Predictive Significance Of NGAL,dNLR And LDH In Non-small Cell Lung Cancer Treated By Camrelizumab Combined With Apatinib Mesylate

Purpose:Camrelizumab(SHR-1210)is an IgG4k humanized antibody targeting programmed death-1(PD-1).Anti-vascular endothelial growth factor(VEGF)drugs are frequently combined with other therapy,and often complicated by mild proteinuria and hypertension.In this study,we have evaluated the efficacy of Neutrophil gelatinase-associated lipocalin(NGAL)and collected derived neutrophils/(leukoeytes minus neutrophils)ratio(dNLR)and lactate dehydrogenase(LDH)as bianarkers predict NSCLC response to Camrelizumab combined with anti-VEGF drug Apatinib Mesylate therapy to enable early assessment of therapy efficacy.Experimental Design:Serum were collected from 28 NSCLC patients.Enzyme linked immunosorbent assay(ELISA)was used to characterize the presence of NGAL,and collected the result of dNLR and LDH.Longitudinal varieties in NGAL,dNLR and LDH levels were compared with varieties in radiographic tumor size in 28 NSCLC patients receiving Camrelizumab combined with Apatinib.The relationship between serum NGAL,dNLR and LDH levels and various stages of NSCLC was analyzed.Results:Of the 28 NSCLC cancer patients who received Camrelizumab combined with anti-VEGF drug Apatinib,2 patients with no follow-up were excluded,4 patients had partial response,15 patients were stable disease,and 7 patients had progressive disease.Compared with before treatment,the serum levels of NGAL in the partial response group and the stable disease group were increase more than those in the progressive disease group,the serum levels of dNLR and LDH in the partial response group and the stable disease group were lower than those in the progressive disease group,and the P value is statistically different.Conclusion:The serum levels of NGAL,dNLR and LDH were the predictors of the efficacy of Camrelizumab combined with Apatinib in the treatment of non-small cell lung cancer.The increase in NGAL was positively correlated with the efficacy,and the overexpression in dNLR and LDH was negatively correlated with efficacy.Patients with NGAL increased,dNLR and LDH low expression have better therapeutic effects.These predictors can be used as clinical biomarkers to provide a reference for the clinical evaluation of non-small cell lung cancer patients receiving Camrelizumab combined with Apatinib.