Can blood-based markers predict RECIST progression in non-small cell lung cancer treated with immunotherapy?

Melda Yeghaian, Teresa M. Tareco Bucho, Melissa de Bruin, Alexander Schmitz, Zuhir Bodalal, Egbert F. Smit, Regina G.H. Beets-Tan, Daan van den Broek, Stefano Trebeschi*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Purpose: 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. Conclusion: 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.

Original languageEnglish
Article number329
JournalJournal of Cancer Research and Clinical Oncology
Volume150
Issue number6
Number of pages10
ISSN0171-5216
DOIs
Publication statusPublished - Jun 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Keywords

  • Blood-based markers
  • Immunotherapy
  • Machine learning
  • NSCLC
  • Progression-free survival
  • RECIST

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