Beypınar İsmail, Urvay Semiha, Ürün Müslih, Erçek Berrak, Demir Hacer, Yıldız Canan, Araz Murat, Oruç Ahmet, Özilice Utku, Balçık Onur Yazdan
Department of Oncology, Alanya Alaaddin Keykubat University, Kestel, Merines Cd., Alanya, 07450, Antalya, Turkey.
Department of Medical Oncology, Kayseri Acıbadem Hospital, Kayseri, Turkey.
Eur J Clin Pharmacol. 2025 Apr;81(4):561-570. doi: 10.1007/s00228-025-03810-0. Epub 2025 Feb 19.
Although there are multiple treatment options, oncologists lack appropriate biomarkers for determining the efficacy and toxicity of immunotherapy. In this study, we aimed to use a combination of the clinical parameters of IMDC risk groups at the time of diagnosis to predict the effectiveness of immunotherapy.
This multicenter cross-sectional study retrospectively analyzed non-small cell lung cancer (NSCLC) patients receiving nivolumab for the prognostic effects of clinical factors, including the IMDC score.
Two hundred and five patients were enrolled in this study. There was no favorable group because the TTI was less than 1 year in the entire study group in the IMDC. The IMDC score and IMDC groups showed significant differences in PFS (p < 0.001; p < 0.001, respectively). Intermediate and poor-risk groups had PFS of 8 and 3 months PFS, respectively. The IMDC group showed a significant effect on OS (p = 0.002). The intermediate- and poor-risk groups had 12- and 4-month OS, respectively. The TTI risk factor excluded patient numbers in the favorable, intermediate, and poor risk groups were 47, 129, and 29, respectively, in the revised IMDC group (rIMDC). The prognostic effect of the rIMDC score and groups remained significant (p < 0.001 and p < 0.001, respectively). The classical IMDC had a significant effect on PFS in the multivariate analysis (p = 0.016). Also, rIMDC score in multivariate analysis resulted with significant effect on OS (p = 0.035).
To date, this is the first study to prove that the IMDC may be a valuable option for predicting both prognosis and treatment efficacy in NSCLC patients receiving especially second or further lines nivolumab treatment.
尽管存在多种治疗选择，但肿瘤学家缺乏用于确定免疫治疗疗效和毒性的合适生物标志物。在本研究中，我们旨在使用诊断时IMDC风险组的临床参数组合来预测免疫治疗的有效性。
这项多中心横断面研究回顾性分析了接受纳武单抗治疗的非小细胞肺癌（NSCLC）患者的临床因素（包括IMDC评分）的预后影响。
本研究共纳入255例患者。由于整个研究组在IMDC中的总治疗时间（TTI）小于1年，因此不存在有利组。IMDC评分和IMDC组在无进展生存期（PFS）方面显示出显著差异（分别为p < 0.001；p < 0.001）。中危组和低危组的PFS分别为8个月和3个月。IMDC组对总生存期（OS）有显著影响（p = 0.002）。中危组和低危组的OS分别为12个月和4个月。在修订后的IMDC组（rIMDC）中，排除TTI风险因素后的有利、中危和低危组患者数量分别为47、129和29例。rIMDC评分和组的预后影响仍然显著（分别为p < 0.001和p < 0.001）。经典IMDC在多变量分析中对PFS有显著影响（p = 0.016）。此外，rIMDC评分在多变量分析中对OS有显著影响（p = 0.035）。
迄今为止，这是第一项证明IMDC可能是预测接受尤其是二线或后续纳武单抗治疗的NSCLC患者预后和治疗疗效的有价值选择的研究。
