Association of baseline peripheral-blood eosinophil count with immune checkpoint inhibitor-related pneumonitis and clinical outcomes in patients with non-small cell lung cancer receiving immune checkpoint inhibitors
Association of baseline peripheral-blood eosinophil count with immune checkpoint inhibitor-related pneumonitis and clinical outcomes in patients with non-small cell lung cancer receiving immune checkpoint inhibitors
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基线外周血嗜酸性粒细胞计数与免疫检查点抑制剂相关肺炎以及接受免疫检查点抑制剂的非小细胞肺癌患者临床结果的关联。
DOI：
10.1016/j.lungcan.2020.08.015
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发表时间：
2020-12-01
期刊：
影响因子：
5.3
通讯作者：
Su, Chunxia
中科院分区：
文献类型：
--
作者：
Chu, Xiangling;Zhao, Jing;Su, Chunxia
目的：免疫检查点抑制剂（ICI）彻底改变了肿瘤治疗领域，但也伴随着免疫相关不良事件（irAE）。ICI相关肺炎（ICI-肺炎）是一种潜在致死性irAE。然而，与ICI-肺炎相关的风险因素仍不清楚。迫切需要使用可靠和可获得的参数来确定ICI-肺炎的风险因素。在这里，我们的目的是确定基线外周血生物标志物与ICI-肺炎和临床结果与晚期非小细胞肺癌（NSCLC）患者谁是治疗与ICIs.Materials和方法：我们进行了回顾性分析，符合条件的晚期NSCLC患者谁是治疗与ICI在我们的中心。采用受试者工作特征（ROC）曲线确定ICI-肺炎风险分析的最佳临界值。进行多因素logistic分析以确定ICI-肺炎的危险因素。结果：共纳入300例患者，其中54例（18%）发生ICI-肺炎。ICI-肺炎患者的基线外周血嗜酸性粒细胞绝对计数（AEC）水平高于无ICI-肺炎患者（P = 0.013）。基线外周血AEC预测ICI-肺炎的最佳阈值为0.125 × 10（9）个细胞/L。高AEC组（AEC >= 0.125 x 10（9）cells/L; 27.7%）的ICI-肺炎发生率高于低AEC组（AEC < 0.125 x 10（9）cells/L; 9.8%，P < 0.001）。此外，AEC高的患者（与低AEC患者相比）的客观缓解率（ORR）较高（40.9% vs 28.8%，P = 0.029）和更长的中位无进展生存期（PFS）（8.93个月对5.87个月，P = 0.038）。在接受ICI治疗的患者中，高AEC（>= 0.125 × 10（9）个细胞/L）的基线特征与ICI-肺炎风险增加相关，并且具有更好的临床结局。
Objectives: Immune checkpoint inhibitors (ICIs) have revolutionized the oncologic treatment landscape, but have been accompanied by immune-related adverse events (irAEs). ICI-related pneumonitis (ICI-pneumonitis) is a potentially fatal irAE. However, the risk factors associated with ICI-pneumonitis remain unclear. There is an urgent need to identify risk factors for ICI-pneumonitis using reliable and accessible parameters. Here, we aimed to identify baseline peripheral-blood biomarkers correlated with ICI-pneumonitis and clinical outcomes in patients with advanced non-small cell lung cancer (NSCLC) who were treated with ICIs.Materials and Methods: We conducted a retrospective analysis of eligible patients with advanced NSCLC who were treated with ICIs at our center. Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value for analyzing risk of ICI-pneumonitis. Multivariate logistic analysis was performed to identify risk factors of ICI-pneumonitis. Clinical characteristics and treatment outcomes were collected and compared according to the optimal cutoff value.Results: A total of 300 patients were included, in which 54 patients (18 %) experienced ICI-pneumonitis. Patients with ICI-pneumonitis had a high level of baseline peripheral-blood absolute eosinophil count (AEC) than those without ICI-pneumonitis (P = 0.013). The optimal threshold of baseline peripheral-blood AEC to predict ICI-pneumonitis was 0.125 x 10(9) cells/L. The incidence of ICI-pneumonitis was higher in the high-AEC group (AEC >= 0.125 x 10(9) cells/L; 27.7 %) than in the low-AEC group (AEC < 0.125 x 10(9) cells/L; 9.8 %, P < 0.001). Moreover, patients with high AEC (compared with those with low AEC) had a higher objective response rate (ORR) (40.9 % versus 28.8 %, P = 0.029) and longer median progression-free survival (PFS) (8.93 months versus 5.87 months, P = 0.038).Conclusions: Among patients treated with ICIs, a baseline feature of high AEC (>= 0.125 x 10(9) cells/L) was associated with an increasing risk of ICI-pneumonitis, and with a better clinical outcome.