Association of baseline peripheral-blood eosinophil count with immune checkpoint inhibitor-related pneumonitis and clinical outcomes in patients with non-small cell lung cancer receiving immune checkpoint inhibitors. (December 2020)

• Record Type: Journal Article
• Authors: Chu, Xiangling; Zhao, Jing; Zhou, Juan; Zhou, Fei; Jiang, Tao; Jiang, Sen; Sun, Xiwen; You, Xiaofang; Fengying, Fengying; Ren, Shengxiang; Zhou, Caicun; Su, Chunxia
• Is Part Of: Lung cancer. Volume 150(2020)
• Page Start: 76
• Page End: 82
• Publication Date: 2020-12
• Subjects: ICI-pneumonitis immune checkpoint inhibitor-related pneumonitis -- NSCLC non-small-cell lung cancer -- PD-1 programmed cell death protein 1 -- ICIs immune-checkpoint inhibitors -- WBC white blood cell count -- ANC absolute neutrophil count -- ALC absolute lymphocyte count -- AMC absolute monocyte count -- AEC absolute eosinophil count -- COP cryptogenic organizing pneumonia -- GGO ground glass opacity -- NSIP nonspecific interstitial pneumonia -- HP hypersensitivity pneumonitis -- PFS progression-free survival -- OS overall survival -- ORR objective response rate -- DCR disease control rate -- OR odds ratio -- HR hazard ratio -- CI onfidence interval; Peripheral blood absolute eosinophil count -- Immune checkpoint inhibitor-related pneumonitis -- Immunotherapy -- NSCLC; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2020.08.015
• Languages: English
• ISSNs: 0169-5002

Abstract

Graphical abstract: Highlights: The risk factors of ICI-pneumonitis remain unclear. Cutoff value of absolute eosinophil count (AEC) was 0.125 × 10 9 cells/L. High-AEC was associated with the occurrence of ICI-pneumonitis. High-AEC was associated with longer PFS and higher ORR in ICI-based therapy. Abstract: Objectives: Immune checkpoint inhibitors (ICIs) have revolutionized the oncologic treatment landscape, but have been accompanied by immune-related adverse events (irAEs). ICI-related pneumonitis (ICI-pneumonitis) is a potentially fatal irAE. However, the risk factors associated with ICI-pneumonitis remain unclear. There is an urgent need to identify risk factors for ICI-pneumonitis using reliable and accessible parameters. Here, we aimed to identify baseline peripheral-blood biomarkers correlated with ICI-pneumonitis and clinical outcomes in patients with advanced non-small cell lung cancer (NSCLC) who were treated with ICIs. Materials and Methods: We conducted a retrospective analysis of eligible patients with advanced NSCLC who were treated with ICIs at our center. Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value for analyzing risk of ICI-pneumonitis. Multivariate logistic analysis was performed to identify risk factors of ICI-pneumonitis. Clinical characteristics and treatment outcomes were collected and compared according to the optimal cutoff value. Results: A total of 300 patients were included, in which 54 patients (18 %) experienced ICI-pneumonitis. Patients with ICI-pneumonitis had a high level of baseline peripheral-blood absolute eosinophil count (AEC) than those without ICI-pneumonitis ( P = 0.013). The optimal threshold of baseline peripheral-blood AEC to predict ICI-pneumonitis was 0.125 × 10 9 cells/L. The incidence of ICI-pneumonitis was higher in the high-AEC group (AEC ≥ 0.125 × 10 9 cells/L; 27.7 %) than in the low-AEC group (AEC < 0.125 × 10 9 cells/L; 9.8 %, P < 0.001). Moreover, patients with high AEC (compared with those with low AEC) had a higher objective response rate (ORR) (40.9 % versus 28.8 %, P = 0.029) and longer median progression-free survival (PFS) (8.93 months versus 5.87 months, P = 0.038). Conclusions: Among patients treated with ICIs, a baseline feature of high AEC (≥0.125 × 10 9 cells/L) was associated with an increasing risk of ICI-pneumonitis, and with a better clinical outcome.