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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Friday, January 3, 2025
Higher blood sodium levels were associated with longer progression-free survival and overall survival among patients with non–small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors as a first-line treatment, according to a recent study published in Scientific Reports by Giandomenico Roviello, MD, PhD, of the University of Florence, Italy, and colleagues. The study points to the possibility of including sodium levels in patients’ risk assessments.
“Higher sodium levels may constitute a crucial factor linked to improved survival outcomes in NSCLC patients undergoing immunotherapy,” the investigators commented.
The retrospective study included 88 patients at the Medical Oncology Center of Florence with a median age of 71 years, 65% of whom were male. Patients received pembrolizumab or atezolizumab (both PD-1 inhibitors) as a first-line treatment, and their blood sodium levels were measured at baseline. All but two had blood sodium levels within the normal range of 135 mEq/L to 145 mEq/L.
The authors found that median progression-free survival was 7.0 months for patients with baseline blood sodium levels of 140 mEq/L and above, compared with 2.1 months for those with blood sodium levels less than 140 mEq/L (P < .01). Median overall survival was also greater for the group of patients with higher baseline blood sodium levels: 15.6 months compared with 6.8 months for patients with lower baseline blood sodium levels (P = .02). In a multivariate analysis, blood sodium levels of 140 mEq/L and above were significantly associated with progression-free survival (P = .01) and overall survival (P = .04).
Of note, the study lacked comprehensive information on patients’ comorbidities and other medications, such as antihypertension treatment. And further investigations are necessary to validate these findings.
Disclosure: The study authors reported no conflicts of interest.
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