Clinical characteristics and risk factors for immune checkpoint inhibitor-related pneumonitis in lung cancer patients
Objective:To retrospectively analyze the clinical characteristics and risk factors of immune checkpoint inhibitor-related pneumonitis(CIP)in lung cancer patients.Methods:Lung cancer patients who were treated with immune checkpoint inhibitors(ICIs)in Jinling Hospital from July 2021 to December 2022 were selected for the study.They were divided into CIP group and non-CIP group according to whether or not CIP occurred.The receiver operating characteristic(ROC)curve determined the optimal cut-off value of continuous variables for predicting CIP in lung cancer patients.The risk factors for CIP in lung cancer patients were analyzed by multivariate Logistic re-gression.Multivariate Cox regression was used to analyze the factors affecting progression-free survival(PFS)in pa-tients with CIP.Results:Of the 307 lung cancer patients treated with ICIs included,38(12.38％)patients devel-oped CIP,and one of them experienced a CIP-related death.The results of multivariate Logistic regression analysis showed that chronic obstructive pulmonary disease,low baseline lymphocyte counts and high baseline eosinophil counts were independent risk factors for the development of CIP in lung cancer patients(P＜0.05).In patients with CIP,multivariate Cox regression showed that smoking history and severe CIP were influential factors for PFS(P＜0.05).Conclusion:Chronic obstructive pulmonary disease,low baseline lymphocyte counts and high baseline eo-sinophil counts are independently associated with an increased risk of CIP in patients with lung cancer.CIP patients with a history of smoking and high clonical grade have poor immunotherapy outcomes.
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