Department of Oncology, Peking University International Hospital, Beijing, 102206, China.
Clin Exp Med. 2024 Mar 15;24(1):52. doi: 10.1007/s10238-024-01298-z.
Besides programmed death ligand 1 (PD-L1) expression, rapid, cost-effective and validated scores or models are critical for the prognosis and prediction of patients received immune checkpoint inhibitors (ICIs). In this retrospective study, 182 patients with NSCLC receiving ICIs from 2015 to 2022 were divided 1:1 into a training cohort and a validation cohort. We identified a score established by three factors and analyzed the prognostic implications by Kaplan-Meier approach (Log rank test) and time-dependent receiver operating characteristic (ROC) analyses. A non-tumor-related score (NTRS) was established that could be used as a prognostic factor (HR 2.260, 95% CI 1.559-3.276, P < 0.001 in training cohort; HR 2.114, 95% CI 1.493-2.994, P < 0.001 in validation cohort) and had a high time-dependent ROC for overall survival (OS) (AUC 0.670-0.782 in training cohort; AUC 0.682-0.841 in validation cohort). PD-L1 (1-49%) and NTRS (score = 0, 1, 2, 3) combination significantly improved the assessment of patients' OS and progress-free survival (PFS), which was statistically different in training cohorts (P < 0.001 for OS, 0.012 for PFS) and validation cohorts (P = 0.01 for OS, < 0.001 for PFS). The NTRS provided a better assessment of durable clinical benefit (DCB) compared to PD-L1 expression (P = 0.009 vs. 0.232 in training cohort; P = 0.004 vs. 0.434 in validation cohort). NTRS may help improve prognosis stratification of patients receiving ICIs in first-line NSCLC and may be combined with tumor-related parameters.
除程序性死亡配体 1（PD-L1）表达外，快速、经济且有效的评分或模型对于接受免疫检查点抑制剂（ICI）治疗的患者的预后和预测至关重要。在这项回顾性研究中，我们将 2015 年至 2022 年期间接受 ICI 治疗的 182 例 NSCLC 患者按 1:1 分为训练队列和验证队列。我们确定了一个由三个因素建立的评分，并通过 Kaplan-Meier 方法（对数秩检验）和时间依赖性接收者操作特征（ROC）分析来分析其预后意义。建立了一个与肿瘤无关的评分（NTRS），可以作为预后因素（训练队列中的 HR 2.260，95%CI 1.559-3.276，P<0.001；验证队列中的 HR 2.114，95%CI 1.493-2.994，P<0.001），并且对总生存（OS）具有较高的时间依赖性 ROC（训练队列中的 AUC 0.670-0.782；验证队列中的 AUC 0.682-0.841）。PD-L1（1-49%）和 NTRS（评分=0、1、2、3）组合显著改善了患者 OS 和无进展生存（PFS）的评估，在训练队列中具有统计学差异（OS 为 P<0.001，PFS 为 0.012）和验证队列（OS 为 P=0.01，PFS 为<0.001）。与 PD-L1 表达相比，NTRS 提供了对持久临床获益（DCB）更好的评估（训练队列中 P=0.009 与 0.232；验证队列中 P=0.004 与 0.434）。NTRS 可能有助于改善一线 NSCLC 患者接受 ICI 治疗的预后分层，并且可以与肿瘤相关参数相结合。
