Clinical determinants and biomarkers for predicting chemotherapeutic response in advanced non-small cell lung cancer: a single-center retrospective study.

IF 2.3 4区医学 Q3 IMMUNOLOGY

Immunotherapy Pub Date : 2026-04-01 Epub Date: 2026-05-12 DOI:10.1080/1750743X.2026.2665977

Ling Zhang, Wei Li, Yidong Wang, Quanbin Zha, Liujun Cao, Deqiang Wang

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引用次数: 0

Abstract

Objective: To evaluate clinical determinants and predictive biomarkers for response to platinum-based doublet chemotherapy in patients with advanced non-small cell lung cancer (NSCLC).

Methods: This retrospective study included 200 advanced NSCLC patients (Jan 2021-Jun 2023) stratified into responders (n = 54) and non-responders (n = 146) according to RECIST version 1.1. Clinical characteristics, pre-chemotherapy inflammatory indexes [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR)], tumor markers [carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1)], and nutritional indicators [albumin (ALB), hemoglobin (HGB)] were analyzed.

Results: ECOG performance status ≥2, stage IV disease, ≥3 metastatic sites, and liver metastases were independent risk factors for poor response, whereas ≥4 chemotherapy cycles were protective. Non-responders had higher NLR, PLR, CEA, CYFRA21-1, and lower ALB and HGB (all p < 0.05). ROC analyses showed good predictive performance (AUC 0.688-0.816, p < 0.001). Responders had longer median progression-free survival (7.0 vs 4.0 months) and overall survival (15.0 vs 9.0 months, both p < 0.001).

Conclusion: ECOG score ≥2, stage IV disease, multiple metastases, and liver metastases negatively impact chemotherapeutic response, whereas treatment continuity is protective. Baseline NLR, PLR, CEA, CYFRA21-1, ALB, and HGB show predictive utility. A favorable chemotherapeutic response is associated with significantly enhanced survival.

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预测晚期非小细胞肺癌化疗反应的临床决定因素和生物标志物：一项单中心回顾性研究

目的：评价晚期非小细胞肺癌（NSCLC）患者铂基双重化疗应答的临床决定因素和预测性生物标志物。方法：本回顾性研究纳入200例晚期非小细胞肺癌患者（2021年1月- 2023年6月），根据RECIST 1.1版本分为反应者（n = 54）和无反应者（n = 146）。分析临床特征、化疗前炎症指标[中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）]、肿瘤标志物[癌胚抗原（CEA）、细胞角蛋白19片段抗原21-1 (CYFRA21-1)]、营养指标[白蛋白（ALB）、血红蛋白（HGB）]。结果：ECOG性能状态≥2、IV期疾病、≥3个转移部位和肝转移是不良反应的独立危险因素，而≥4个化疗周期具有保护作用。无应答者NLR、PLR、CEA、CYFRA21-1较高，ALB和HGB较低（均p p p p）。结论：ECOG评分≥2、IV期疾病、多发转移和肝转移对化疗反应有负面影响，而治疗连续性具有保护作用。基线NLR、PLR、CEA、CYFRA21-1、ALB和HGB具有预测作用。良好的化疗反应与显著提高的生存率相关。

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来源期刊

Immunotherapy 医学-免疫学

CiteScore

5.00

自引率

3.60%

发文量

113

审稿时长

6-12 weeks

期刊介绍： Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field. Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.