First-line chemoimmunotherapy for patients with small-cell lung cancer and interstitial lung abnormality: CIP risk and prognostic analysis.

IF 2.3 3区医学 Q3 ONCOLOGY

Thoracic Cancer Pub Date : 2024-10-22 DOI:10.1111/1759-7714.15471

Yu Li, Yuxin Jiang, Luyun Pan, Jun Yao, Shuo Liang, Yanjun Du, Dong Wang, Hongbing Liu, Fang Zhang, Qin Wang, Tangfeng Lv, Ping Zhan

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引用次数: 0

Abstract

Background: Patients with non-small-cell lung cancer (NSCLC) receiving immunotherapy face a potential risk of developing checkpoint inhibitor-related pneumonitis (CIP). However, there is no clear understanding of the specific link between interstitial lung abnormality (ILA) and CIP in patients with small-cell lung cancer (SCLC). In addition, the prognosis of SCLC patients with ILA who receive chemoimmunotherapy is uncertain. Our study aimed to investigate the effect of ILA on the occurrence of CIP in SCLC patients receiving first-line chemoimmunotherapy and to assess its relationship with prognosis.

Methods: We conducted a retrospective analysis of SCLC patients who received chemoimmunotherapy as a first-line treatment between January 2018 and April 2024. The diagnosis of ILA was assessed by two experienced pulmonologists based on pretreatment chest computed tomography images. We investigated independent risk factors for CIP using logistic regression analysis and factors affecting PFS and OS using Cox regression analysis.

Results: A total of 128 patients with SCLC were included in the study. ILA was present in 41 patients (32.03%), and CIP occurred in 16 patients (12.50%). In multivariate logistic regression analysis, previous ILA (OR, 5.419; 95% CI, 1.574-18.652; p = 0.007) and thoracic radiation therapy (TRT) (OR, 5.259; 95% CI, 1.506-18.365; p = 0.009) were independent risk factors for CIP. ILA (HR, 2.083; 95% CI, 1.179-3.681; p = 0.012) and LDH (HR, 1.002; 95% CI, 1.001-1.002; p < 0.001) were statistically significant for increased mortality risk in multivariate Cox regression analysis.

Conclusions: In SCLC patients receiving first-line chemoimmunotherapy, baseline ILA is a risk factor for CIP and is associated with poorer prognosis.

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小细胞肺癌和肺间质异常患者的一线化疗免疫疗法：CIP风险和预后分析。

背景：接受免疫疗法的非小细胞肺癌（NSCLC）患者面临患检查点抑制剂相关肺炎（CIP）的潜在风险。然而，目前还不清楚小细胞肺癌（SCLC）患者肺间质异常（ILA）与 CIP 之间的具体联系。此外，患有肺间质异常的小细胞肺癌患者接受化疗免疫治疗后的预后也不确定。我们的研究旨在探讨ILA对接受一线化疗免疫治疗的SCLC患者发生CIP的影响，并评估其与预后的关系：我们对2018年1月至2024年4月期间接受化疗免疫治疗作为一线治疗的SCLC患者进行了回顾性分析。ILA的诊断由两位经验丰富的肺科专家根据治疗前的胸部计算机断层扫描图像进行评估。我们采用逻辑回归分析研究了CIP的独立风险因素，并采用Cox回归分析研究了影响PFS和OS的因素：研究共纳入了 128 例 SCLC 患者。41例患者（32.03%）出现ILA，16例患者（12.50%）出现CIP。在多变量逻辑回归分析中，既往 ILA（OR，5.419；95% CI，1.574-18.652；P = 0.007）和胸部放射治疗（TRT）（OR，5.259；95% CI，1.506-18.365；P = 0.009）是 CIP 的独立危险因素。ILA（HR，2.083；95% CI，1.179-3.681；p = 0.012）和LDH（HR，1.002；95% CI，1.001-1.002；p 结论：在接受一线化疗的SCLC患者中，ILA和LDH是CIP的独立危险因素：在接受一线化疗免疫治疗的SCLC患者中，基线ILA是CIP的一个危险因素，并与较差的预后相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.