Early CRP kinetics predicts immunotherapy response in NSCLC in the phase III OAK trial
Menée à partir de données portant sur 758 patients atteints d'un cancer du poumon non à petites cellules et inclus dans un essai de phase III comparant l'atézolizumab et le docétaxel, cette étude met en évidence une association entre l'évolution précoce des niveaux sériques de la protéine C réactive et la réponse à une immunothérapie
Static biomarkers like PD-L1 are insufficient to accurately predict response to immune checkpoint inhibition (ICI). Therefore, on-treatment biomarkers, that measure immediate therapy-associated changes, are currently shifting into the focus of immuno-oncology. A prime example of a simple predictive on-treatment biomarker is the early C-reactive protein (CRP) kinetics with its predictive CRP flare-response phenomenon. Here, we were able to confirm the predictive value of CRP-flare response kinetics in the pivotal phase 3 OAK trial (NCT02008227), which compared atezolizumab with docetaxel in patients with non-small cell lung cancer (NSCLC). Of note, CRP flare-response predicted favorable outcomes only in the ICI-treated subgroup, which suggests that it is an immunotherapy-specific phenomenon. In conclusion, we have for the first time validated the high predictive value of early CRP kinetics in a pivotal phase 3 trial, justifying the broad use of this cost-effective and easy-to-implement on-treatment biomarker to optimize therapy monitoring for patients with NSCLC.
JNCI Cancer Spectrum , article en libre accès, 2022