Immune-inflammatory markers and clinical characteristics as predictors of the depth of response and prognosis of patients with PD-L1 ≥50% metastatic non-small cell lung cancer receiving first-line immunotherapy.

IF 2.3 3区医学 Q3 ONCOLOGY Thoracic Cancer Pub Date : 2024-10-01 Epub Date: 2024-08-27 DOI:10.1111/1759-7714.15406

Xixi Zheng, Lili Zhou, Hui Shi, Juan An, Weiran Xu, Xiaosheng Ding, Yichun Hua, Weiwei Shi, Xiaoyan Li

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Abstract

Background: Patients with programmed cell death-ligand 1 (PD-L1) ≥50% metastatic non-small cell lung cancer (NSCLC) treated with first-line immunotherapy showed heterogeneous tumor responses. In this study, we investigated the clinical and immune-inflammatory markers distinguishing patients with metastatic NSCLC achieving high depth of tumor response (HDPR) from those with non-high depth of response (NHDPR). The impact of clinical features on the prognosis of patients with PD-L1 ≥50% were further clarified.

Methods: The clinical characteristics and immune-inflammatory markers of 17 patients with PD-L1 ≥50% metastatic NSCLC at Beijing Tiantan Hospital between July 2020 and December 2023 were retrospectively analyzed.

Results: Among the 17 patients, seven (41.2%) patients achieved HDPR (range: -50%, -72%) and 10 (58.8%) patients achieved NHDPR (range: -13%, -45%). Below normal CD4 + T lymphocytes/CD8 + T lymphocytes (CD4/CD8) ratio (p = 0.01) and oncogenes and/or tumor suppressor gene mutations (TP53/KRAS/EGFR) (p = 0.001) were found enriched for NHDPR compared with HDPR. With a median follow-up of 26.0 months (range: 17.2-34.8 months), the median progression-free survival (PFS) following first-line immunotherapy and overall survival (OS) were 9.0 months (95% CI: 5.0-13.0) and not reached (NR), respectively. The neutrophil-to-lymphocyte ratio (NLR) was identified as an independent prognostic factor on first-line PFS. Patients with an NLR ≥4 exhibited a shorter median PFS (7.0 months vs. NR; p = 0.033; 95% CI: 1.2-80.2) than those with an NLR <4 following first-line immunotherapy.

Conclusions: Among patients with PD-L1 ≥50% metastatic NSCLC who received first-line immunotherapy, a lower CD4/CD8 ratio and the presence of genes mutations showed a diminished tumor response and a higher NLR ratio exhibited a worse median PFS.

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免疫炎症标记物和临床特征是预测接受一线免疫疗法的 PD-L1≥50% 转移性非小细胞肺癌患者反应深度和预后的指标。

背景：程序性细胞死亡配体1（PD-L1）≥50%的转移性非小细胞肺癌（NSCLC）患者在接受一线免疫疗法治疗后表现出不同的肿瘤反应。在这项研究中，我们研究了临床和免疫炎症标记物，以区分获得高深度肿瘤反应（HDPR）和非高深度反应（NHDPR）的转移性 NSCLC 患者。进一步阐明了临床特征对PD-L1≥50%患者预后的影响：方法：回顾性分析2020年7月至2023年12月期间北京天坛医院收治的17例PD-L1≥50%转移性NSCLC患者的临床特征和免疫炎症指标：17例患者中，7例（41.2%）达到HDPR（范围：-50%，-72%），10例（58.8%）达到NHDPR（范围：-13%，-45%）。与 HDPR 相比，NHDPR 患者的 CD4 + T 淋巴细胞/CD8 + T 淋巴细胞（CD4/CD8）比率低于正常水平（p = 0.01），且癌基因和/或抑癌基因突变（TP53/KRAS/EGFR）（p = 0.001）。中位随访时间为26.0个月（范围：17.2-34.8个月），一线免疫治疗后的中位无进展生存期（PFS）和总生存期（OS）分别为9.0个月（95% CI：5.0-13.0）和未达标（NR）。中性粒细胞与淋巴细胞比值（NLR）被认为是影响一线PFS的独立预后因素。NLR≥4的患者的中位PFS（7.0个月 vs. NR; p = 0.033; 95% CI: 1.2-80.2）比NLR结论的患者短：在接受一线免疫疗法的PD-L1≥50%的转移性NSCLC患者中，CD4/CD8比值越低、存在基因突变的患者肿瘤反应越弱，NLR比值越高的患者中位PFS越短。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.