2022 World Conference on Lung Cancer (ePosters)-EP05.01-013. Increased C-reactive Protein after Chemoradiotherapy and Immunotherapy in Locally Advanced Non-small Lung Cancer Indicates Worse Survival

EP05.01-013. Increased C-reactive Protein after Chemoradiotherapy and Immunotherapy in Locally Advanced Non-small Lung Cancer Indicates Worse Survival

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A study conducted at the Institute of Oncology Ljubljana in Slovenia found that increased levels of C-reactive protein (CRP) after chemoradiotherapy and immunotherapy in patients with locally advanced non-small cell lung cancer (LA-NSCLC) are associated with worse survival outcomes. Adjuvant durvalumab is the standard treatment for fit patients with PD-L1 positive tumors after chemoradiotherapy. The study aimed to determine if immune response markers such as the neutrophil-to-lymphocyte ratio (NLR), CRP levels, and antibiotic usage could predict survival in LA-NSCLC patients.<br /><br />The medical records of 85 patients with LA-NSCLC who received definitive chemoradiotherapy and immunotherapy were analyzed. NLR, CRP levels, and antibiotic use were collected from the medical database, and overall survival was calculated. The study found that only increased CRP levels predicted worse survival, while antibiotic use showed a trend but not a significant association with survival.<br /><br />The three-year survival rate was 59.3%, and the median overall survival time was not reached after a median follow-up of 36 months. Patients with normal CRP levels after immunotherapy had a significantly better median overall survival time compared to those with levels above the upper limit of normal. Higher CRP levels after immunotherapy were associated with shorter survival. NLR ratio before, during, or after treatment did not predict survival.<br /><br />In univariate analysis, increased CRP levels before chemoradiotherapy and before immunotherapy were significantly associated with worse survival. The use of antibiotics during therapy also showed a trend towards worse survival. In multivariate analysis, only CRP levels six times above the upper limit of normal at the end of treatment significantly predicted worse survival.<br /><br />In conclusion, this study suggests that increased CRP levels after chemoradiotherapy and immunotherapy in LA-NSCLC patients indicate worse survival outcomes. Monitoring CRP levels may be useful in assessing patient prognosis and guiding treatment decisions. Further research is needed to validate these findings and explore the potential impact of antibiotics on survival in LA-NSCLC patients.

Asset Subtitle

Karmen Stanic

Meta Tag

Speaker Karmen Stanic

Topic Locally Advanced Non-small Cell Lung Cancer - Chemoradiotherapy and Radiotherapy

Keywords

C-reactive protein

chemoradiotherapy

immunotherapy

locally advanced non-small cell lung cancer

survival outcomes

adjuvant durvalumab

neutrophil-to-lymphocyte ratio

antibiotic usage

three-year survival rate

patient prognosis