Clinical significance of serum CXCL12 level in predicting immune checkpoint inhibitor response in patients with non-small cell lung cancer
Objective To investigate the predictive value of stromal cell derived factor 1(CXCL12)in treatment response of non-small cell lung cancer(NSCLC)patients treated with immune checkpoint inhibitors(ICIs).Methods A retrospective analysis was performed on 70 patients with stage Ⅲ B/Ⅳ unresectable NSCLC treated with ICIs in Daqing People's Hospital from January 2022 to December 2022,and ICIs response was assessed every 8 weeks.The efficacy was evaluated by Response Evaluationn Criteria in Solid Tumors(RECIST version,1.1)including complete response(CR),partial response(PR),stable disease(SD)and progressive disease(PD),and the objective response rate was calculated by CR+PR+SD.Clinical benefit was defined as CR,PR,or SD≥12 weeks;No clinical benefit was defined as PD or SD＜12 weeks.The serum CXCL12 levels were detected by enzyme-linked immunosorbent assay(ELISA)and the relationship between CXCL12 and treatment response was analyzed.The factors affecting objective mitigation and clinical benefit were analyzed by Logistics regression model.Baseline serum CXCL12 levels were analyzed using subject characteristic work curves to predict objective response and clinical benefit.Results According to ICIs treatment response,the patients were divided into objective remission group(46 cases),progress group(24 cases),clinical benefit group(35 cases)and clinical no benefit group(35 cases).The baseline serum CXCL12 levels in the objective response group and clinical benefit group were 1.38(1.16,2.17)ng/ml and 1.37(1.14,1.83)ng/ml,respectively,which were lower than the 2.71(1.94,3.06)ng/ml and 2.69(1.70,3.42)ng/ml in the progressive and clinical no benefit groups,the differences were statistically significant(P＜0.05).The serum CXCL12 level at baseline was only correlated with the stage(P＜0.05),but not with other clinicopathological parameters.Logistic regression model analysis showed that baseline serum CXCL12 was an independent factor affecting objective remission and clinical benefit in NSCLC patients(P＜0.05).Baseline serum CXCL12 had a good ability to predict objective response and clinical benefit,with sensitivity of 0.792,0.714,specificity of 0.717,0.800,and cutoff values of 1.880 ng/ml.Conclusion Serum CXCL12 level is a potential biomarker for predicting the benefit of ICIs treatment in patients with advanced NSCLC.
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