Predicting checkpoint inhibitors pneumonitis in non-small cell lung cancer using a dynamic online hypertension nomogram. (August 2022)

• Record Type: Journal Article
• Authors: Jia, Xiaohui; Chu, Xiangling; Jiang, Lili; Li, Yanlin; Zhang, Yajuan; Mao, Ziyang; Liang, Ting; Du, Yonghao; Xu, Longwen; Shen, Yuan; Niu, Gang; Meng, Rui; Ni, Yunfeng; Su, Chunxia; Guo, Hui
• Is Part Of: Lung cancer. Volume 170(2022)
• Page Start: 74
• Page End: 84
• Publication Date: 2022-08
• Subjects: Checkpoint inhibitors pneumonitis -- Hypertension -- Dynamic nomogram -- Non-small cell lung cancer; AEC absolute eosinophil count -- ALC absolute lymphocyte count -- ANC absolute neutrophil count -- AUC area under the curve -- AUROC area under the ROC curve -- CIP checkpoint inhibitors pneumonitis -- CTCAE V4.0 common terminology criteria for adverse events version 4.0 -- DCA decision curve analysis -- ECOG Eastern Oncology Collaboration Group -- ICIs immune checkpoint inhibitors -- ILD interstitial lung disease -- IPF idiopathic pulmonary fibrosis -- irAEs immune-related adverse events -- NLR neutrophils-lymphocyte ratio -- NSCLC non-small cell lung cancer -- PLR platelet/lymphocyte ratio -- PLT platelet count -- ROC receiver operating characteristic -- SII systemic immune-inflammation index -- WBC white blood cells (WBC); 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.2022.06.001
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: Hypertension is an independent risk factor for checkpoint inhibitor pneumonitis (CIP). Dynamic hypertension nomogram is constructed to predict CIP with satisfactory calibration. High-risk patients (total points ≥ 135) had a higher risk of CIP. Abstract: Objectives: Checkpoint inhibitors pneumonitis (CIP) is one of the most lethal adverse events in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs). Currently, there is no recognized and effective predictive model to predict CIP in NSCLC. Materials and Methods: This study retrospectively analyzed 460 NSCLC patients who were first treated with ICIs. Patients were divided into three cohorts based on the occurrence of CIP: any grade CIP cohort, grade ≥ 2 CIP cohort and grade ≥ 3 CIP cohort. Results: A dynamic hypertension nomogram was constructed with elements including hypertension, interstitial lung disease (ILD), emphysema at baseline, and higher baseline platelet/lymphocyte ratio (PLR). The C indices of the training cohort and the internal and external validation cohort in any grade CIP cohort were 0.872, 0.833 and 0.840, respectively. The constructed hypertension nomogram was applied to grade ≥ 2 cohort and grade ≥ 3 cohort, and their C indices were 0.844 and 0.866, respectively. Compared with the non-hypertension nomogram, the hypertension nomogram presented better predictive power. Conclusions: After validated by internal and external validation cohorts, the dynamic online hypertension has the potential to become a convenient, intuitive, and personalized clinical tool for assessing the risk of CIP in NSCLC patients.