Ersoy Mustafa
Department of Internal Medicine, Faculty of Medicine, Kütahya Health Sciences University, Kutahya, Turkey.
Clin Med Insights Oncol. 2025 Sep 11;19:11795549251371094. doi: 10.1177/11795549251371094. eCollection 2025.
In non-small cell lung cancer (NSCLC) treatment, immunotherapy has become the standard therapy when platinum-based chemotherapy is ineffective, in the absence of a targetable mutation. However, a significant proportion of patients do not benefit from this treatment, underscoring the critical need for predictive biomarkers. This study aims to investigate the potential predictive role of immature granulocytes in response to nivolumab treatment, which can be used as a second-line therapy independent of programmed death ligand 1 (PDL-1) expression and other markers. Furthermore, the study seeks to determine whether there is a difference in the treatment response of immature granulocytes between the 2 main subtypes of NSCLC: lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD).
This retrospective study enrolled 50 patients with NSCLC who underwent treatment at the Kütahya Health Sciences University Evliya Çelebi Education and Research Hospital and Kütahya City Hospital between January 2021 and January 2025. The study examined the difference between patients' baseline immature granulocyte levels and their initial response to treatment, as assessed by positron emission tomography-computed tomography.
The study found a statistically significant association between higher baseline immature granulocyte levels and poorer treatment response. Subgroup analysis by lung cancer subtype revealed that the difference was more prominent in the LUSCs group.
Immature granulocytes may predict response to nivolumab treatment in NSCLC patients, particularly in the LUSCs subgroup. Based on the findings of this study, immature granulocytes and other neutrophil-dependent inflammatory markers could serve as potential predictors of immunotherapy response and provide insights into the mechanisms of immunotherapy resistance, warranting further investigation. Our study may also encourage future research to look for separate markers for LUSCs and LUADs, given the continued critical need for predictive markers in this field.
在非小细胞肺癌（NSCLC）治疗中，当铂类化疗无效且不存在可靶向突变时，免疫疗法已成为标准疗法。然而，相当一部分患者无法从这种治疗中获益，这凸显了对预测性生物标志物的迫切需求。本研究旨在探讨未成熟粒细胞在纳武单抗治疗反应中的潜在预测作用，纳武单抗可作为独立于程序性死亡配体1（PDL-1）表达及其他标志物的二线治疗药物。此外，该研究旨在确定NSCLC的两种主要亚型——肺鳞状细胞癌（LUSC）和肺腺癌（LUAD）——之间未成熟粒细胞的治疗反应是否存在差异。
这项回顾性研究纳入了2021年1月至2025年1月期间在屈塔希亚健康科学大学埃夫利亚·切莱比教育与研究医院和屈塔希亚市医院接受治疗的50例NSCLC患者。该研究通过正电子发射断层扫描-计算机断层扫描评估患者基线未成熟粒细胞水平与其初始治疗反应之间的差异。
研究发现，较高的基线未成熟粒细胞水平与较差的治疗反应之间存在统计学上的显著关联。按肺癌亚型进行的亚组分析显示，这种差异在LUSC组中更为突出。
未成熟粒细胞可能预测NSCLC患者对纳武单抗治疗的反应，尤其是在LUSC亚组中。基于本研究的结果，未成熟粒细胞和其他中性粒细胞依赖性炎症标志物可作为免疫治疗反应的潜在预测指标，并为免疫治疗耐药机制提供见解，值得进一步研究。鉴于该领域对预测性标志物的持续迫切需求，我们的研究也可能鼓励未来的研究寻找LUSC和LUAD各自的标志物。
