ArticleJournal for immunotherapy of cancer2023
Early kinetics of C reactive protein for cancer-agnostic prediction of therapy response and mortality in patients treated with immune checkpoint inhibitors: a multicenter cohort study.
Article in Journal for immunotherapy of cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Biomarker endpoints in cancer cachexia clinical trials: Systematic Review 5 of the cachexia endpoint series.Journal of cachexia, sarcopenia and muscle · 2024Pooled it
- C-reactive protein (CRP) as a prognostic biomarker in patients with urothelial carcinoma: A systematic review and meta-analysis.Critical reviews in oncology/hematology · 2024Pooled it
- Radiotherapy-induced abscopal effects in immune checkpoint inhibitor-refractory metastatic disease: results from a large multicenter real-world cohort study.Oncoimmunology · 2026Article
- Observational
- One-Week Inflammatory Kinetics After First-Line Nivolumab Plus Ipilimumab in Metastatic Renal Cell Carcinoma: A Multicenter Landmark Analysis.Targeted oncology · 2026Article
- Systemic Inflammation and Risk of Thromboembolism, Mortality, and Treatment Response in Patients With Cancer Receiving Immune Checkpoint Inhibitors.European journal of clinical investigation · 2026Article
- Assessment of Meet-URO and CANLPH Prognostic Models in Metastatic RCC: Insights from a Single-Institution Cohort Predominantly Treated with TKIs.Diagnostics (Basel, Switzerland) · 2026Article
- C-Reactive Protein Kinetics as Prognostic Biomarkers in Stage IV-Melanoma Treated With Immune Checkpoint Inhibitors in the Japanese Population: A Single-Center, Retrospective Cohort Study.The Journal of dermatology · 2026Article
- Integrating C-reactive protein flare and early MRI dynamics for enhanced prediction of immunotherapy response.Journal for immunotherapy of cancer · 2025Article
- Pre-treatment C-reactive protein level is a prognostic marker of patients treated with immune checkpoint inhibitors for renal cell carcinoma: a systematic review and meta-analysis.Translational andrology and urology · 2025Article
- Blood-Based Inflammatory Markers Are Associated with Treatment Outcomes in Head and Neck Squamous Cell Carcinoma Receiving Anti-PD-1 Therapy: CRP as a Superior Predictive Marker.International journal of molecular sciences · 2025Article
- The efficacy and peripheral blood predictors in recurrent platinum-resistant ovarian cancer patients treated with immune checkpoint inhibitors.Journal of ovarian research · 2025Article
- CRAFITY score and nomogram predict the clinical efficacy of lenvatinib combined with immune checkpoint inhibitors in hepatocellular carcinoma.World journal of gastroenterology · 2025Article
- Association between emotional distress and the efficacy of advanced gastric cancer patients undergoing treatment with immune checkpoint inhibitors: a cohort study and propensity score matching study.Frontiers in oncology · 2025Article
- Optimizing early-phase immunotherapy trials: the role of biomarker enrichment strategies.Frontiers in immunology · 2025Review
- Targeted anti-cancer agents and risk of venous thromboembolism.Haematologica · 2024Review
- Early Change in C-Reactive Protein and Venous Thromboembolism in Patients Treated With Immune Checkpoint Inhibitors.JACC. CardioOncology · 2024Article
Corrections and comments
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Authors and funding
23 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundC reactive protein (CRP) kinetics have recently been suggested as predictive biomarkers for the efficacy of immune checkpoint inhibitor (ICI) therapy in selected cancer types. The aim of this study was to characterize early CRP kinetics as a tumor-agnostic biomarker for ICI treatment outcomes.
methodsIn this multicenter retrospective cohort study, two independent cohorts of patients with various cancer types undergoing palliative ICI treatment at Austrian academic centers served as the discovery (n=562) and validation cohort (n=474). Four different patterns of CRP kinetics in the first 3 months of ICI therapy were defined (CRP-flare responders, CRP-responders, CRP non-responders, patients with all-normal CRP). Objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) were defined as coprimary endpoints. Univariable and multivariable logistic regression, landmark analysis and Cox regression including CRP kinetics as time-dependent variable were performed.
resultsThe ORR in patients with all-normal CRP, CRP responders, CRP flare-responders and CRP non-responders was 41%, 38%, 31% and 12%, respectively. The median OS and PFS estimates were 24.5 months (95% CI 18.5 to not reached) and 8.2 months (95% CI 5.9 to 12.0) in patients with all-normal CRP, 16.1 months (95% CI 12.6 to 19-8) and 6.1 months (95% CI 4.9 to 7.2) in CRP-responders, 14.0 months (95% CI 8.5 to 19.4) and 5.7 months (95% CI 4.1 to 8.5) in CRP flare-responders and 8.1 months (95% CI 5.8 to 9.9) and 2.3 months (95% CI 2.2 to 2.8) in CRP non-responders (log-rank p for PFS and OS<0.001). These findings prevailed in multivariable analysis and could be fully confirmed in our validation cohort. Pooled subgroup analysis suggested a consistent predictive significance of early CRP kinetics for treatment efficacy and outcome independent of cancer type.
conclusionEarly CRP kinetics represent a tumor-agnostic predictor for treatment response, progression risk and mortality in patients with cancer undergoing ICI therapy.
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