PMID- 34354375
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220425
IS  - 1179-1322 (Print)
IS  - 1179-1322 (Electronic)
IS  - 1179-1322 (Linking)
VI  - 13
DP  - 2021
TI  - Intrapulmonic Cavity or Necrosis on Baseline CT Scan Serves as an Efficacy 
      Predictor of Anti-PD-(L)1 Inhibitor in Advanced Lung Squamous Cell Carcinoma.
PG  - 5931-5939
LID - 10.2147/CMAR.S319480 [doi]
AB  - BACKGROUND: Predictive markers for guidance and monitoring of immunotherapy in 
      lung squamous cell carcinoma (LSCC) are an interesting topic but have yet to be 
      fully explored. A primary characteristic of LSCC is tumor necrosis that results 
      in extensive immune suppression in patients. We sought to assess whether tumor 
      necrosis or cavity on baseline CT could effectively predict the efficacy of 
      immune checkpoint inhibitors (ICIs) in advanced LSCC. METHODS: Advanced LSCC 
      cases undergoing pre-treatment chest CT imaging and receiving ICIs were 
      retrospectively collected. All CT images were reviewed by an independent chest 
      radiologist blinded to any previous diagnosis to confirm morphological 
      alterations in necrosis or cavity. We performed Logistic regression and developed 
      Cox proportional hazards models to assess the predictive performance of baseline 
      necrosis or cavity characteristics in advanced LSCC. Survival estimates were 
      observed using Kaplan-Meier curves. RESULTS: Ninety-three patients were eligible 
      for analysis, predominantly consisting of patients with ECOG performance status 
      of 0 or 1 (97.8%), male patients (95.7%), and heavy smokers (92.5%). 
      Intrapulmonic necrosis or cavity on CT scan was present in 52.7% of all patients. 
      Generally, the objective response rate (ORR) in patients with necrosis or cavity 
      to ICI treatment was significantly worse versus those without (30.6% vs 54.5%, p 
      = 0.020), with the subgroup ORRs as follows: ICI monotherapy (necrosis vs 
      non-necrosis: 10.0% vs 36.8%, p =0.047) and ICI combination therapy (44.8% vs 
      68.0%, p =0.088). Multivariable analysis identified intrapulmonic necrosis or 
      cavity at baseline as a major risk factor for advanced LSCC (HR 4.042, 95% 
      CI1.149-10.908, p = 0.006). Multivariate Cox analysis showed that baseline 
      necrosis or cavity and ICI monotherapy were unfavorable factors for 
      progression-free survival (HR 1.729; 95% CI1.203-2.484, p =0.003). CONCLUSION: 
      LSCC patients with intrapulmonic cavity or necrosis on baseline CT scan may 
      respond poorly to anti-PD-(L)1-treatment, monotherapy and combination therapy 
      alike.
CI  - (c) 2021 Lu et al.
FAU - Lu, Tao
AU  - Lu T
AD  - Department of Radiology, Fujian Medical University Cancer Hospital, Fujian Cancer 
      Hospital, Fuzhou, People's Republic of China.
FAU - Zhang, Longfeng
AU  - Zhang L
AD  - Department of Thoracic Oncology, Fujian Medical University Cancer Hospital, 
      Fujian Cancer Hospital, Fuzhou, People's Republic of China.
FAU - Chen, Mingqiu
AU  - Chen M
AUID- ORCID: 0000-0001-7928-172X
AD  - Department of Thoracic Radiation Oncology, Fujian Medical University Cancer 
      Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China.
FAU - Zheng, Xiaobin
AU  - Zheng X
AUID- ORCID: 0000-0002-8093-1475
AD  - Department of Thoracic Oncology, Fujian Medical University Cancer Hospital, 
      Fujian Cancer Hospital, Fuzhou, People's Republic of China.
FAU - Jiang, Kan
AU  - Jiang K
AD  - Department of Thoracic Oncology, Fujian Medical University Cancer Hospital, 
      Fujian Cancer Hospital, Fuzhou, People's Republic of China.
FAU - Zheng, Xinlong
AU  - Zheng X
AD  - Department of Thoracic Oncology, Fujian Medical University Cancer Hospital, 
      Fujian Cancer Hospital, Fuzhou, People's Republic of China.
FAU - Li, Chao
AU  - Li C
AD  - Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer 
      Hospital, Fuzhou, People's Republic of China.
FAU - Xiao, Weijin
AU  - Xiao W
AD  - Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer 
      Hospital, Fuzhou, People's Republic of China.
FAU - Miao, Qian
AU  - Miao Q
AD  - Department of Thoracic Oncology, Fujian Medical University Cancer Hospital, 
      Fujian Cancer Hospital, Fuzhou, People's Republic of China.
FAU - Yang, Shanshan
AU  - Yang S
AD  - Department of Thoracic Oncology, Fujian Medical University Cancer Hospital, 
      Fujian Cancer Hospital, Fuzhou, People's Republic of China.
FAU - Lin, Gen
AU  - Lin G
AD  - Department of Thoracic Oncology, Fujian Medical University Cancer Hospital, 
      Fujian Cancer Hospital, Fuzhou, People's Republic of China.
LA  - eng
PT  - Journal Article
DEP - 20210730
PL  - New Zealand
TA  - Cancer Manag Res
JT  - Cancer management and research
JID - 101512700
PMC - PMC8331205
OTO - NOTNLM
OT  - cavity
OT  - immune-checkpoint inhibitor
OT  - lung squamous cell carcinoma
OT  - necrosis
OT  - predictive marker
COIS- The authors declare that they have no conflicts of interest for this work.
EDAT- 2021/08/07 06:00
MHDA- 2021/08/07 06:01
PMCR- 2021/07/30
CRDT- 2021/08/06 06:46
PHST- 2021/05/13 00:00 [received]
PHST- 2021/07/08 00:00 [accepted]
PHST- 2021/08/06 06:46 [entrez]
PHST- 2021/08/07 06:00 [pubmed]
PHST- 2021/08/07 06:01 [medline]
PHST- 2021/07/30 00:00 [pmc-release]
AID - 319480 [pii]
AID - 10.2147/CMAR.S319480 [doi]
PST - epublish
SO  - Cancer Manag Res. 2021 Jul 30;13:5931-5939. doi: 10.2147/CMAR.S319480. 
      eCollection 2021.