Serum PCSK9 levels at the second nivolumab cycle predict overall survival in elderly patients with NSCLC: a pilot study

Aldo Bonaventura, Francesco Grossi, Federico Carbone, Alessandra Vecchié, Silvia Minetti, Nicholas Bardi, Edoardo Elia, Anna Maria Ansaldo, Daniele Ferrara, Erika Rijavec, Maria Giovanna Dal Bello, Giovanni Rossi, Federica Biello, Marco Tagliamento, Angela Alama, Simona Coco, Paolo Spallarossa, Franco Dallegri, Carlo Genova, Fabrizio Montecucco

Research output: Contribution to journalArticlepeer-review


Monoclonal antibodies targeting PD-1 are used for treating NSCLC. To date, proprotein convertase subtilisin/kexin type 9 (PCSK9) has been poorly investigated in the oncologic field. Here, we aimed at evaluating whether serum PCSK9 might represent a predictive factor for OS in older patients with advanced NSCLC under nivolumab treatment. Among 78 patients with advanced, pre-treated NSCLC previously enrolled in a prospective study at Ospedale Policlinico San Martino in Genoa (Italy), 44 patients have been included in this sub-analysis due to the availability of serum samples for the measurement of PCSK9. Before each nivolumab administration, clinical information and blood samples were collected. Median age was 71, with a prevalence of the male sex. The most represented histological type of lung cancer was adenocarcinoma. The majority of patients were former smokers (72.1%). Median PCSK9 levels were 123.59 (86.32-169.89) ng/mL and 117.17 (80.46-147.79) ng/mL at cycle 1 and 2, respectively. Based on a receiver operating characteristic curve analysis, a PCSK9 value at cycle 2 of 95 ng/mL was found as the best cutoff point for OS. Kaplan-Meier analysis demonstrated that patients below the PCSK9 cutoff (< 95 ng/mL) experienced a better OS, as confirmed by Cox proportional hazard regression analysis. In this pilot study, circulating levels of PCSK9 < 95 ng/mL at the time of the second cycle of nivolumab treatment could independently predict a better OS in elderly patients with advanced, pre-treated NSCLC. However, further studies are warranted to validate these preliminary results.

Original languageEnglish
Pages (from-to)1351-1358
Number of pages8
JournalCancer Immunology and Immunotherapy
Issue number8
Early online dateJul 20 2019
Publication statusPublished - 2019


Dive into the research topics of 'Serum PCSK9 levels at the second nivolumab cycle predict overall survival in elderly patients with NSCLC: a pilot study'. Together they form a unique fingerprint.

Cite this