Qin Haoyue, Huang Zhe, Yan Huan, Song Lianxi, Zeng Liang, Xu Qinqin, Guo Wenhuan, Lin Shaoding, Jiang Wenjuan, Wang Zhan, Deng Li, Zhang Xing, Tong Fan, Zhang Ruiguang, Liu Zhaoyi, Zhang Lin, Dong Xiaorong, Yang Nong, Zhang Yongchang
Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China.
Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang 421001, Hunan, China.
iScience. 2024 Sep 10;27(10):110910. doi: 10.1016/j.isci.2024.110910. eCollection 2024 Oct 18.
This retrospective study demonstrated that patients with advanced non-small cell lung cancer who experienced any-grade or grade 1-2 immune-related adverse events (irAEs) with immune checkpoint inhibitor plus chemotherapy (ICI+Chemo) as first-line treatment regimen had significantly longer progression-free survival (PFS; < 0.001) and overall survival (OS; < 0.05) compared with patients without any irAE. Three variables were identified as predictors of favorable PFS and OS: absence of baseline brain metastasis ( < 0.05), receiving first-line ICI+Chemo ( < 0.01), and occurrence of any grade adverse events ( < 0.001). Using these three variables, two nomograms were generated to predict PFS and OS, which were validated using two independent cohorts treated with Chemo or ICI+Chemo ( = 161) or ICI monotherapy ( = 109). Patients with low scores in discovery and validation cohorts consistently had significantly longer PFS ( < 0.001) and OS ( < 0.05) than those with high scores. Our findings provide preliminary evidence of the clinical utility of a nomogram in prognosticating ICI-treated patients.
这项回顾性研究表明，与未发生任何免疫相关不良事件（irAE）的患者相比，接受免疫检查点抑制剂联合化疗（ICI+Chemo）作为一线治疗方案且发生任何级别或1-2级irAE的晚期非小细胞肺癌患者的无进展生存期（PFS；<0.001）和总生存期（OS；<0.05）显著更长。确定了三个变量作为PFS和OS良好的预测因素：无基线脑转移（<0.05）、接受一线ICI+Chemo（<0.01）以及发生任何级别的不良事件（<0.001）。利用这三个变量，生成了两个列线图来预测PFS和OS，并在接受化疗或ICI+Chemo（n=161）或ICI单药治疗（n=109）的两个独立队列中进行了验证。在发现和验证队列中得分较低的患者的PFS（<0.001）和OS（<0.05）始终显著长于得分较高的患者。我们的研究结果为列线图在预测ICI治疗患者预后方面的临床应用提供了初步证据。
