Details

Autor(en) / Beteiligte

• Liu, Linxi

Titel

The Prognostic Role of Eosinophil Count on Mortality Rates and Risk of ICI-Pneumonitis in NSCLC Patients Treated with ICI Therapy

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2023

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Background: Non-small cell lung cancer (NSCLC) is an important public health issue in the United States. Treatment of NSCLC has evolved in the past decade to include immune checkpoint inhibitors (ICIs). Identification of the prognostic factors could enable physicians to stratify patients with a high risk of mortality or toxicity, to more appropriate treatment, thus saving them treatment side effects and valuable time.Objectives: The objectives of this thesis are to 1) describe the demographic and clinical characteristics of patients with different levels of absolute eosinophil count (AEC), 2) determine whether survival rates and 3) risk of ICI-pneumonitis (ICIP) are different for subjects with different levels of AEC, and 4) use routine biomarkers to build an overall survival prediction model for NSCLC patients receiving ICI therapy.Methods: Using a prospective cohort study design and electronic medical records, I established a cohort of NSCLC patients on ICI therapy at the Wilmot Cancer Center in Rochester, New York from April 2015 to June 2020, and followed up until February 2022. Cox proportional hazards regression was used for Aims 2 and 4. Logistic regression was used for Aim 3.Results: Compared to AEC=200 cells/μL, AEC≤100 cells/μL was associated with a 138% increased risk of mortality (95% CI=46%–290%) and 2.14 times the risk of ICIP (OR=2.14; 95% CI=0.58–7.85); AEC≥300 cells/μL was associated with a 202% increased risk of mortality (95% CI=66%–449%) and 1.98 times the risk of ICIP (OR=1.98; 95% CI=0.49–8.03). The ICIP risk was 7% during a median follow-up of 12 months. The survival prediction model included liver metastasis, performance status, chemotherapy use, sex, cancer stage at diagnosis and line of therapy, body mass index, eosinophil count, and neutrophil count (C-index=0.70).Conclusions: This study provides 1) evidence for the prognostic value of baseline blood eosinophil count on overall survival, 2) a survival prediction model that consists of easy-to-acquire and inexpensive factors, and 3) a real-world risk estimate of ICIP, in NSCLC patients receiving ICI therapy. Due to a small number of ICIP cases, this study did not find a statistically significant association between eosinophil count and ICIP risk.