Wu Yan, Li Dapeng, Wu Mengyao, Yang Ying, Shen Meng, Chen Kai
Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Front Oncol. 2022 Oct 13;12:1004663. doi: 10.3389/fonc.2022.1004663. eCollection 2022.
Immune-related adverse events (irAEs) have drawn a lot of attention lately as a result of the predominance of immunotherapy in advanced non-small cell lung cancer (NSCLC). However, the clinical evidence for irAEs in real life is limited. In this paper, the occurrence of irAEs in Chinese NSCLC patients was examined, and possible risk factors for the emergence of severe irAEs were discovered.
Our retrospective investigation assessed the occurrence of adverse events (AEs) and prognosis of 213 patients who received immunotherapy for NSCLC. Using univariate and multivariate logistic regression models, the association between clinicopathological traits and the incidence of severe irAEs was investigated. To assess the prognostic impact of irAEs, survival data was analyzed.
Among the 213 NSCLC patients, 122 (57.3%) had irAEs of any grade, and 38 (17.8%) had high-grade (grade 3-5) AEs. Baseline peripheral absolute eosinophil count (AEC) (HR 6.58, 95% CI: 1.5-28.8, P=0.012) was found to be an independent predictor of high-grade irAEs by multivariate analysis. The survival analysis revealed that patients with severe irAEs had worse OS (15.7 vs. 20.8 months, 95% CI: 11.6-19.8 vs. 16.0-25.5, P=0.026).
According to our findings, the peripheral absolute eosinophil count (AEC) is a reliable indicator of severe irAEs in NSCLC. Serious irAEs that occur in patients often reflect poor prognoses. In the future, high-grade irAEs should receive more attention.
由于免疫疗法在晚期非小细胞肺癌(NSCLC)中占主导地位,免疫相关不良事件(irAE)最近受到了广泛关注。然而,现实生活中irAE的临床证据有限。本文研究了中国NSCLC患者中irAE的发生情况,并发现了严重irAE出现的可能危险因素。
我们的回顾性研究评估了213例接受NSCLC免疫治疗患者的不良事件(AE)发生情况和预后。使用单因素和多因素逻辑回归模型,研究临床病理特征与严重irAE发生率之间的关联。为了评估irAE对预后的影响,对生存数据进行了分析。
在213例NSCLC患者中,122例(57.3%)发生了任何级别的irAE,38例(17.8%)发生了高级别(3 - 5级)AE。多因素分析发现,基线外周血绝对嗜酸性粒细胞计数(AEC)(HR 6.58,95%CI:1.5 - 28.8,P = 0.012)是高级别irAE的独立预测因素。生存分析显示,发生严重irAE的患者总生存期较差(15.7个月对20.8个月,95%CI:11.6 - 19.8对16.0 - 25.5,P = 0.026)。
根据我们的研究结果,外周血绝对嗜酸性粒细胞计数(AEC)是NSCLC中严重irAE的可靠指标。患者发生的严重irAE往往反映预后不良。未来,高级别irAE应受到更多关注。