The significance of inflammatory markers in prognosticating the effectiveness and safety of immunotherapy in conjunction with chemotherapy during the primary intervention of advanced non-small cell lung carcinoma

Zhen Wang; Xiaoxue Li; Jiahong Chen; Yin Hua; Xiaoqiang Zhong; Chunhui Tang; Sumin Gong; Ling Yang

doi:10.1016/j.lungcan.2024.107817

The significance of inflammatory markers in prognosticating the effectiveness and safety of immunotherapy in conjunction with chemotherapy during the primary intervention of advanced non-small cell lung carcinoma

Lung Cancer. 2024 May 9:192:107817. doi: 10.1016/j.lungcan.2024.107817. Online ahead of print.

Authors

Zhen Wang¹, Xiaoxue Li¹, Jiahong Chen², Yin Hua¹, Xiaoqiang Zhong³, Chunhui Tang¹, Sumin Gong¹, Ling Yang⁴

Affiliations

¹ Department of Oncology, Nanjing Medical University, Qingdao Municipal Hospital, Nanjing, Jiangsu Province 211166, China.
² Department of Otolaryngology, Qingdao Women and Children's Hospital, Qingdao, Shandong Province 266000, China.
³ Department of Emergency Medicine, Chuanbei Medical College, Zigong City Third People's Hospital, Zigong, Sichuan Province 643020, China.
⁴ Department of Oncology, Nanjing Medical University, Qingdao Municipal Hospital, Nanjing, Jiangsu Province 211166, China. Electronic address: yling19861@163.com.

PMID: 38735177
DOI: 10.1016/j.lungcan.2024.107817

Abstract

Objective: The aim of this study is to scrutinize the prognostic significance of inflammatory biomarkers concerning the effectiveness and safety of combining PD-1 inhibition with chemotherapy in the management of advanced NSCLC.

Methods: We conducted a retrospective analysis involving 206 NSCLC patients who received treatment at Qingdao Municipal Hospital. The study encompassed the acquisition of baseline clinical attributes and hematological parameters of these patients. The optimal threshold values for PLT and NLR were ascertained based on pre-treatment evaluations, with a particular focus on their association with PFS. Variables linked to PFS were subject to scrutiny through Kaplan-Meier analysis and logistic regression. The Receiver Operating Characteristic (ROC) curve served as the means to determine the ideal cut-off values for categorizing levels of inflammatory markers into high and low classifications. We employed Chi-square tests to evaluate the relationship between elevated and reduced baseline levels of inflammatory markers and irAE.

Results: Kaplan-Meier analysis disclosed that patients in the low baseline PLT group and the low NLR group exhibited a substantially more favorable prognosis in contrast to their counterparts in the high baseline PLT and high NLR groups. Multivariate analysis indicated that diminished baseline PLT and NLR levels before treatment independently foretell extended PFS. Chi-square analysis underscored a substantial correlation between baseline WBC, NEUT, LYMPH, MONO, and NLR levels and irAE.

Conclusion: Subdued baseline PLT and NLR levels may serve as indicators of a more auspicious prognosis in patients contending with advanced NSCLC undergoing the combination of PD-1 inhibition and chemotherapy. Elevated baseline levels of inflammatory markers antedating PD-1 therapy in advanced NSCLC may be intimately interrelated with the occurrence of irAE.

Keywords: Advanced non-small cell lung cancer; Immune-related adverse events; Inflammatory biomarkers; PD-1 inhibitors; Prognostication.