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COPD 与接受一线 ICI 联合化疗的晚期非小细胞肺癌患者较差生存期相关

COPD is associated with poorer survival in patients with advanced non-small cell lung cancer treated with first-line ICI plus chemotherapy.

期刊
BMC Pulmonary Medicine
PMID
42472803
原文
PubMed ↗
发布日期

作者

  • Akihisa Takano — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Daisuke Shibahara — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. shibahara.daisuke.805@m.kyushu-u.ac.jp.
  • Hiroaki Ogata — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Sai Yasukochi — Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan.
  • Ryosuke Matsukane — Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan.
  • Toshifumi Ninomiya — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Takahiro Utsumi — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Yuki Ikematsu — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Kohei Otsubo — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Yoshimasa Shiraishi — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Eiji Iwama — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Mayako Uchida — Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan.
  • Isamu Okamoto — Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

作者单位

  • Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. shibahara.daisuke.805@m.kyushu-u.ac.jp.
  • Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan.

摘要

中文

慢性阻塞性肺疾病（COPD）常与非小细胞肺癌（NSCLC）并存。既往研究提示 COPD 可能与接受免疫检查点抑制剂（ICI）单药治疗患者的较好预后相关,但其在接受 ICI 联合化疗患者中的影响尚不明确。本回顾性单中心研究纳入 55 例接受一线 ICI 联合化疗并行肺功能检查的 IV 期 NSCLC 既往吸烟者。COPD 定义为支气管舒张后 FEV1/FVC < 0.70,患者分为 COPD 组（n = 33）和非 COPD 组（n = 22）。采用 Kaplan-Meier 法和 Cox 比例风险模型分析无进展生存期（PFS）和总生存期（OS）。为减少基线混杂因素,采用基于倾向评分的逆概率加权（IPTW）。在未校正分析中,COPD 组中位 PFS 为 5.3 个月,非 COPD 组为 11.1 个月（风险比[HR] 1.79, 95% CI 0.95–3.37;p = 0.071）。IPTW 校正后,COPD 组 PFS 显著缩短（中位 4.6 个月 vs 13.7 个月；HR 2.54, 95% CI 1.29–5.00;p = 0.007）。未校正分析中,COPD 组中位 OS 为 12.7 个月,非 COPD 组未达到（HR 1.56, 95% CI 0.73–3.33;p = 0.247）。IPTW 校正后,COPD 组 OS 显著缩短（中位 11.8 个月 vs 未达到；HR 3.00, 95% CI 1.16–7.73;p = 0.023）。COPD 可能与接受一线 ICI 联合化疗的晚期 NSCLC 既往吸烟者的较差生存期相关,但仍需在更大队列中进行验证。

English

Chronic obstructive pulmonary disease (COPD) frequently coexists with non-small cell lung cancer (NSCLC). Previous studies suggest that COPD may be associated with improved outcomes in patients receiving immune checkpoint inhibitor (ICI) monotherapy, but its impact in patients treated with ICI plus chemotherapy remains unclear. In this retrospective single-institution study, we evaluated 55 ever-smokers with stage IV NSCLC treated with first-line ICI plus chemotherapy who underwent pulmonary function testing. COPD was defined as a post-bronchodilator FEV1/FVC ratio < 0.70, and patients were classified into COPD (n = 33) and non-COPD (n = 22) groups. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier methods and Cox proportional hazards models. To reduce baseline confounding, inverse probability of treatment weighting (IPTW) based on propensity scores was applied. In unadjusted analyses, median PFS was 5.3 months in the COPD group and 11.1 months in the non-COPD group (hazard ratio [HR] 1.79, 95% confidence interval [CI] 0.95-3.37; p = 0.071). After IPTW adjustment, PFS was significantly shorter in the COPD group (median 4.6 months vs 13.7 months; HR 2.54, 95% CI 1.29-5.00; p = 0.007). In unadjusted analyses, median OS was 12.7 months in the COPD group and not reached in the non-COPD group (HR 1.56, 95% CI 0.73-3.33; p = 0.247). After IPTW adjustment, OS was significantly shorter in the COPD group (median 11.8 months vs not reached; HR 3.00, 95% CI 1.16-7.73; p = 0.023). COPD may be associated with poorer survival among ever-smokers with advanced NSCLC receiving first-line ICI plus chemotherapy, although further validation in larger cohorts is warranted.

分类与指标

研究类型
临床研究
病种
肺癌
JCR 分区
Q2
影响因子
3.1
新锐分区
3区