Is C-reactive protein associated with survival in patients with non-small cell lung cancer treated with atezolizumab?

This study was carried out to see whether a reduction in inflammatory marker C-reactive protein (CRP) following treatment with atezolizumab (Tecentriq) is associated with an improved survival in patients with non-small cell lung cancer (NSCLC). The authors found that a lower CRP following treatment was associated with improved survival in these patients. 

NSCLC is a common form of lung cancer. It is responsible for around 85% of all lung cancer cases worldwide. Despite advances in treatments, NSCLC has a high mortality rate.

Atezolizumab is an immunotherapy. It targets an immune protein PD-L1. This leads to the activation of the immune system so it can attack and kill cancer cells. CRP is a protein that increases when there is inflammation in the body. CRP can be increased in cancers such as NSCLC. The role of CRP as an indicator of survival in patients with NSCLC receiving atezolizumab is not known. 

This study evaluated patients with NSCLC in 2 other clinical trials that were treated with atezolizumab or docetaxel (Taxotere) chemotherapy. Blood samples were taken from patients prior to treatment and every 3-weeks after treatment to evaluate CRP levels. 

Patients who experienced a complete or partial response to atezolizumab had a reduction in CRP levels after 6 weeks compared to levels before treatment. On the other hand, patients who had disease progression on atezolizumab treatment had an increase in CRP levels compared to before treatment.

28% of patients treated with atezolizumab showed a decrease of CRP by 1.5 times at 6 weeks. Compared to patients treated with docetaxel, those treated with atezolizumab who had a decrease in CRP levels after 6 weeks had an increase in survival without cancer progression. Patients treated with atezolizumab who had CRP level reductions also had improved overall survival. 

The authors found that a decrease of CRP levels at 6 weeks after treatment with atezolizumab was associated with improved survival in patients with NSCLC.

Genentech, the manufacturer of atezolizumab, provided support to the authors of this study.