The CURB65 score predicted 180-day mortality of non-small cell lung carcinoma patients with immune checkpoint inhibitor-associated pneumonitis: A pilot retrospective analysis

Abstract

IntroductionThe immune checkpoint inhibitor-associated pneumonitis (CIP) is a particularly worrisome and potentially lethal form of immune-related adverse events. An objective and evidence-based assessment tool for evaluating the severity of CIP is in urgent need. CURB65 (consciousness, urea nitrogen, respiratory rate, blood pressure, and age) is a potential candidate to meet the need.MethodsA retrospective study was conducted to explore preliminarily if CURB65 could predict the mortality in non-small cell lung carcinoma (NSCLC) patients with CIP.ResultsA total number of 28 NSCLC patients with CIP were included in the current study and classified into low-CURB65 group (n = 21) and high-CURB65 group (n = 7). Mortality after onset of CIP was consistently higher in the high-CURB65 group than in the low-CURB65 group (30-day: 57.1% vs. 0; 90-day: 71.4% vs. 4.76%; 180-day:71.4% vs. 14.29%). Two patients (9.5%) in the low-CURB65 group had severe CIP, and more than half of patients in the high-CURB65 group had severe CIP (p = 0.0008). The patients in the high-CURB65 group received more aggressive treatment. Both groups showed a predominant organizing pneumonia-like pattern on CT scan. CURB65 was moderately correlated with the American Society of Clinical Oncology (ASCO) grade of CIP, with a Pearson correlation coefficient R of 0.524.ConclusionCURB65 accurately stratified the risk of mortality in NSCLC patients with CIP. CURB65 might complement the ASCO grade in the assessment and prediction of mortality in these populations.

Predictive value of community-acquired pneumonia severity scores on lung cancer patients with immune checkpoint inhibitor-associated pneumonitis: a retrospective analysis

“…In previous study we found that the CURB65 accurately strati ed the risk of mortality in NSCLC patients with CIP. (17) To further explore the utility of CAP severity scores in CIP, we tested the e cacy of above-mentioned severity scores (PSI, CURB65, CRB65 and SMART-COP) in predicting mortality of CIP in larger lung cancer population, which included both NSCLC and SCLC.…”

“…(14,16) In previous study, we found that the CURB65 accurately strati ed the risk of mortality in NSCLC patients with CIP. (17) The CURB65 might complement the American Society of Clinical Oncology (ASCO) grade in the assessment and prediction of mortality in these population. Our previous study only included NSCLC patients from one hospital.…”