total population. Subgroup analysis of patients with adenocarcinoma (ADC) revealed that patients with meaningful improvements in less than 2...