杜瓦卢马布
医学
危险系数
内科学
放化疗
肺癌
癌症
置信区间
肿瘤科
外科
彭布罗利珠单抗
免疫疗法
作者
Akira Sugimoto,Hiroyasu Kaneda,Noriko Yoshimoto,Kenji Nagata,Tatsuo Fujii,Koichi Michimoto,Shunsuke Ueno,Takao Kamimori,Yoshie Ishii,Mai Sakagami,Haruo Inokuchi,Keiko Shibuya,Megumi Mizutani,Hiroaki Nagamine,Kenji Nakahama,Yasuyuki Matsumoto,Yoko Tani,Kenji Sawa,Tomoya Kawaguchi
标识
DOI:10.1038/s41598-024-70214-y
摘要
Abstract The usefulness of the derived neutrophil-to-lymphocyte ratio (dNLR) and its dynamics before/after durvalumab consolidation therapy to predict safety or efficacy remains unclear. We retrospectively reviewed patients with locally advanced non-small cell lung cancer treated with durvalumab consolidation therapy after chemoradiotherapy (D group) or chemoradiotherapy alone (non-D group) at multiple institutions. We investigated the association between dNLR, or its dynamics, and pneumonitis, checkpoint inhibitor-related pneumonitis (CIP), irAEs, and efficacy. Ninety-eight and fifty-six patients were enrolled in the D and non-D groups, respectively. The dNLR at baseline was significantly lower in patients who experienced irAEs or CIP than in those who did not. The low dNLR group, 28 days following durvalumab consolidation therapy (dNLR28 ≤ 3), demonstrated longer progression-free survival (PFS) and overall survival (OS) than the high dNLR group (dNLR28 > 3) (PFS, hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.22–0.88, p = 0.020; OS, HR 0.39, 95% CI 0.16–0.94, p = 0.037). Among patients with high dNLR at baseline (dNLR > 3), the dNLR28 ≤ 3 group showed longer PFS than the dNLR28 > 3 group ( p = 0.010). The dNLR is a predictive factor for irAEs and CIP in patients receiving durvalumab consolidation therapy. The dNLR at 28 days after durvalumab consolidation therapy and its dynamics predict favorable outcomes.
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