外周 CD4(+) T 细胞与接受化疗-免疫治疗的晚期非小细胞肺癌患者的缓解和生存相关

The aim of the present study was to explore the potential of peripheral immune cells in predicting the response and prognosis of patients with advanced non-small cell lung cancer (NSCLC) receiving anti-PD-1 immunotherapy and platinum-based chemotherapy. PARTICIPANTS AND METHODS: We utilized flow cytometry to examine the levels and dynamics of blood immune cells in 79 advanced NSCLC patients treated with the chemoimmunotherapy between December 2019 and January 2022. The pre- and post-treatment blood samples were collected within 3 days prior to the initiation of the first and third cycle of combination treatment, respectively. Progression-free survival (PFS) and overall survival (OS) analyses were conducted using Kaplan-Meier method and Cox regression models.

The pre-treatment CD4 + /Total T cells ratio was significantly higher in responders than non-responders ( P < 0.05). The levels of pre-treatment total lymphocytes ( P = 0.012), total B lymphocytes ( P = 0.025), and NK cells ( P = 0.022), and post-treatment NK cells ( P = 0.011) and NKT cells ( P = 0.035) were significantly associated with OS. Post-treatment CD8 + /Total T cells ratio was positively correlated with OS ( P = 0.038). In multivariate analysis, post-treatment NK cells and post-treatment CD4 + CD8 + /Total T cells ratio were negatively associated with OS (hazard ratio [HR] = 10.30, P = 0.038) and PFS (HR = 1.95, P = 0.022), respectively. Notably, significantly positive correlations were observed between CD4 + /Total T cells ratio and prognosis both before and after treatment ( P < 0.05).

To summarize, our finding reveals that high CD4 + /total T cells ratio was associated with favorable response and prognosis, highlighting its potential as a predictive biomarker to guide the selection of likely responders to platinum and anti-PD-1 combination therapy.