ArticleCancer medicine2023
The prognostic and predictive roles of plasma C-reactive protein and PD-L1 in non-small cell lung cancer.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 7 citations in OpenAlex.
- Systemic Inflammation Modifies the Efficacy of Bevacizumab Added to Atezolizumab Plus Chemotherapy for Advanced Non-Squamous Non-Small Cell Lung Cancer: A Multicenter Retrospective Study.Thoracic cancer · 2026Article
- Elevated baseline C-reactive protein predicts poorer survival in lung cancer: a 22-year retrospective cohort study.Translational lung cancer research · 2026Article
- Metastatic NSCLC patients in the real world in Finland.Acta oncologica (Stockholm, Sweden) · 2025Article
- Plasma proteomics to explore benefit from anti-PD-(L)1 in advanced solid tumors: a prospective pilot study.Scientific reports · 2025Article
- C-reactive protein as robust laboratory value associated with prognosis in patients with stage III non-small cell lung cancer (NSCLC) treated with definitive radiochemotherapy.Scientific reports · 2024Article
- The prognostic value and model construction of inflammatory markers for patients with non-small cell lung cancer.Scientific reports · 2024Article
- The contribution of the CRP/CD64 axis to renal cancer progression by inducing protumor activation of tumor-associated macrophages.Clinical & translational immunology · 2024Article
- The prognostic and predictive roles of plasma C-reactive protein and PD-L1 in non-small cell lung cancer.Cancer medicine · 2023Article
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9 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAnti-PD-(L)1 agents have revolutionized the treatment paradigms of non-small cell lung cancer (NSCLC), while predictive biomarkers are limited. It has been previously shown that systemic inflammation, indicated by elevated C-reactive protein (CRP) level, is associated with a poor prognosis in anti-PD-(L)1 treated. The aim of the study was to analyze the prognostic and predictive value of CRP in addition to traditional prognostic and predictive markers and tumor PD-L1 score.
methodsWe identified all NSCLC patients (n = 329) who had undergone PD-L1 tumor proportion score (TPS) analysis at Oulu University Hospital 2015-22. CRP levels, treatment history, immune checkpoint inhibitor (ICI) therapy details, and survival were collected. The patients were categorized based on CRP levels (≤10 vs. >10) and PD-L1 TPS scores (<50 vs. ≥50).
resultsIn the whole cohort (n = 329), CRP level of ≤10 mg/L was associated with improved survival in univariate (HR 0.30, Cl 95% 0.22-0.41) and multivariate analyzes (HR 0.44, CI 95% 0.28-0.68). With ICI treated (n = 70), both CRP of ≤10 and PD-L1 TPS of ≥50 were associated with improved progression-free survival (PFS) in univariate (HR 0.51, CI 95% 0.27-0.96; HR 0.54, CI 95% 0.28-1.02) and multivariate (HR 0.48, CI 95% 0.26-0.90; HR 0.50, CI 95% 0.26-0.95) analyzes. The combination (PD-L1 TPS ≥50 and CRP >10) carried a high negative predictive value with a median PFS of 4.11 months (CI 95% 0.00-9.63), which was similar to patients with low PD-L1 (4.11 months, CI 95% 2.61-5.60).
conclusionsAdding plasma CRP levels to PD-L1 TPS significantly increased the predictive value of sole PD-L1. Furthermore, patients with high CRP beard little benefit from anti-PD-(L)1 therapies independent of PD-L1 score. The study highlights the combined evaluation of plasma CRP and PD-L1 TPS as a negative predictive marker for ICI therapies.
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