Title |
Early C-reactive protein kinetics predicts immunotherapy response in non-small cell lung cancer in the phase III OAK trial
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Published in |
JNCI Cancer Spectrum, April 2023
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DOI | 10.1093/jncics/pkad027 |
Pubmed ID | |
Authors |
Jonas Saal, Tobias Bald, Markus Eckstein, Manuel Ritter, Peter Brossart, Jörg Ellinger, Michael Hölzel, Niklas Klümper |
Abstract |
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. |
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