Reduced FEV 1 as Prognostic Factors in Patients With Advanced NSCLC Receiving Immune Checkpoint Inhibitors

Frontiers in Medicine

article

Yi-Luen Shen¹  Chia-I Shen¹  Chi-Lu Chiang¹  Hsu-Ching Huang¹  Kun-Ta Chou¹  Chao-Hua Chiu¹  Yuh-Min Chen¹  Yung-Hung Luo¹ 

[1] Department of Chest Medicine, Taipei Veterans General Hospital;Division of Chest Medicine, Department of Internal Medicine, Asia University Hospital;School of Medicine, National Yang Ming Chiao Tung University;Institute of Clinical Medicine, National Yang Ming Chiao Tung University

关键词: forced expiratory volume (FEV) 1 second;    immune checkpoint inhibitor (ICI);    advanced non-small cell lung cancer;    pulmonary function test (PFT);    chronic lung disease (CLD);   

DOI  :  10.3389/fmed.2022.860733

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background The aim of study is to investigate the influence of pulmonary function on the prognosis in patients with advanced non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors (ICI). Patients and Methods Data were collected retrospectively from 151 patients with stage IV NSCLC who received ICI and completed spirometry before ICI therapy in Taipei Veterans General Hospital between January 2016 and December 2020. The co-primary end points were overall survival (OS) and progression-free survival (PFS) between groups divided by 80% predicted FEV 1 since ICI therapy started; the secondary outcomes were objective response rate. Results Among 151 patients enrolled to this study, 67.5% of patients were men, 75.5% were adenocarcinoma, 24.5% had known targetable driver mutation, 33.8% received first-line ICI, and 62.8% received ICI monotherapy. The objective response rate was 24.5% and disease control rate was 54.3%. In multivariable analysis, patient with reduced FEV 1 had inferior PFS (FEV 1 < 80% vs. FEV 1 ≥ 80%, adjusted HR = 1.80, P = 0.006) and OS (FEV 1 < 80% vs. FEV 1 ≥ 80%, adjusted HR = 2.50, P < 0.001). Median PFS and OS in the preserved FEV 1 group (≥80% predicted FEV 1 ) compared to the reduced FEV 1 group (<80% predicted FEV 1 ) were 5.4 vs. 2.9 months (HR = 1.76, P = 0.003) and 34.9 vs. 11.1 months (HR = 2.44, P < 0.001), respectively. The other independent prognostic factors of OS include stage IVA disease (adjusted HR = 0.57, P = 0.037), initial liver metastasis (adjusted HR = 2.00, P = 0.049), ICI monotherapy (adjusted HR = 1.73, P = 0.042) and ICI related pneumonitis (adjusted HR = 3 .44, P = 0.025). Conclusions Reduced FEV 1 is strongly associated with inferior clinical outcomes in patients with advanced NSCLC treated with ICI.

【 授权许可】

CC BY