Immunophenotyping of peripheral blood in NSCLC patients discriminates responders to immune checkpoint inhibitors

Area of Science:

• Oncology
• Immunology
• Hematology

Background:

• Immune checkpoint inhibitors (ICIs) have transformed non-small cell lung cancer (NSCLC) treatment.
• Reliable biomarkers for predicting ICI efficacy in NSCLC are currently lacking.
• Existing biomarkers like PD-L1, MSI, and TMB show limitations in accuracy.

Purpose of the Study:

• To investigate the predictive potential of peripheral blood parameters for ICI treatment response in NSCLC.
• To identify novel biomarkers associated with progression-free survival (PFS) and overall survival (OS) in NSCLC patients undergoing immunotherapy.

Main Methods:

• Prospective observational cohort study of 224 stage III/IV NSCLC patients treated with ICIs.
• Analysis of baseline and post-treatment peripheral blood parameters including immune cells, complement proteins (C3, C4), and cytokines.
• Correlation of these parameters with treatment response and survival endpoints.

Main Results:

• Higher baseline Tregs, MPV, hemoglobin, and lower monocytes correlated with favorable PFS and OS.
• Increased baseline basophils and lower C3 levels predicted improved PFS.
• Baseline immature granulocytes, C3, and monocytes were associated with partial regression.
• Changes in lymphocyte counts after three months indicated PFS non-benefit.
• Higher lymphocytes, erythrocytes, hemoglobin, MCV, MPV, and lower NLR after three months were linked to OS benefit.

Conclusions:

• Peripheral venous blood parameters show promise as predictive biomarkers for NSCLC patients receiving ICIs.
• Baseline Tregs, C3, monocytes, and MPV warrant further investigation as potential biomarkers for NSCLC immunotherapy.