Scholarlink

Background <p>Non-small-cell lung cancer (NSCLC) exhibits variable outcomes and remains a leading cause of cancer-related mortality, despite advances in immunotherapy. This study aimed to develop a prognostic model using real-world data (RWD) to stratify patients by survival outcomes and evaluate the benefit of immunotherapy across risk groups.</p> Methods <p>A retrospective cohort of 270 patients with NSCLC (2015–2024) treated with chemotherapy alone (54%) or chemoimmunotherapy (46%) was analyzed. Clinical, laboratory (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], monocyte-to-lymphocyte ratio [MLR]), and histopathological data were collected. Multivariate Cox regression identified prognostic factors for overall survival (OS) and validated them via bootstrapping.</p> Results <p>The cohort (median age, 65; 78% male) had a median OS of 11.2 months and a median progression-free survival (PFS) of 7.7 months. The final prognostic model incorporated histology (adenocarcinoma vs. large cell/squamous cell carcinoma/rare subtypes: HR = 1.6–2.03), recurrence state (HR = 0.51), and NLR (HR = 1.13). Patients were stratified into low- (median OS = 14.6 months) and high-risk (median OS = 9.6 months; <i>p &lt;</i> 0.001) groups. Immunotherapy significantly increased PFS in low-risk patients (12.2 vs. 7.1 months, <i>p =</i> 0.002) and showed an increasing trend in OS (16.9 vs. 11.3 months, <i>p =</i> 0.12). High-risk patients derived no OS/PFS benefit (<i>p</i> ≥ 0.56).</p> Conclusion <p>This RWD-derived prognostic model effectively stratifies NSCLC patients into distinct risk groups. Immunotherapy-chemotherapy provided meaningful PFS improvement in low-risk patients but minimal benefit in high-risk subgroups, underscoring the need for tailored therapeutic strategies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prognostic model integrating histology, systemic inflammation, and recurrence status predicts immunotherapy response in advanced non-small-cell lung cancer patients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月3日

查看全文
  • F. V. Moiseenko,
  • M. A. Krasavina,
  • I. R. Agranov,
  • E. V. Artemieva,
  • A. P. Oganesian,
  • A. S. Gabina,
  • M. L. Makarkina,
  • E. O. Elsakova,
  • V. A. Henshtein,
  • N. M. Volkov,
  • V. V. Egorenkov,
  • V. M. Moiseenko,
  • M. Yu. Fedyanin,
  • G. S. Kopeina,
  • B. Zhivotovsky,
  • A. V. Zamaraev

摘要

Background

Non-small-cell lung cancer (NSCLC) exhibits variable outcomes and remains a leading cause of cancer-related mortality, despite advances in immunotherapy. This study aimed to develop a prognostic model using real-world data (RWD) to stratify patients by survival outcomes and evaluate the benefit of immunotherapy across risk groups.

Methods

A retrospective cohort of 270 patients with NSCLC (2015–2024) treated with chemotherapy alone (54%) or chemoimmunotherapy (46%) was analyzed. Clinical, laboratory (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], monocyte-to-lymphocyte ratio [MLR]), and histopathological data were collected. Multivariate Cox regression identified prognostic factors for overall survival (OS) and validated them via bootstrapping.

Results

The cohort (median age, 65; 78% male) had a median OS of 11.2 months and a median progression-free survival (PFS) of 7.7 months. The final prognostic model incorporated histology (adenocarcinoma vs. large cell/squamous cell carcinoma/rare subtypes: HR = 1.6–2.03), recurrence state (HR = 0.51), and NLR (HR = 1.13). Patients were stratified into low- (median OS = 14.6 months) and high-risk (median OS = 9.6 months; p < 0.001) groups. Immunotherapy significantly increased PFS in low-risk patients (12.2 vs. 7.1 months, p = 0.002) and showed an increasing trend in OS (16.9 vs. 11.3 months, p = 0.12). High-risk patients derived no OS/PFS benefit (p ≥ 0.56).

Conclusion

This RWD-derived prognostic model effectively stratifies NSCLC patients into distinct risk groups. Immunotherapy-chemotherapy provided meaningful PFS improvement in low-risk patients but minimal benefit in high-risk subgroups, underscoring the need for tailored therapeutic strategies.