Predictive Value of Baseline Total Bilirubin Levels on the Efficacy of Immunotherapy in Advanced Non-Small Cell Lung Cancer
10.11969/j.issn.1673-548X.2025.05.025
- VernacularTitle:基线总胆红素水平对晚期非小细胞肺癌免疫治疗疗效的预测价值
- Author:
Lijie MA
1
;
Wanling ZHU
;
Hao CHEN
Author Information
1. 221000 徐州医科大学
- Publication Type:Journal Article
- Keywords:
Immunotherapy;
Non-small cell lung cancer;
Efficacy;
Total bilirubin
- From:
Journal of Medical Research
2025;54(5):136-140,173
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation between peripheral blood total bilirubin(TBIL)levels and the efficacy and prognosis of immunotherapy in advanced non-small cell lung cancer(NSCLC),as well as its relationship with immune inflammation.Methods A retrospective analysis was conducted on 246 patients with advanced NSCLC who received immunotherapy from June 2019 to June 2022.Pre-treatment TBIL levels were collected,and the optimal cutoff value for TBIL was determined using the"X-tile"software and the ROC curve.The impact of pre-treatment TBIL on the short-term efficacy and long-term prognosis of advanced NSCLC was an-alyzed.Results The optimal cutoff value for TBIL was identified as 10.5μmol/L using the"X-tile"software and the ROC curve.A-nalysis of short-term efficacy indicated that patients with higher TBIL levels had a significantly better objective response rate(ORR)compared to those with lower levels(51.3％vs 33.8％,P=0.006).The disease control rate(DCR)was also higher in the higher TBIL level group compared to the low level group(92.9％vs 81.2％,P=0.007).Kaplan-Meier survival analysis revealed that patients with elevated TBIL levels had a longer median progression-free survival(PFS)compared to those with lower TBIL levels,with 13.0 vs 7.0 months,respectively(P＜0.001).Similarly,the median overall survival(OS)was greater in the higher TBIL level group than in the lower TBIL level group,with 16.0 vs 12.0months,respectively(P＜0.001).Additionally,there were significant differences in neutro-phil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII)between two groups of different TBIL levels(P＜0.05).Conclusion In immunotherapy for advanced non-small cell lung cancer,patients with higher baseline levels of TBIL exhibit a positive correlation with the efficacy and prognosis of immunotherapy.TBIL might be served as an important predictive marker for immunotherapy in patients with advanced NSCLC.
