PDF(Pubmed)
Abstract：
OBJECTIVE: In this study, we aimed to evaluate the potential of routine blood markers, serum tumour markers and their combination in predicting RECIST-defined progression in patients with stage IV non-small cell lung cancer (NSCLC) undergoing treatment with immune checkpoint inhibitors.
METHODS: We employed time-varying statistical models and machine learning classifiers in a Monte Carlo cross-validation approach to investigate the association between RECIST-defined progression and blood markers, serum tumour markers and their combination, in a retrospective cohort of 164 patients with NSCLC.
RESULTS: The performance of the routine blood markers in the prediction of progression free survival was moderate. Serum tumour markers and their combination with routine blood markers generally improved performance compared to routine blood markers alone. Elevated levels of C-reactive protein (CRP) and alkaline phosphatase (ALP) ranked as the top predictive routine blood markers, and CYFRA 21.1 was consistently among the most predictive serum tumour markers. Using these classifiers to predict overall survival yielded moderate to high performance, even when cases of death-defined progression were excluded. Performance varied across the treatment journey.
CONCLUSIONS: Routine blood tests, especially when combined with serum tumour markers, show moderate predictive value of RECIST-defined progression in NSCLC patients receiving immune checkpoint inhibitors. The relationship between overall survival and RECIST-defined progression may be influenced by confounding factors.
METHODS: We employed time-varying statistical models and machine learning classifiers in a Monte Carlo cross-validation approach to investigate the association between RECIST-defined progression and blood markers, serum tumour markers and their combination, in a retrospective cohort of 164 patients with NSCLC.
RESULTS: The performance of the routine blood markers in the prediction of progression free survival was moderate. Serum tumour markers and their combination with routine blood markers generally improved performance compared to routine blood markers alone. Elevated levels of C-reactive protein (CRP) and alkaline phosphatase (ALP) ranked as the top predictive routine blood markers, and CYFRA 21.1 was consistently among the most predictive serum tumour markers. Using these classifiers to predict overall survival yielded moderate to high performance, even when cases of death-defined progression were excluded. Performance varied across the treatment journey.
CONCLUSIONS: Routine blood tests, especially when combined with serum tumour markers, show moderate predictive value of RECIST-defined progression in NSCLC patients receiving immune checkpoint inhibitors. The relationship between overall survival and RECIST-defined progression may be influenced by confounding factors.
摘要：
目的：在本研究中，我们的目的是评估血常规指标的潜力，在接受免疫检查点抑制剂治疗的IV期非小细胞肺癌（NSCLC）患者中，血清肿瘤标志物及其组合预测RECIST定义的进展。
方法：我们在蒙特卡洛交叉验证方法中采用了时变统计模型和机器学习分类器，以研究RECIST定义的进展与血液标志物之间的关联。血清肿瘤标志物及其组合，在164例NSCLC患者的回顾性队列中。
结果：常规血液标志物在预测无进展生存期中的表现是中等的。与单独的常规血液标志物相比,血清肿瘤标志物及其与常规血液标志物的组合通常改善了性能。C-反应蛋白（CRP）和碱性磷酸酶（ALP）水平升高是预测血液常规指标的最高水平。CYFRA21.1始终是最具预测性的血清肿瘤标志物之一。使用这些分类器来预测总生存期产生了中等到较高的性能，即使排除了死亡定义的进展病例.在整个治疗过程中，性能各不相同。
结论：血常规检查，特别是当与血清肿瘤标志物结合时，在接受免疫检查点抑制剂的NSCLC患者中显示RECIST定义的进展的中等预测价值。总生存期和RECIST定义的进展之间的关系可能受到混杂因素的影响。
方法：我们在蒙特卡洛交叉验证方法中采用了时变统计模型和机器学习分类器，以研究RECIST定义的进展与血液标志物之间的关联。血清肿瘤标志物及其组合，在164例NSCLC患者的回顾性队列中。
结果：常规血液标志物在预测无进展生存期中的表现是中等的。与单独的常规血液标志物相比,血清肿瘤标志物及其与常规血液标志物的组合通常改善了性能。C-反应蛋白（CRP）和碱性磷酸酶（ALP）水平升高是预测血液常规指标的最高水平。CYFRA21.1始终是最具预测性的血清肿瘤标志物之一。使用这些分类器来预测总生存期产生了中等到较高的性能，即使排除了死亡定义的进展病例.在整个治疗过程中，性能各不相同。
结论：血常规检查，特别是当与血清肿瘤标志物结合时，在接受免疫检查点抑制剂的NSCLC患者中显示RECIST定义的进展的中等预测价值。总生存期和RECIST定义的进展之间的关系可能受到混杂因素的影响。
