Jia Xiaohui, Zhang Yajuan, Liang Ting, Du Yonghao, Li Yanlin, Mao Ziyang, Xu Longwen, Shen Yuan, Liu Mengjie, Niu Gang, Guo Hui, Jiao Min
Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an 710061, Shaanxi, P. R. China.
Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an 710061, Shaanxi, P. R. China.
Am J Cancer Res. 2023 Jun 15;13(6):2681-2701. eCollection 2023.
Checkpoint inhibitor pneumonitis (CIP) is a common type of immune-related adverse events (irAEs) with poor clinical prognosis. Currently, there is a lack of effective biomarkers and predictive models to predict the occurrence of CIP. This study retrospectively enrolled 547 patients who received immunotherapy. The patients were divided into CIP cohorts of any grade, or grade ≥2 or ≥3. Multivariate logistic regression analysis was used to determine the independent risk factors, based on which we established Nomogram A and B for respectively predicting any grade or grade ≥2 CIP. For Nomogram A to predict any grade CIP, the C indexes in the training and validation cohorts were 0.827 (95% CI=0.772-0.881) and 0.860 (95% CI=0.741-0.918), respectively. Similarly, for Nomogram B to predict grade 2 or higher CIP, the C indexes of the training and validation cohorts were 0.873 (95% CI=0.826-0.921) and 0.904 (95% CI=0.804-0.973), respectively. In conclusion, the predictive power of nomograms A and B has proven satisfactory following internal and external verification. They are promising clinical tools that are convenient, visual, and personalized for assessing the risks of developing CIP.
检查点抑制剂肺炎(CIP)是一种常见的免疫相关不良事件(irAE),临床预后较差。目前,缺乏有效的生物标志物和预测模型来预测CIP的发生。本研究回顾性纳入了547例接受免疫治疗的患者。将患者分为任何级别的CIP队列,或2级及以上或3级及以上队列。采用多因素logistic回归分析确定独立危险因素,并据此建立了分别预测任何级别或2级及以上CIP的列线图A和B。对于预测任何级别CIP的列线图A,训练队列和验证队列中的C指数分别为0.827(95%CI=0.772-0.881)和0.860(95%CI=0.741-0.918)。同样,对于预测2级及以上CIP的列线图B,训练队列和验证队列中的C指数分别为0.873(95%CI=0.826-0.921)和0.904(95%CI=0.804-0.973)。总之,列线图A和B经内部和外部验证后,预测能力令人满意。它们是很有前景的临床工具,方便、直观且个性化,可用于评估发生CIP的风险。