Abstract

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 tested positive. However, the clinical markers for the selection of patients who will benefit from ICIs treatment before hand are largely unknown. In this study, a retrospective 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 set up the nomogram model to make quantitative prediction for overall survival (OS) and progression-free survival (PFS) based on different variables, and established a scoring group chart as well as Decision curve analysis (DCA) to assess clinical benefits of ICIs in treatment of patients with advanced/metastatic NSCLC. We found that serum globulin (GLB)>26.6 (g/L) (HR=1.865, P=0.002), absolute neutrophil counts (ANC) (109/L)>5 (HR=2.146, P<0.001), and bone metastasis (HR=2.148, P<0.001) were independent factors affecting the PFS of NSCLC patients. GLB>26.6 (g/L) (HR=1.741, P=0.018), ANC(109/L)>5 (HR=1.807, P=0.008), bone metastasis (HR=1.651, P=0.002), and PD-L1 Negative (HR=2.432,P=0.032) were independent factors affecting the survival of NSCLC patients. These data show that patients with the four favorable factors had better survivals. Thus, in patients with advanced/metastatic NSCLC receiving ICIs treatment, the GLB, ANC, bone metastasis, and PD-L1 may serve as useful predictive markers for the prognosis of NSCLC patients with ICIs treatment.