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Impact of preexisting antinuclear antibodies on combined immunotherapy and chemotherapy in advanced non-small cell lung cancer patients

Medical Oncology volume 37, Article number: 111 (2020) Cite this article

Abstract

Combined immunotherapy and chemotherapy is a promising standard treatment in patients with advanced non-small cell lung cancer (NSCLC). This study aimed to evaluate the relationship between the combined therapy and pretreatment serum antinuclear antibody (ANA) levels as a prognostic indicator in patients with NSCLC. We retrospectively analyzed patients with advanced NSCLC who were treated with combinatorial immunotherapy and chemotherapy between January and December 2019 at six institutions in Japan. Relationship between ANA status and patients’ characteristics were reviewed. A total of 77 patients with advanced NSCLC were enrolled in the study. Patients were divided into ANA-positive (ANA ≥ 1:160) and ANA-negative (ANA < 1:160) groups. The ANA-positive group tended to have a shorter progression-free survival and significantly shorter overall survival in univariate (hazard ratio [HR], 2.11, 95% confidence interval [CI] 0.88–5.07, p = 0.093; and HR 3.11, 95% CI 1.14–8.49, p = 0.027, respectively) and multivariate (HR 1.90, 95% CI 0.77–4.68, p = 0.16; and HR 3.37, 95% CI 1.15–9.86, p = 0.027, respectively) analyses than ANA-negative group. The incidence of discontinuation of all treatment components due to severe adverse events was significantly higher in the ANA-positive than in ANA-negative group (50% vs. 15.9%, p = 0.042). The study showed that the presence of antinuclear antibodies may result in a poor prognosis in patients treated with combinatorial immunotherapy and chemotherapy, although further prospective investigations are needed.

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Acknowledgements

We greatly thank the patients, their families, and all investigators involved in this study.

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None.

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Affiliations

  1. Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602–8566, Japan

    Kenji Morimoto, Tadaaki Yamada, Ryota Nakamura, Yuki Katayama, Satomi Tanaka, Yohei Matsui, Yoshie Morimoto, Masahiro Iwasaku, Yoshiko Kaneko, Junji Uchino & Koichi Takayama

  2. Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan

    Chieko Takumi & Noriya Hiraoka

  3. Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan

    Yuri Ogura & Takayuki Takeda

  4. Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan

    Keisuke Onoi & Yusuke Chihara

  5. Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan

    Ryusuke Taniguchi & Takahiro Yamada

  6. Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan

    Osamu Hiranuma

Authors
  1. Kenji Morimoto
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  2. Tadaaki Yamada
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  3. Ryota Nakamura
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  4. Yuki Katayama
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  5. Satomi Tanaka
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  6. Chieko Takumi
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  7. Noriya Hiraoka
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  8. Yuri Ogura
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  9. Takayuki Takeda
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  10. Keisuke Onoi
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  11. Yusuke Chihara
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  12. Ryusuke Taniguchi
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  13. Takahiro Yamada
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  14. Yohei Matsui
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  15. Osamu Hiranuma
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  16. Yoshie Morimoto
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  17. Masahiro Iwasaku
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  18. Yoshiko Kaneko
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  19. Junji Uchino
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  20. Koichi Takayama
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Contributions

Kenji Morimoto, Tadaaki Yamada, and Koichi Takayama contributed to the conception and design. Kenji Morimoto, Ryota Nakamura, Yuki Katayama, Satomi Tanaka, Chieko Takumi, Noriya Hiraoka, Yuri Ogura, Takayuki Takeda, Keisuke Onoi, Yusuke Chihara, Ryusuke Taniguchi, Takahiro Yamada, Yohei Matsui, and Osamu Hiranuma obtained the clinical data. Data were interpreted by Kenji Morimoto, Tadaaki Yamada, Yoshie Morimoto, Masahiro Iwasaku, Yoshiko Kaneko, Junji Uchino, and Koichi Takayama. The first draft of the manuscript was prepared by Kenji Morimoto and Tadaaki Yamada and all authors commented on previous versions of the manuscript. The final version of the manuscript was read and approved by all the authors.

Corresponding author

Correspondence to Tadaaki Yamada.

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Conflict of interest

All authors declared that they have no conflict of interest.

Ethical approval

The study protocol was approved by the ethics committees of each hospital, including Kyoto Prefectural University of Medicine (Approval no. ERB-C-1803). Informed consent was waived and official website was used as an opt-out method, which was approved by the Ethics Committee of each hospital.

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Morimoto, K., Yamada, T., Nakamura, R. et al. Impact of preexisting antinuclear antibodies on combined immunotherapy and chemotherapy in advanced non-small cell lung cancer patients. Med Oncol 37, 111 (2020). https://doi.org/10.1007/s12032-020-01440-3

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  • DOI: https://doi.org/10.1007/s12032-020-01440-3

Keywords

  • Antinuclear antibodies
  • Non-small cell lung cancer
  • Combinatorial immunotherapy and chemotherapy
  • Retrospective analysis
  • Immune-related adverse event