|Table of Contents|

Analysis of the correlation between immune checkpoint inhibitor pneumonia and immunotherapeutic efficacy in non-small cell lung cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 18
Page:
3388-3394
Research Field:
Publishing date:

Info

Title:
Analysis of the correlation between immune checkpoint inhibitor pneumonia and immunotherapeutic efficacy in non-small cell lung cancer
Author(s):
ZHANG Li1; 2; WANG Qiang3; HU Yan4; XIANG Zhuo3; GUO Yu3; BI Jingwang3
1.Graduate School,Jinzhou Medical University,Liaoning Jinzhou 121001,China;2.Department of Oncology,the 960th Hospital of People's Liberation Army,Shandong Jinan 250012,China;3.Oncology Department,Shandong Second Provincial General Hospital,Shandong Jinan 250023,China;4.Venous Configuration Center,Qingdao Women and Children's Hospital,Shandong Qingdao 266034,China.
Keywords:
non-small cell lung cancer; checkpoint inhibitor pneumonitis; peripheral blood markers; prognosisModern
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2023.18.010
Abstract:
Objective:To investigate the factors associated with the development of checkpoint inhibitor pneumonia (CIP) in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitor (ICIs) and determine the relevance of CIP and its associated factors to clinical outcomes in patients.Methods:Clinical data of patients with NSCLC who received ICIs treatment in the 960th Hospital of the PLA Joint Logistic Support Force and the Second People's Hospital of Shandong Province from September 1,2019 to September 1,2022 were retrospectively analyzed.The patients were divided into two groups:The group with CIP and the group without CIP,and then the patients with CIP were divided into two sub-groups:Low grade CIP and high grade CIP.Progression-free survival (PFS) and overall survival (OS) were measured by Kaplan-Meier method.Univariate and multivariate Cox proportional hazard regression models were used to analyze prognostic factors,and receiver operating curve (ROC) was used to determine the optimal cut-off value of peripheral blood circulation markers in the diagnosis of CIP.Results:A total of 34 patients (34/143,23.8%) who received ICIs developed CIP,with an extended progression-free survival (PFS) compared to non-CIP patients (18 vs 10 months,P=0.002),and no statistically significant difference in overall survival (OS) (24 vs 37 months,P=0.176).Subgroup analysis showed that low-grade CIP patients had longer PFS (22 vs 4 months,P＜0.001) and OS (27 vs 13 months,P=0.004) than high-grade CIP patients.The optimal thresholds for peripheral blood markers NPR,NLR,CRP and neutrophils to predict CIP were 0.018 (AUC=0.677),4.976 (AUC=0.651),8.800 (AUC=0.750) and 6.105 (AUC=0.640),respectively.Further analysis showed that high NLR was associated with lower OS (P=0.001).Conclusion:In patients with non-small cell lung cancer treated with ICIs,the occurrence of CIP is associated with clinical benefit.Patients with low-grade CIP show better clinical outcomes,and NPR,NLR,and neutrophils can be used as predictors of CIP.High NLR is associated with poor prognosis.

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