Early C-reactive protein kinetics predicts immunotherapy response in non-small cell lung cancer in the phase III OAK trial. Issue 2 (2nd April 2023)

• Record Type: Journal Article
• Authors: Saal, Jonas; Bald, Tobias; Eckstein, Markus; Ritter, Manuel; Brossart, Peter; Ellinger, Jörg; Hölzel, Michael; Klümper, Niklas
• Is Part Of: JNCI cancer spectrum. Volume 7:Issue 2(2023)
• Publication Date: 2023-04-02
• DOI: 10.1093/jncics/pkad027
• Languages: English
• ISSNs: 2515-5091

Abstract

Abstract: Static biomarkers like programmed death-ligand 1 (PD-L1) are insufficient to accurately predict response to immune checkpoint inhibition. Therefore, on-treatment biomarkers, which 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 III OAK trial (NCT02008227), which compared atezolizumab with docetaxel in patients with non-small cell lung cancer. Of note, CRP flare-response predicted favorable outcomes only in the immune checkpoint inhibition–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 III trial, justifying the broad use of this cost-effective and easy-to-implement on-treatment biomarker to optimize therapy monitoring for patients with non-small cell lung cancer.