{Reference Type}: Journal Article
{Title}: Predictive Value of Modified Glasgow Prognostic Score and Persistent Inflammation among Patients with Non-Small Cell Lung Cancer Treated with Durvalumab Consolidation after Chemoradiotherapy: A Multicenter Retrospective Study.
{Author}: Tanimura K;Takeda T;Yoshimura A;Honda R;Goda S;Shiotsu S;Fukui M;Chihara Y;Uryu K;Takei S;Katayama Y;Hibino M;Yamada T;Takayama K;
{Journal}: Cancers (Basel)
{Volume}: 15
{Issue}: 17
{Year}: 2023 Sep 1
{Factor}: 6.575
{DOI}: 10.3390/cancers15174358
{Abstract}: <B>BACKGROUND: </B>Durvalumab consolidation after chemoradiotherapy (CRT) is a standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, studies on immunological and nutritional markers to predict progression-free survival (PFS) and overall survival (OS) are inadequate. Systemic inflammation causes cancer cachexia and negatively affects immunotherapy efficacy, which also reflects survival outcomes.<BR><B>METHODS: </B>We retrospectively investigated 126 patients from seven institutes in Japan.<BR><B>RESULTS: </B>The modified Glasgow Prognostic Score (mGPS) values, before and after CRT, were the essential predictors among the evaluated indices. A systemic inflammation-based prognostic risk classification was created by combining mGPS values before CRT, and C-reactive protein (CRP) levels after CRT, to distinguish tumor-derived inflammation from CRT-induced inflammation. Patients were classified into high-risk (n = 31) and low-risk (n = 95) groups, and the high-risk group had a significantly shorter median PFS of 7.2 months and an OS of 19.6 months compared with the low-risk group. The hazard ratios for PFS and OS were 2.47 (95% confidence interval [CI]: 1.46-4.19, p < 0.001) and 3.62 (95% CI: 1.79-7.33, p < 0.001), respectively. This association was also observed in the subgroup with programmed cell death ligand 1 expression of ≥50%, but not in the <50% subgroup. Furthermore, durvalumab discontinuation was observed more frequently in the high-risk group than in the low-risk group.<BR><B>CONCLUSIONS: </B>Combining pre-CRT mGPS values with post-CRT CRP levels in patients with locally advanced NSCLC helps to predict the PFS and OS of durvalumab consolidation after CRT.