Association between pretreatment C-reactive protein level and survival in non-small cell lung cancer patients treated with immune checkpoint inhibitors: A meta-analysis

Haoyu Wang; Ruiyuan Yang; Ke Zhou; Suyan Wang; Cheng Cheng; Dan Liu; Weimin Li

doi:10.1016/j.intimp.2023.110937

Association between pretreatment C-reactive protein level and survival in non-small cell lung cancer patients treated with immune checkpoint inhibitors: A meta-analysis

Int Immunopharmacol. 2023 Nov;124(Pt B):110937. doi: 10.1016/j.intimp.2023.110937. Epub 2023 Sep 25.

Authors

Haoyu Wang¹, Ruiyuan Yang², Ke Zhou³, Suyan Wang⁴, Cheng Cheng⁴, Dan Liu², Weimin Li⁵

Affiliations

¹ Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
² Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
³ Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
⁴ Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
⁵ Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China. Electronic address: weimin003@163.com.

PMID: 37757636
DOI: 10.1016/j.intimp.2023.110937

Abstract

Background: Current evidence suggests that C-reactive protein (CRP) levels may affect cancer prognosis. However, the effect of CRP has not been validated in immunotherapy recipients with non-small cell lung cancer (NSCLC). Therefore, we performed a meta-analysis to explore the prognostic value of CRP level in patients with NSCLC treated with immune checkpoint inhibitors.

Methods: PubMed, Web of Science, Embase, and Scopus databases were systematically retrieved for eligible publications, and hazard ratios (HRs) with corresponding 95% confidence intervals (95%CIs) were extracted and merged to evaluate the correlation between pretreatment CRP levels and overall survival (OS) and progression-free survival (PFS). Subgroup and sensitivity analyses were conducted to confirm these findings.

Results: Thirty-five cohorts consisting of 4698 patients were included in the primary analysis. Pooled results demonstrated that a higher pretreatment CRP level is associated with worse OS and PFS (OS: HR = 1.13, 95 %CI:1.09-1.18; PFS: HR = 1.16, 95 %CI:1.10-1.22). These findings remained robust after further statistical analyses.

Conclusion: Pretreatment CRP level could be a promising biomarker for NSCLC immunotherapy. However, prospective studies are required to validate these findings.

Keywords: C-reactive protein; Immune checkpoint inhibitors; Lung cancer; Meta-analysis; Survival.

Publication types

Meta-Analysis

MeSH terms

C-Reactive Protein
Carcinoma, Non-Small-Cell Lung*
Humans
Immune Checkpoint Inhibitors / therapeutic use
Lung Neoplasms*
Prognosis

Substances

Immune Checkpoint Inhibitors
C-Reactive Protein