Identifying risk factors and biomarkers for severe CIP in lung cancer patients- a retrospective case series study

Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy, but they can induce immune-related adverse events, including immune checkpoint inhibitor-associated pneumonia (CIP), a severe lung complication. CIP, particularly Grades 3-4, is associated with poor prognosis, indicating a critical need for research on this issue. Our study aimed to investigate the risk factors and biomarkers associated with severe CIP in lung cancer patients treated with ICIs, where OS represents overall survival and PFS denotes progression-free survival.

We conducted a retrospective analysis of 106 lung cancer patients with CIP at the First Affiliated Hospital of Zhejiang University from 2019 to 2023, categorized into four severity grades.

The median time to onset of CIP was 5.17 months. Patients with Grade 3-4 CIP had a median PFS of 6.5 months and OS of 11.2 months. Univariate analysis identified phosphocreatine kinase below 61.5 U/l, Forced Vital Capacity (FVC) below 1.96, and BMI below 21.26 as predictive factors for Grades 3-4 CIP. Multivariate analysis confirmed that a decreased FVC was a significant predictor.

A decreased FVC below 1.96 emerged as a predictive factor for Grades 3-4 CIP, highlighting the importance of monitoring FVC in patients receiving ICIs.