Clinical observation of detection of immune checkpoint inhibitors by peripheral blood markers in the treatment of immune-related toxicity risk in non-small cell lung cancer
Objective To explore the clinical significance of immune checkpoint inhibitors(ICIs)recognized by peripheral blood markers in the treatment of advanced non-small cell lung cancer(NSCLC)with immune related toxicity(irAE)risk.Methods A retrospective analysis was conducted on 195 patients with advanced NSCLC who received ICIs at the Affiliated Hospital of Youjiang University for Nationalities from August 2018 to April 2023.Follow up was conducted and irAE was recorded.Compare the relationship between irAE and clinical pathological characteristics of patients.Kaplan Meier was used to plot the progression free survival(PFS)survival curve,and log rank tests were performed for survival differences.Using a logistic multiple factor regression model to analyze the factors affecting irAE.Evaluate the diagnostic efficacy of peripheral blood biomarkers for irAE using receiver operating characteristic(ROC)curves.Use R software to create a column chart.The median follow-up time for all patients was 7.91 months(1.0-45.63 months),and the median dosing cycle for ICIs was 4(1-49)cycles.57 patients experienced irAE,mainly including pneumonia,diarrhea,elevated lipase/amylase levels,and skin reactions.The baseline NLR,PLR,MLR,and LDH levels in patients with irAE were higher than those in patients without irAE(P<0.001).Compared with patients without irAE,patients with irAE had a higher ORR(47.37%vs.25.36%;P=0.003).The median PFS of patients without irAE(313 days,95%CI:242-383 days)was slightly longer than that of patients with irAE(235 days,95%CI:199-270 days),and the difference was not statistically significant(P=0.144).Logistic multiple regression analysis showed that NLR,PLR,and ICIs treatment were independent factors affecting irAE(P<0.05).The C-index of the training queue and the validation queue are close,with values of 0.71 and 0.75,respectively.The high fitting degree of the calibration curve confirms that the column chart has a high predictive value.Conclusion Baseline NLR,PLR,and multi line treatment ICIs may be factors affecting irAE in advanced NSCLC patients.
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