Peripheral blood markers predict prognosis in patients with advanced non-small cell lung cancer receiving immunotherapy

Abstract

In recent years, immunotherapy has significantly reshaped the pattern of non-small cell lung cancer (NSCLC) treatment. However, the issue of how to pinpoint potential responsive populations more accurately warrants immediate and focused attention. This study mainly explored the correlation between baseline peripheral blood biomarkers and prognosis in patients with advanced NSCLC undergoing immunotherapy. A retrospective analysis was performed on 139 patients diagnosed with advanced NSCLC who underwent first-line immunotherapy treatment between 2019 and 2022. Baseline demographic information and peripheral blood parameter data were collected. The Cox proportional hazards regression model was used to estimate hazard ratios and 95% confidence intervals to identify independent prognostic factors, while Kaplan–Meier survival analysis with log-rank tests was applied to compare survival differences between groups. Finally, the predictive efficacy of biomarkers was assessed utilizing the receiver operating characteristic curve. C-reactive protein (CRP) and carcinoembryonic antigen (CEA) were independent predictors for both progression-free survival (PFS) and overall survival (OS). Eosinophils > 0.23 × 109/L, PLT (platelets) > 228 × 109/L, albumin ≤ 37.2g/L, CRP > 6.21mg/L, or CEA > 6.23ng/ml was associated with poorer PFS. Meanwhile, (hemoglobin) ≤ 132g/L, platelets > 228 × 109/L, CRP > 7.59mg/L, or CEA > 7.39ng/ml may imply an inferior OS outcome. And the combination of CRP and CEA yielded areas under the curve with 0.675 and 0.656 for predicting PFS and OS, respectively. CRP and CEA hold the potential to predict the prognosis of advanced NSCLC patients undergoing first-line immunotherapy.