Progression-Free Survival Under Immune Checkpoint Inhibitors for Metastatic Non-Small-Cell Lung Cancer: A
Paul Boré1, Margaux Geier2, Loïc Campion1,3
1Institut de Cancérologie de l'Ouest, 44805, Saint-Herblain, France.
Oncology and Therapy
|August 4, 2025
Summary
This study identified key biomarkers to predict immune checkpoint inhibitor efficacy in non-small-cell lung cancer (NSCLC). Factors like lung metastases and smoking status improve predictions, aiding better patient selection for treatment.
Area of Science:
- Oncology
- Immunotherapy
- Biomarker Discovery
Background:
- Immune checkpoint inhibitors (ICI) are standard for non-small-cell lung cancer (NSCLC), but many patients experience early progression.
- Improved patient selection is crucial for optimizing ICI therapy effectiveness.
- Program death ligand-1 (PDL1) expression alone is insufficient for predicting treatment outcomes.
Purpose of the Study:
- To identify clinical and biological biomarkers for predicting real-world progression-free survival (rwPFS) in NSCLC patients treated with ICI.
- To develop and validate a predictive model for ICI efficacy beyond PDL1 status.
Main Methods:
- Retrospective analysis of 173 metastatic NSCLC patients treated with nivolumab (second-line or further).
- Univariate and multivariate analyses screened clinical and biological parameters for association with rwPFS.
- A predictive nomogram model was developed and validated in a separate cohort of 253 NSCLC patients.
Main Results:
- Five independent prognostic biomarkers identified: bone/lung metastases, smoking status, first-line PFS (PFS1), and neutrophil-to-lymphocyte ratio (NLR).
- The nomogram model stratified patients into three distinct prognostic groups with median rwPFS of 11.7, 3.9, and 1.6 months.
- The predictive model's performance was confirmed in the validation cohort.
Conclusions:
- A novel predictive model using five simple biomarkers was developed to predict ICI efficacy in NSCLC, irrespective of PDL1 status.
- Favorable prognostic factors include lung metastases, longer PFS1, low NLR, and non-smoking status.
- Bone metastases were associated with a poorer prognosis, highlighting their significance in treatment response.
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