Association of baseline peripheral-blood eosinophil count with immune checkpoint inhibitor-related pneumonitis and clinical outcomes in patients with non-small cell lung cancer receiving immune checkpoint inhibitors

Chu, Xiangling; Zhao, Jing; Zhou, Juan; Zhou, Fei; Jiang, Tao; Jiang, Sen; Sun, Xuejun; You, Xiaofang; Wu, Fengying; Ren, Shengxiang; Su, Chunxia

doi:10.1016/j.lungcan.2020.08.015

Cited by 79 publications

(111 citation statements)

References 39 publications

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“…In the sensitivity analyses excluding the crude ORs, 10 studies were included [25][26][27][28][29][30][31][32][33][34]. Risk factors that could be pooled and were significantly related with the development of irAEs were squamous histology (OR 1.847; CI 95% 1.048-3.256), a higher number of pack-years of smoked tobacco (OR 2.662; CI 95% 1.014-6.989) and the presence of ground glass attenuation in CT imaging (OR 77.1; CI 95% 7.82-760.3) (Supplementary Table 2).…”

Section: Resultsmentioning

confidence: 99%

Risk factors for adverse events induced by immune checkpoint inhibitors in patients with non-small-cell lung cancer: a systematic review and meta-analysis

Suazo-Zepeda

Bokern

Vinke

et al. 2021

Cancer Immunol Immunother

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Background Immune checkpoint inhibitors (ICIs) can cause serious immune-related adverse events (irAEs). This study aimed to identify risk factors for all types of irAEs induced by ICIs in patients with non-small-cell lung cancer (NSCLC), by systematic review and meta-analyses. Methods A systematic search was performed in Pubmed, Embase and Web of Science by two independent reviewers. Studies were selected that included patients with NSCLC and evaluated characteristics of patients with and without irAEs induced by ICIs. Quality and risk of bias of the selected studies were assessed. Random effects meta-analyses were conducted to estimate pooled odds ratios (ORs) for risk factors of developing all type of irAEs, and separately for pneumonitis, interstitial lung disease and severe irAEs. With the objective of exploring sources of heterogeneity, stratified analyses were performed by quality and region. Results 25 studies met the inclusion criteria. In total, the data of 6696 patients were pooled. 33 different risk factors for irAEs were reported. irAEs of interest were reported for 1653 (25%) of the patients. Risk factors related to the development of irAEs were: C-reactive protein, neutrophil lymphocyte ratio (NLR), use of PD-1 inhibitor, high PD-L1 expression, an active or former smoking status, ground glass attenuation, and a better treatment response. Conclusion The identified risk factors for the development of these irAEs are mostly related to the alteration of the immune system, proinflammatory states and loss of immunological self-tolerance. Patients identified as having a higher risk for irAEs should be monitored more closely.

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Section: Resultsmentioning

confidence: 99%

Risk factors for adverse events induced by immune checkpoint inhibitors in patients with non-small-cell lung cancer: a systematic review and meta-analysis

Suazo-Zepeda

Bokern

Vinke

et al. 2021

Cancer Immunol Immunother

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“…Intrapleural administration of IL-2 is also known to cause significant eosinophilic pleural effusion [38]. In recent years, it has been shown that the number of peripheral blood eosinophils before administration is a valuable marker for predicting the effect when using cancer immunotherapies, especially immune checkpoint inhibitors [6][7][8][9][10][11]. Eosinophils infiltrate the tumor, and their activation there helps T cells infiltrate the tumor as well [4,39].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, it has been shown that tumor-related eosinophilia may have extended survival benefits for some cancer patients [3][4][5]. In recent years, it has been demonstrated that peripheral blood eosinophils before administration are a potential predictive marker for a beneficial clinical response in cancer immunotherapy, particularly immune checkpoint inhibitors [6][7][8][9][10][11]. This finding suggested malignant pleural effusion (MPE) is an essential tool for investigating the tumor microenvironment (TME).…”

Section: Introductionmentioning

confidence: 99%

Eosinophilic pleural effusion due to lung cancer has a better prognosis than non-eosinophilic malignant pleural effusion

