Durvalumab化疗放疗 (CRT) 后的巩固治疗是晚期非小细胞肺癌 (NSCLC) 的标准治疗。然而，有关免疫和营养标志物以预测无进展生存 (PFS) 和总生存 (OS) 的研究不足。系统性炎症引起的肿瘤消瘦对免疫治疗疗效产生负面影响，这也反映在生存结果上。我们在日本的七家机构进行了回顾性研究，研究对象为126名患者。在评估的指标中，经过 CRT 前后的改良格拉斯哥预后评分 (mGPS) 值是必要的预测因素。通过将CRT前mGPS值与CRT后C-反应蛋白 (CRP) 水平相结合，创建了基于系统性炎症的预后风险分级，以区分肿瘤来源的炎症和CRT诱导的炎症。患者被分为高风险组 (n = 31) 和低风险组 (n = 95)，高风险组的中位无进展生存为7.2个月，总生存为19.6个月，明显短于低风险组。无进展生存比值比和总生存比值为2.47 (95% 置信区间 [CI]: 1.46-4.19, p < 0.001) 和 3.62 (95% CI: 1.79-7.33, p < 0.001)。这种关联还观察到在PD-L1表达≥50%的亚组中，而在<50%的亚组中没有观察到。此外，高风险组的durvalumab停药比率显著高于低风险组。将局部晚期NSCLC患者的CRT前mGPS值与CRT后CRP水平相结合，有助于预测Durvalumab化疗放疗后的巩固治疗的PFS和OS。

Durvalumab consolidation after chemoradiotherapy (CRT) is a standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, studies on immunological and nutritional markers to predict progression-free survival (PFS) and overall survival (OS) are inadequate. Systemic inflammation causes cancer cachexia and negatively affects immunotherapy efficacy, which also reflects survival outcomes.We retrospectively investigated 126 patients from seven institutes in Japan.The modified Glasgow Prognostic Score (mGPS) values, before and after CRT, were the essential predictors among the evaluated indices. A systemic inflammation-based prognostic risk classification was created by combining mGPS values before CRT, and C-reactive protein (CRP) levels after CRT, to distinguish tumor-derived inflammation from CRT-induced inflammation. Patients were classified into high-risk (n = 31) and low-risk (n = 95) groups, and the high-risk group had a significantly shorter median PFS of 7.2 months and an OS of 19.6 months compared with the low-risk group. The hazard ratios for PFS and OS were 2.47 (95% confidence interval [CI]: 1.46-4.19, p < 0.001) and 3.62 (95% CI: 1.79-7.33, p < 0.001), respectively. This association was also observed in the subgroup with programmed cell death ligand 1 expression of ≥50%, but not in the <50% subgroup. Furthermore, durvalumab discontinuation was observed more frequently in the high-risk group than in the low-risk group.Combining pre-CRT mGPS values with post-CRT CRP levels in patients with locally advanced NSCLC helps to predict the PFS and OS of durvalumab consolidation after CRT.