Efficacy and safety of immunotherapy in real-world patients with advanced non-small cell lung cancer

• DOI: 10.1016/j.ctarc.2025.100908
• Publication Date: 2025-03-25T01:16:09Z
• Authors: Na Yin; Ruihan Yang; Xiangliang Liu; Xiao Chen
• Keywords: Cancer Immunotherapy

The aim of this study was to explore the predictors immunotherapy efficacy for advanced non-small cell lung cancer (NSCLC) in real world and analyze clinical safety patients receiving NSCLC. Clinical pathological data from diagnosed with NSCLC treated immune checkpoint inhibitors (ICIs) were collected. Survival analysis differential comparison progression-free survival (PFS) performed using Kaplan-Meier method Log-rank test. Univariate multivariate analyses PFS objective response rate (ORR) by Cox proportional risk regression models logistic influence factors associated prognosis immunotherapy. (1) Overall, median (median PFS, mPFS) 237 11.3 months (range: 8.5-14.1), ORR 55.7 %. overall population found that age ≥65 years, Eastern Cooperative Oncology Group (ECOG) physical status (PS) score 0-1, stage III, absence liver metastases, combined chemotherapy prognostic nutritional index (PNI) ≥47.8 independent longer immunotherapy-advanced multifactorial suggested ECOG PS score, number ICI lines ORR. (2) In "stage IV, first-line, 0-1" subgroup, 106（106/237）patients had an mPFS 10.9 9.6-12.2) 59.4 subgroups PNI influencers PFS. A univariate only High-PNI (3) Additional affecting explored. subgroup among 64 (64/237) accessible programmed death-ligand 1 (PD-L1) expression levels showed a trend towards benefit PD-L1 tumor proportion (TPS) ≥ 50 % TPS < compared (p=0.196); 91 (91/237) traceable genetic test results positive driver genes (KRAS/MET/RET/HER2/EGFR/ALK) shorter than negative (HR=1.712, 95 CI: 0.994-2.947, p=0.048); Subgroup assessment significantly prolonged initial or best outcome complete (CR) partial remission (PR) stable disease (SD) progressive (PD) (P 0.001). (4) Immune-related adverse events (irAEs) requiring pharmacological intervention discontinuation recorded. 61 (61/237) experienced irAEs during treatment. Grade 1∼2 reactions occurred 27.8 grade ≥3 3.8 patients. There no statistical difference occurrence (P=0.728) severity (P=0.612) between ICIs. This reports practical experience ICIs treatment China analyzing real-world generally consistent those trials, greatest impact on PS, stage, PNI. Therefore, physicians can predict future based indicators make individualized choices.