Takeuchi

Okano

Machida

et al. 2021

Cancer Immunol Immunother

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Objective Tumor-related eosinophilia may have extended survival benefits for some cancer patients. However, there has been no report on the prognosis difference between eosinophilic pleural effusion (EPE) and non-EPE in lung cancer patients. Our study aimed to investigate the prognosis difference between EPE and non-EPE due to lung cancer. Patients and methods We retrospectively reviewed patients diagnosed with lung cancer who presented with malignant pleural effusion (MPE) between May 2007 and September 2020 at the National Hospital Organization Kochi Hospital. EPE is defined as pleural fluid with a nucleated cell count containing 10% or more eosinophils. Results A total of 152 patients were included: 89 were male (59%). The median age was 74.4 years (range 37–101), and all patients were pathologically shown to have MPE. Most patients (140; 92%) had an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0/1. Twenty patients had EPE. The median overall survival (OS) of all 152 lung cancer patients with MPE was 298 days. The median OS of the patients with EPE was 766 days, and the median OS of the patients with non-EPE was 252 days. Kaplan–Meier univariate analysis showed that lung cancer patients with EPE had a significantly better prognosis than patients with non-EPE (P < 0.05). Cox proportional regression analysis showed that EPE, ECOG PS, sex, and the neutrophil-to-lymphocyte ratio in the serum (sNLR) may be independent prognostic factors affecting survival in patients with MPE. Conclusion Lung cancer patients with EPE have a better prognosis than those with non-EPE.

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“…77 At present, some peripheral blood-related biomarkers, such as neutrophil to lymphocyte ratio, C-reactive protein and lactate dehydrogenase level, have been proved to predict the efficacy of immunotherapy. [78][79][80][81] Qin et al evaluated the influence of blood cholesterol level on the growth of liver tumor cells in vitro models. 82 They found a negative correlation between blood cholesterol levels and tumor growth.…”

Section: Peripheral Blood Cholesterol Level Can Be a Biomarker To Predict The Efficacy Of Immunotherapymentioning

confidence: 99%

Cholesterol Metabolism as a Potential Therapeutic Target and a Prognostic Biomarker for Cancer Immunotherapy

Zhang¹,

Zhao²,

Li³

et al. 2021

OTT

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Checkpoint-based immunotherapies, such as programmed cell death-1 (PD-1)/ programmed cell death ligand-1 (PD-L1) inhibitors, have shown promising clinical outcomes in many types of cancers. Unfortunately, the response rate of immune checkpoint inhibitors is low. It is very important to discover novel therapeutic targets and prognostic biomarkers. Cholesterol metabolism has been demonstrated to be related to the occurrence and development of a variety of tumors and may provide a new breakthrough in the development of immunotherapy. First of all, cholesterol metabolism in the tumor microenvironment affects the function of tumor-infiltrating immune cells. In addition, intracellular cholesterol homeostasis is an important regulator of immune cell function. Furthermore, drugs that act on cholesterol metabolism affect the efficacy of immunotherapy. What is more, peripheral blood cholesterol level can be a biomarker to predict the efficacy of immunotherapy. In this review, we aimed to explore the potential role of cholesterol metabolism on immunotherapy. By summarizing the major findings of recent preclinical and clinical studies on cholesterol metabolism in immunotherapy, we suggested that cholesterol metabolism could be a potential therapeutic target and a prognostic biomarker for immunotherapy.

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Association of baseline peripheral-blood eosinophil count with immune checkpoint inhibitor-related pneumonitis and clinical outcomes in patients with non-small cell lung cancer receiving immune checkpoint inhibitors

Cited by 79 publications

References 39 publications

Risk factors for adverse events induced by immune checkpoint inhibitors in patients with non-small-cell lung cancer: a systematic review and meta-analysis

Risk factors for adverse events induced by immune checkpoint inhibitors in patients with non-small-cell lung cancer: a systematic review and meta-analysis

Eosinophilic pleural effusion due to lung cancer has a better prognosis than non-eosinophilic malignant pleural effusion

Cholesterol Metabolism as a Potential Therapeutic Target and a Prognostic Biomarker for Cancer Immunotherapy

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