AUTHOR=Liu Xiaoyu , Hao Na , Yang Shuangning , Li Jieyao , Wang Liping 

TITLE=Predictive factors and prognosis of immune checkpoint inhibitor-related pneumonitis in non-small cell lung cancer patients

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1145143

DOI=10.3389/fonc.2023.1145143

ISSN=2234-943X

ABSTRACT=Objective: To investigate the influencing factors and prognosis of immune checkpoint inhibitor-related pneumonitis (CIP) in advanced non-small cell lung cancer (NSCLC) patients during or after receiving immune checkpoint inhibitors. Methods: The clinical and laboratory indicator data of 222 advanced NSCLC patients treated with PD-1/PD-L1 inhibitors at the First Affiliated Hospital of Zhengzhou University between December 2017 and November 2021 were collected retrospectively. The patients were divided into a CIP group (n=41) and a non-CIP group (n=181) according to whether they developed CIP before the end of follow-up. Logistic regression was used to evaluate CIP risk factors, and Kaplan‒Meier curves were used to describe the overall survival (OS) of the two groups. The log-rank test was used to compare the survival of different groups. Results: There were 41 patients who developed CIP, and the incidence rate of CIP was 18.5%. Univariate and multivariate logistic regression analyses showed that low pretreatment hemoglobin (HB) and albumin (ALB) levels were independent risk factors for CIP. Univariate analysis suggested that history of chest radiotherapy was related to the incidence of CIP. The median OS of the CIP group and non-CIP were 15.63 months and 30.50 months (HR 95% CI 2.167(1.355, 3.463), P<0.05), respectively. Univariate and multivariate COX analyses suggested that a high NLR, a low ALB level and CIP development were independent prognostic factors for worse OS of advanced NSCLC patients treated with ICIs. Additionally, the early-onset and high-grade CIP were related to shorter OS in the subgroup. Conclusion: Lower pretreatment HB and ALB levels were independent risk factors for CIP. A high NLR, a low ALB level and CIP development were risk factors for the prognosis of advanced NSCLC patients treated with ICIs.