Peripheral absolute eosinophil count identifies the risk of serious immune-related adverse events in non-small cell lung cancer

Abstract

BackgroundImmune-related adverse events (irAEs) have drawn a lot of attention lately as a result of the predominance of immunotherapy in advanced non-small cell lung cancer (NSCLC). However, the clinical evidence for irAEs in real life is limited. In this paper, the occurrence of irAEs in Chinese NSCLC patients was examined, and possible risk factors for the emergence of severe irAEs were discovered.MethodsOur retrospective investigation assessed the occurrence of adverse events (AEs) and prognosis of 213 patients who received immunotherapy for NSCLC. Using univariate and multivariate logistic regression models, the association between clinicopathological traits and the incidence of severe irAEs was investigated. To assess the prognostic impact of irAEs, survival data was analyzed.ResultsAmong the 213 NSCLC patients, 122 (57.3%) had irAEs of any grade, and 38 (17.8%) had high-grade (grade 3-5) AEs. Baseline peripheral absolute eosinophil count (AEC) (HR 6.58, 95% CI: 1.5-28.8, P=0.012) was found to be an independent predictor of high-grade irAEs by multivariate analysis. The survival analysis revealed that patients with severe irAEs had worse OS (15.7 vs. 20.8 months, 95% CI: 11.6-19.8 vs. 16.0-25.5, P=0.026).ConclusionAccording to our findings, the peripheral absolute eosinophil count (AEC) is a reliable indicator of severe irAEs in NSCLC. Serious irAEs that occur in patients often reflect poor prognoses. In the future, high-grade irAEs should receive more attention.

Immune-Related Adverse Events and Survival Among Patients With Metastatic NSCLC Treated With Immune Checkpoint Inhibitors

“…Why irAEs occur in some patients but not others remains poorly understood, but a variety of predictive factors in NSCLC have been described. Demographic characteristics (age, sex, race, body mass index, and ECOG), concomitant medications (corticosteroids, proton pump inhibitors, and antibiotics), peripheral laboratory markers (hemoglobin, albumin, C-reactive protein, and others), tumor characteristics (histology, stage, PD-L1 expression, driver mutation status, and disease burden), and treatment-related factors (treatment line, response, ICI agent, concurrent chemotherapy, time to starting ICI, cumulative dose, and cumulative cycles of ICI) are inconsistently reported as predictive factors associated with irAE development . In our cohort, we identified several baseline patient characteristics associated with irAE development: 60 years or older, ECOG performance status 0, high expression of PD-L1, absence of bone metastases, DNLR of 3 or less, and levels of hemoglobin, albumin, and LDH within reference range.…”

“…Demographic characteristics (age, sex, race, body mass index, and ECOG), concomitant medications (corticosteroids, proton pump inhibitors, and antibiotics), peripheral laboratory markers (hemoglobin, albumin, C-reactive protein, and others), tumor characteristics (histology, stage, PD-L1 expression, driver mutation status, and disease burden), and treatment-related factors (treatment line, response, ICI agent, concurrent chemotherapy, time to starting ICI, cumulative dose, and cumulative cycles of ICI) are inconsistently reported as predictive factors associated with irAE development. [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]48,[60][61][62] In our cohort, we identified several baseline patient characteristics associated with irAE development: 60 years or older, ECOG performance status 0, high expression of PD-L1, absence of bone metastases, DNLR of 3 or less, and levels of hemoglobin, albumin, and LDH within reference range. Other than response to ICI therapy, irAE development was not associated with treatment-related characteristics (ICI agent, ICI alone or in combination with chemotherapy, and treatment line) in our study population.…”

Blood cell counts can predict adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis

“…A total of 18 studies (11,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) were included in the analysis. These studies were published between 2019 to 2022.…”