Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Immune Checkpoint Inhibitor Score Predicts Survival Benefit of Immunotherapy in Patients with Non-small Cell Lung Cancer

  • Da Hyun Kang (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Chang-Min Choi (Department of Pulmonary and Critical Care Medicine/Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cheol-Kyu Park (Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • In-Jae Oh (Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Young-Chul Kim (Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Seong Hoon Yoon (Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital) ;
  • Yoonjoo Kim (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Jeong Eun Lee (Department of Internal Medicine, Chungnam National University College of Medicine)
  • Received : 2023.12.06
  • Accepted : 2024.05.12
  • Published : 2024.10.31
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Abstract

Background: The use of immune checkpoint inhibitors (ICIs) in patients with advanced lung cancer is increasing. Despite ongoing studies to predict the efficacy of ICIs, its use in clinical practice remains difficult. Thus, we aimed to discover a predictive marker by analyzing blood cell characteristics and developing a scoring system for patients treated with ICIs. Methods: This was a prospective multicenter study in patients with advanced non-small cell lung cancer (NSCLC) who received ICIs as second-line treatment from June 2021 to November 2022. Blood cell parameters in routine blood samples were evaluated using an automated hematology analyzer. Immune checkpoint inhibitor score (IChIS) was calculated as the sum of neutrophil count score and immature granulocyte score. Results: A total of 143 patients from four institutions were included. The treatment response was as follows: partial response, 8.4%; stable disease, 37.1%; and progressive disease, 44.8%. Median progression-free survival and overall survival after ICI treatment was 3.0 and 8.3 months, respectively. Median progression-free survival in patients with an IChIS of 0 was 4.0 months, which was significantly longer than 1.9 months in patients with an IChIS of 1 and 1.0 month in those with an IChIS of 2 (p=0.001). The median overall survival in patients with an IChIS of 0 was 10.2 months, which was significantly longer than 6.8 and 1.8 months in patients with an IChIS of 1 and 2, respectively (p<0.001). Conclusion: Baseline IChIS could be a potential biomarker for predicting survival benefit of immunotherapy in NSCLC.

Keywords

Acknowledgement

This research was supported by a grant (No. KATRD-S-2020-1) from the Korean

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