ArticleFrontiers in immunology2025
Prognostic Significance of baseline systemic inflammation markers in PD-L1-negative advanced non-small cell lung cancer patients treated with the BRICS sequential regimen.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic significance of the C-reactive protein-to-lymphocyte ratio in patients with cancers.Frontiers in oncology · 2026Pooled it
- Peripheral blood biomarkers in PD-1/PD-L1 immunotherapy: distinguishing predictive from prognostic biomarkers.Frontiers in immunology · 2026Review
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6 authors.
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Abstract
Background: Non-small cell lung cancer (NSCLC) remains a leading cause of cancer mortality, with PD-L1-negative tumors exhibiting poor response to immune checkpoint inhibitors (ICIs) and chemotherapy. The multimodal BRICS regimen-integrating stereotactic body radiotherapy (SBRT), Methods: A retrospective analysis included 23 PD-L1-negative (TPS <1%), EGFR/ALK wild-type advanced NSCLC patients treated with BRICS (2018-2024). Pretreatment markers (e.g., CLR, LDH) were assessed from blood samples. The sequential regimen involved: (1) SBRT (24 Gy/3 fractions); (2) oral probiotics (6 g/day); (3) nab-paclitaxel (200 mg); and (4) anti-PD-1 antibody over six 21-day cycles. Primary endpoints were progression-free survival (PFS) and overall survival (OS), analyzed via Cox regression and Kaplan-Meier curves. Results: Efficacy outcomes were robust: objective response rate 74.0%, disease control rate 95.7%, median PFS 16.0 months (95% CI: 9.11-22.89), and median OS 32.7 months (95% CI: 11.53-53.87). Univariate analysis showed elevated CLR predicted increased progression risk (HR = 2.907, p=0.04) and death risk (HR = 2.995, p=0.049), while high LDH correlated with worse PFS (HR = 3.448, p=0.013) and OS (HR = 3.016, p=0.041). Subgroup stratification confirmed shorter median PFS (7.10 vs. 20.0 months, p=0.008) and OS (9.20 vs. 36.20 months, p=0.031) for high LDH (≥250 U/L), and reduced PFS (14.20 vs. 19.10 months, p=0.032) and OS (17.70 vs. 36.20 months, p=0.038) for high CLR (≥10). Conclusion: Baseline CLR and LDH are independent prognostic biomarkers for PD-L1-negative NSCLC patients receiving BRICS, reflecting systemic inflammation that may limit efficacy. These markers could optimize patient stratification and guide personalized therapy.
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