化学免疫疗法是晚期非小细胞肺癌（NSCLC）的标准治疗方法。然而，有关临床预测因素的数据仍然很少。我们的目标是确定接受化学免疫治疗的患者的临床生物标志物。这项多中心、真实世界队列研究包括 2018 年 12 月至 2022 年 5 月期间接受化学免疫治疗的化疗患者。使用多变量分析来确定之间的关联生存结果和患者背景，包括基线中性粒细胞与淋巴细胞比率 (NLR) 及其动态变化 (ΔNLR)。为了进一步研究 NLR 的临床意义，根据 NLR 和 ΔNLR 组合定义的外周免疫状态对患者进行分类。该研究纳入了 280 名患者，中位随访时间为 30.1 个月。多变量分析显示，老年个体、体能状态差、肿瘤比例评分<1%、肝转移、基线NLR≥5和ΔNLR≥0与较短的无进展生存期和总生存期(OS)独立显着相关。外周免疫状态高（定义为 NLR <5 且 ΔNLR < 0）的患者显着改善长期生存（2 年 OS 率为 58.3%），而外周免疫状态低（定义为 NLR ≥ 5 且 ΔNLR ≥ 0）的结果极差（2 年 OS 率为 5.6%）。尽管患者的外周免疫状态不同，但在严重不良事件和治疗相关死亡率方面，安全性并无显着差异（分别为 P = 0.46 和 0.63）。我们的研究提供了有关临床预后因素的真实世界证据化学免疫疗法。基线 NLR 和 ΔNLR 的综合评估可以帮助识别可能从化学免疫治疗中获得持久缓解的患者。© 2024。作者。

Chemoimmunotherapy is a standard treatment for advanced non-small-cell lung cancer (NSCLC). However, data on clinical predictive factors remain scarce.We aim to identify clinical biomarkers in patients undergoing chemoimmunotherapy.This multicenter, real-world cohort study included chemonaive patients who underwent chemoimmunotherapy between December 2018 and May 2022. Multivariate analysis was used to determine associations between survival outcomes and patient background, including baseline neutrophil-to-lymphocyte ratio (NLR) and its dynamic change (ΔNLR). To further investigate the clinical significance of NLR, patients were classified based on their peripheral immune status, defined by a combination of NLR and ΔNLR.The study included 280 patients with 30.1 months of median follow-up. Multivariate analysis revealed that older individuals, poor performance status, tumor proportion score < 1%, liver metastasis, baseline NLR ≥ 5, and ΔNLR ≥ 0 independently correlated significantly with shorter progression-free and overall survival (OS). Patients with high peripheral immune status (defined as NLR <5 and ΔNLR < 0) significantly improved long-term survival (2-year OS rate of 58.3%), whereas those with low peripheral immune status (defined as NLR ≥ 5 and ΔNLR ≥ 0) had extremely poor outcomes (2-year OS rate of 5.6%). Safety profiles did not differ significantly in terms of severe adverse events and treatment-related death rates despite the patients' peripheral immune status (P = 0.46 and 0.63, respectively).Our study provides real-world evidence regarding clinical prognostic factors for the efficacy of chemoimmunotherapy. The combined assessment of baseline NLR and ΔNLR could facilitate the identification of patients who are likely to achieve a durable response from chemoimmunotherapy.© 2024. The Author(s).