非小细胞肺癌患者免疫检查点抑制剂相关性肺炎与免疫检查点抑制剂疗效相关性分析OACSTPCD
Analysis of the relationship between checkpoint inhibitor-related pneumonitis and the efficacy of immune checkpoint inhibitor in patients with non-small cell lung cancer
目的:探讨免疫检查点抑制剂(ICI)治疗非小细胞肺癌(NSCLC)患者发生免疫检查点抑制剂相关性肺炎(CIP)的发生情况和免疫治疗疗效的关系,分析接受ICI治疗的NSCLC患者的预后相关因素.方法:回顾性分析2020年3月至2023年3月在新疆医科大学附属肿瘤医院接受ICI治疗145例NSCLC患者的临床资料,将患者分为CIP组和非CIP组,随后将发生CIP的患者分为轻度(1、2级)CIP和重度(3、4级)CIP两个亚组,通过Kaplan-Meier法比较生存曲线,分析CIP的发生及严重程度对于患者PFS及OS的影响.通过单因素及多因素COX风险比例回归模型分析与PFS和OS相关的预后因素.结果:145例患者中有26例患者出现CIP,发生率为17.93%,重度CIP发生率为3.45%.CIP组患者PFS明显长于非CIP组患者(12.3 vs 7.6个月,P<0.05),CIP组与非CIP组的OS比较差异无统计学意义(16.2 vs 15.8个月,P>0.05).亚组分析显示,轻度CIP和重度CIP相比,PFS(12.2 vs 12.9个月)及OS(16.1 vs 17.8个月)均无统计学意义(均P>0.05).多因素COX回归分析显示,CIP[HR=0.55,95%CI(0.33,0.90),P=0.02]、免疫疗程>6个[HR=0.51,95%CI(0.31,0.85),P=0.01]是影响患者PFS的有利预后因素,免疫疗程>6个[HR= 0.4,95%CI(0.18,0.88),P=0.02]是影响OS的有利预后因素.结论:CIP的发生率为17.93%,CIP的发生与PFS的延长密切相关.免疫疗程>6个是影响NSCLC患者PFS、OS的有利预后因素.
Objective:To investigate the relationship between the incidence of immune checkpoint inhibitor-associated pneumonia(CIP)and the efficacy of immunotherapy in non-small cell lung cancer(NSCLC)patients treated with immune checkpoint inhibitors(ICIs),and to explore the prognostic factors of patients receiving ICI treatment.Methods:The clinical and follow-up data of 145 NSCLC patients treated with ICIs in the Affiliated Cancer Hospital of Xinjiang Medical University from March 2020 to March 2023 were retrospectively analyzed.The patients were divided into CIP group and non-CIP group.The patients with CIP were sub-divided into mild(grade 1,2)and severe(grade 3,4)CIP subgroups.The effects of the occurrence and severity of CIP on the overall survival(OS)time and progression-free survival(PFS)time of the patients were analyzed by comparing the survival curve using Kaplan-Meier method.Univariate and multivariate COX proportional hazard regression models were used to analyze the prognostic factors associated with PFS and OS.Results:A total of 26 patients developed CIP,with an incidence rate of 17.93%(26/145),and the incidence of severe CIP was 3.4%.The PFS in CIP group was significantly longer than that in non-CIP group(12.3 vs 7.6 months,P<0.05).There was no significant difference in OS between CIP group and non-CIP group(16.2 vs 15.8 months,P>0.05).Subgroup analysis showed that there were no significant differences in PFS(12.2 vs 12.9 months)and OS(16.1 vs 17.8 months)between mild CIP and severe CIP groups(all P>0.05).Multivariate COX regression analysis showed that CIP(HR=0.55,95%CI[0.33,0.90],P=0.02)and the course of immunotherapy>6 cycles(HR=0.51,95%CI[0.31,0.85],P=0.01)were favorable prognostic factors for PFS.The course of immunotherapy>6 cycles(HR=0.4,95%CI[0.18,0.88],P=0.02)was a favorable prognostic factor for OS.Conclusion:The incidence of CIP is 17.93%.The occurrence of CIP is closely related to the prolongation of PFS.Immunotherapy course>6 cycles is a favorable prognostic factor for PFS and OS of NSCLC patients.
陈翔;加冷·热哈提汗;顾国民;阿布地力·阿布都许库;莎毕娜·迪力夏提;杨喆;王海峰
新疆医科大学附属肿瘤医院 胸腹放疗科,新疆 乌鲁木齐 830000
临床医学
非小细胞肺癌免疫检查点抑制剂免疫相关不良反应检查点抑制剂相关性肺炎预后
non-small cell lung cancer(NSCLC)immune checkpoint inhibitor(ICI)immune-related adverse event(irAE)checkpoint inhibitor-associated pneumonia(CIP)prognosis
《中国肿瘤生物治疗杂志》 2024 (001)
54-61 / 8
新疆维吾尔自治区自然科学基金(No.2021D01C381)
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