Abstract
Background
The adaptation of immune checkpoint inhibitors (ICIs) has achieved promising effects in patients with non-small cell lung cancer (NSCLC). However, not all patients with NSCLC benefit from immunotherapy. There is an urgent need to explore some biomarkers to predict the efficacy and survival rate of patients with advanced NSCLC after immunotherapy. The objective of this study is to monitor the changes of peripheral blood lymphocyte subpopulations and analyze their correlation with the efficacy and prognosis of immunotherapy.
Methods
A total of 153 patients with advanced NSCLC were examined. Peripheral blood lymphocyte subsets including CD4+ T cells, CD8+ T cells, CD4+/CD8+ ratio, NK cells, and Tregs were collected before any treatment, before immunotherapy, and after 4 cycles of immunotherapy. T-test was used to analyze the influencing factors of lymphocyte subtypes and their changes before and after immunotherapy. Logistic regression was used to analyze the relationship between lymphocyte subtypes and efficacy with ROC curve being plotted. Log-rank test and Cox regression model were used to evaluate the relationship between lymphocyte subtypes and progression-free survival (PFS).
Results
Gender, age, pathology, distant metastasis, and EGFR mutations all affect the proportion of peripheral blood lymphocyte subpopulations in patients with advanced NSCLC. Compared with baseline, the effective group showed that the proportions of CD4+ T cells, CD4+/CD8+ ratio, NK cells and Tregs were significantly higher, and the proportions of CD8+ T cells were significantly lower in peripheral blood after 4 cycles of immunotherapy. On the contrary, the ineffective group showed no signs of significant differences. Baseline CD4+ T cells, NK cells and Tregs were independent predictors of immunotherapy efficacy and PFS.
Conclusions
Immune checkpoint inhibitors induce changes in the proportion of peripheral blood lymphocyte subsets in patients with effective immunotherapy. The levels of lymphocyte subsets have a good predictive value for efficacy and prognosis of patients with advanced NSCLC.