非小细胞肺癌患者免疫相关不良事件与患者疗效和预后的相关性

Correlation of Immune-Related Adverse Events with Prognosis and Efficacy in Patients with Non-small Cell Lung Cancer

目的分析非小细胞肺癌(NSCLC)患者免疫相关不良事件(irAEs)与患者疗效和预后的相关性。方法回顾性分析2019年5月至2022年5月在南阳南石医院接受免疫检查点抑制剂(ICI)治疗的96例NSCLC患者临床资料,比较发生irAEs和未发生irAEs患者的客观缓解率(ORR)和疾病控制率(DCR)、无进展生存期(PFS)和总生存期(OS)。应用单变量和多变量Cox比例风险模型分析PFS和OS相关的预后因素。将发生irAEs的患者分为多重irAEs组和单一irAEs组,分析两组对ICI应答及PFS和OS。结果31例患者出现irAEs,irAEs患者ORR、DCR、PFS、OS优于非irAEs患者(P<0.05)。多变量分析显示,ECOG评分(0~1分)、发生irAEs是PFS、OS的独立保护因素(P<0.05)。多重irAEs患者应答率高于单一irAEs患者(P<0.05)。结论irAEs的发生与接受ICI治疗的NSCLC患者的临床获益相关;尤其是多重irAEs,是NSCLC患者ICI治疗效率更高、预后更好的潜在性标志物。

Objective To analyze the correlation of immune-related adverse events(irAEs)with prognosis and efficacy in patients with non-small cell lung cancer(NSCLC).Methods The clinical data of 96 patients with NSCLC who received immune checkpoint inhibitor(ICI)treatment in Nanyang Nanshi Hospital from May 2019 to May 2022 were retrospectively analyzed,and the clinical data of patients with irAEs and those without irAEs were compared.Response rate(ORR)and disease control rate(DCR),progression-free survival(PFS)and overall survival(OS)were compared in patients with and without irAEs.Univariate and multivariate Cox proportional hazards models were used to analyze prognostic factors associated with PFS and OS.The patients with irAEs were divided into multiple irAEs group and single irAEs group,and their response to ICI,PFS and OS were analyzed.Results irAEs occurred in 31 patients.The ORR,DCR,PFS and OS of patients with irAEs were better than those of patients without irAEs(P<0.05).Multivariate analysis showed that ECOG score(0-1)and the occurrence of irAEs were independent favorable factors of PFS and OS(P<0.05).The response rate of patients with multiple irAEs was higher than that of patients with single irAEs(P<0.05).Conclusion The occurrence of irAEs is associated with the clinical benefit of NSCLC patients treated with ICI.In particular,multiple irAEs are potential markers for higher efficiency of ICI therapy and better prognosis in NSCLC patients.