A Cohort Study on Dual Predictive Markers of Immune Combination Therapy for Advanced Non-Small Cell Lung Cancer

Overview

Journal Biomark Insights

Publisher Sage Publications

Date 2025 Feb 17

PMID 39957864

Authors

Maike Zheng

Mingming Hu

Yanxia Liu

Xiaomi Li

Guirong Wang

Tongmei Zhang

Yan Zhao

Affiliations

Soon will be listed here.

Abstract

Background: Immune checkpoint inhibitors (ICIs) hold a great promise in treatment of non-small cell lung cancer (NSCLC), while only a portion of patients benefited from the treatment, and others could not achieve optimal therapeutic effects from initial immunotherapy, even for those patients with PD-L1 (Programed cell death ligand 1) tested positive. However, the clinical markers for the selection of patients who will benefit from ICIs combination treatment beforehand are largely unknown.

Objectives: The purpose of this study was to explore the non-invasive biomarkers that can predict the efficacy of immune combination therapy in advanced/metastatic NSCLC patients.

Design: This study employed a retrospective cohort design to analyze dual predictive biomarkers in advanced non-small cell lung cancer (NSCLC) patients with immune combination therapy.

Method: An analysis was conducted on baseline information of 144 patients with advanced/metastatic NSCLC who received ICIs treatment from the November of 2018 to the January of 2023 in Beijing Chest Hospital. We established a scoring group chart to make quantitative prediction for overall survival (OS) and progression-free survival (PFS) based on 4 variables, and set up the nomogram model as well as Decision curve analysis (DCA) to assess clinical benefits of ICIs combination in treatment of patients with advanced/metastatic NSCLC.

Results: We found that serum globulin (GLB) >26.6 (g/L) (HR = 1.865, = .002), absolute neutrophil counts (ANC) (10/L) > 5 (HR = 2.146, < .001), and bone metastasis (HR = 2.148, < .001) were independent factors affecting the PFS of NSCLC patients. GLB > 26.6 (g/L) (HR = 1.741, = .018), ANC (10/L) >5 (HR = 1.807, = .008), bone metastasis (HR = 1.651, = .002), and PD-L1 Negative (HR = 2.432, = .032) were independent factors affecting the OS of NSCLC patients. Same variables and cut-off value have good predictive efficacy in both PFS and OS.

Conclusion: In patients with advanced/metastatic NSCLC receiving ICIs combination treatment, the GLB, ANC, bone metastasis, and PD-L1 may serve as useful predictive markers for the prognosis of NSCLC patients with ICIs combination treatment.

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