Multicenter cohort study of early kinetics of CRP for cancer-agnostic prediction of therapy response and mortality in ICI-treated patients

A multicenter retrospective cohort study in Austria investigated the cancer-agnostic predictive value of early C reactive protein (CRP) kinetics for response and outcomes of palliative immune checkpoint inhibitor (ICI) treatment. Four different patterns of CRP kinetics in the first 3 months of ICI therapy were defined: all-normal CRP (at baseline and at 3 months consistently below upper level of normal 5 mg/l), CRP-response (decline of at least 30% between baseline and 3 months), CRP flare-response (CRP increase followed by decrease to at least 30% below baseline level), and CRP non-response. The ORR in these four groups was 41%, 38%, 31%, and 12%, respectively. Median PFS was 8.2 months, 6.1 months, 5.7 months, and 2.3 months, respectively (log-rank p<0.001). Median OS was 24.5 months, 16.1 months, 14.0 months, and 8.1 months, respectively (log-rank p <0.001). The associations remained significant in multivariable analysis, and were independent of cancer type. The authors conclude that early CRP kinetics represent a tumor-agnostic predictor of response and outcomes in patients with cancer receiving ICI therapy.xtagstartz/p>