ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1596223
This article is part of the Research TopicAdvancing NSCLC Treatment: Overcoming Challenges in Immune Checkpoint Inhibitor TherapyView all 14 articles
Prognostic Analysis and Association of the Systemic Immune-Inflammatory Index with Immune Checkpoint Inhibitor Pneumonitis in Patients with Non-Small Cell Lung Cancer
Provisionally accepted
- Radiology, Jingzhou Hospital Affiliated to Yangtze University, China, China
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Objective: The Systemic Immune-Inflammatory Index (SII) is a comprehensive indicator reflecting immune response and disease burden. However, its significance in immune checkpoint inhibitorrelated pneumonitis (CIP) in cases of non-small cell lung cancer (NSCLC) remains poorly explored. This study evaluated the association between SII and the incidence, severity, and prognostic effects of CIP in NSCLC patients.A retrospective analysis involved 215 NSCLC patients receiving immune checkpoint inhibitor (ICI) therapy, of whom 35 developed CIP while 180 did not. Baseline clinical characteristics and dynamic changes in peripheral blood biochemical markers were analyzed. Risk factors associated with the onset and severity of CIP were assessed, along with the diagnostic application of the SII for CIP.Results: Multivariate logistic regression identified smoking history (odds ratio [OR]: 3.23; p = 0.01), pre-existing lung disease (OR: 3.36; p < 0.01), squamous cell carcinoma (OR: 2.39; p = 0.03), and combined ICI therapy (OR: 4.77; p < 0.01) as independent risk factors for CIP onset. SII was also identified as independently predictive of severe CIP (OR: 6.35; p = 0.04). Receiver operating characteristic (ROC) curves demonstrated that SII had moderate accuracy for diagnosing CIP (area under the curve [AUC]: 0.63) and high diagnostic accuracy for severe CIP (AUC: 0.81). Multivariate Cox regression also showed that severe CIP was substantially related to reduced overall survival (OS) relative to mild CIP (hazard ratio [HR]: 0.06, 95% confidence interval [CI]: 0.01-0.52; p = 0.01).The results suggested the potential of SII as an indicator for diagnosing the presence and severity of CIP. Elevated SII levels were independently associated with the development of severe CIP, which, in turn, emerged as a key prognostic factor influencing overall survival in affected patients.
Keywords: non-small-cell lung cancer, checkpoint inhibitor-associated pneumonitis, Systemic immune-inflammatory index, Neutrophil-to-lymphocyte ratio, severity
Received: 19 Mar 2025; Accepted: 30 May 2025.
Copyright: © 2025 Cai, Huang, Sun, Wu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuanyi Huang, Radiology, Jingzhou Hospital Affiliated to Yangtze University, China, China
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