Prognostic value of the CHAM score in non-small cell lung cancer patients treated with nivolumab

Reliable prognostic markers are needed to improve risk stratification in patients with non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors. We evaluated the prognostic value of the CHAM score, a composite marker integrating systemic inflammation, hematologic parameters, and metastatic burden, in nivolumab-treated NSCLC patients. To our knowledge, its prognostic relevance in this setting has not been previously investigated.

This retrospective cohort study included 91 patients with histologically confirmed NSCLC who received nivolumab between 2020 and 2026. The CHAM score was derived from C-reactive protein, albumin, hemoglobin levels, and metastatic extent. Overall and progression-free survival were analyzed using the Kaplan-Meier method and compared with the log-rank test. Multivariable Cox proportional hazards regression evaluated the prognostic impact of the CHAM score, and receiver operating characteristic curve analysis determined the optimal cut-off.

During follow-up, 59 deaths were observed. Patients with a CHAM score ≥ 4 had shorter overall survival than those with a CHAM score < 4, with median survival times of 6.7 and 18.7 months, respectively (log-rank p < 0.001). Progression-free survival was also reduced in the high-risk group, with median values of 2.6 versus 11.2 months (log-rank p < 0.001). In multivariable Cox regression analyses, a high CHAM score remained independently associated with worse overall and progression-free survival (p < 0.05 for both). Receiver operating characteristic analysis identified a CHAM score of 4 as the optimal cut-off.

The CHAM score may provide practical prognostic stratification in nivolumab-treated NSCLC patients; however, external validation is required.