Development and validation of a risk-prediction model for immune-related adverse events in patients with non-small-cell lung cancer receiving PD-1/PD-L1 inhibitors.

Qing Qiu; Chenghao WU; Wenxiao Tang; Longfei JI; Guangwei Dai; Yuzhen Gao; Enguo Chen; Hanliang Jiang; Xinyou Xie; Jun Zhang

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Development and validation of a risk-prediction model for immune-related adverse events in patients with non-small-cell lung cancer receiving PD-1/PD-L1 inhibitors.

Author: Qing QIU ¹ ; Chenghao WU ¹ ; Wenxiao TANG ¹ ; Longfei JI ¹ ; Guangwei DAI ¹ ; Yuzhen GAO ¹ ; Enguo CHEN ² ; Hanliang JIANG ² ; Xinyou XIE ³ ; Jun ZHANG ⁴
Author Information

1. Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
2. Department of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
3. Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China. scottxie@zju.edu.cn.
4. Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China. jameszhang2000@zju.edu.cn.
Publication Type:Journal Article
Keywords: Age; Body mass index; Immune-related adverse events; Non-small cell lung cancer; PD-1/PD-L1 inhibitor; Systemic immune-inflammation index
MeSH: Male; Humans; Carcinoma, Non-Small-Cell Lung/drug therapy*; Lung Neoplasms/drug therapy*; Immune Checkpoint Inhibitors/adverse effects*; Programmed Cell Death 1 Receptor; Retrospective Studies; Apoptosis
From: Journal of Zhejiang University. Science. B 2023;24(10):935-942
CountryChina
Language:English
Abstract: Lung cancer remains the leading cause of cancer deaths worldwide and is the most common cancer in males. Immune-checkpoint inhibitors (ICIs) that target programmed cell death protein-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) have achieved impressive efficacy in the treatment of non-small-cell lung cancer (NSCLC) (Pardoll, 2012; Champiat et al., 2016; Gao et al., 2022). Although ICIs are usually well tolerated, they are often accompanied by immune-related adverse events (irAEs) (Doroshow et al., 2019). Non-specific activation of the immune system produces off-target immune and inflammatory responses that can affect virtually any organ or system (O'Kane et al., 2017; Puzanov et al., 2017). Compared with adverse events caused by chemotherapy, irAEs are often characterized by delayed onset and prolonged duration and can occur in any organ at any stage of treatment, including after cessation of treatment (Puzanov et al., 2017; von Itzstein et al., 2020). They range from rash, pneumonitis, hypothyroidism, enterocolitis, and autoimmune hepatitis to cardiovascular, hematological, renal, neurological, and ophthalmic irAEs (Nishino et al., 2016; Kumar et al., 2017; Song et al., 2020). Hence, we conducted a retrospective study to identify validated factors that could predict the magnitude of the risk of irAEs in patients receiving PD-1/PD-L1 inhibitors; our approach was to analyze the correlation between the clinical characteristics of patients at the start of treatment and relevant indicators such as hematological indices and the risk of developing irAEs. Then, we developed an economical, practical, rapid, and simple model to assess the risk of irAEs in patients receiving ICI treatment, as early as possible.