为了探究细菌性肺感染（BLI）对免疫检查点抑制剂（ICIs）治疗效果和非小细胞肺癌（NSCLC）患者因检查点抑制剂（CIP）相关肺炎引起的肺炎发病率的影响，我们进行了回顾性队列研究。研究纳入2020年6月至2022年12月在昆明理工大学附属医院接受至少两次ICI治疗的507例NSCLC患者。根据胸部高分辨CT扫描是否存在并发BLI诊断将患者分为两组：238例NSCLC伴BLI组（NSCLC-BLI组）和269例NSCLC单独组。收集的治疗结果指标包括客观疗效率（ORR）、无进展生存期（PFS）、总生存期（OS）和CIP发病率。我们分析了BLI对ICI治疗的疗效和NSCLC患者CIP发病率的影响。根据国际肺癌研究协会（IASLC）第8版将NSCLC患者分为I至IV期进行纳入标准。与NSCLC组相比，NSCLC-BLI组在接受ICI治疗时显示出更高的ORR。由多因素逻辑回归和Cox分析，在调整混杂因素后，BLI被确认为ORR（HR=0.482，95%CI：0.391-0.550；P<0.001）和PFS（HR=0.619，95%CI：0.551-0.771；P<0.001）的独立正预后因子。BLI与OS之间没有相关性。在26例CIP中，12例在NSCLC-BLI组，14例在NSCLC组，发病率无显著差异（P=0.145）。接受ICI治疗的NSCLC伴BLI患者相比于无BLI的NSCLC单独组，显示出更高的ORR和PFS，且没有增加CIP风险，将BLI定位为接受ICIs的NSCLC患者中改善预后的预测因子。然而，该研究存在一些局限性，包括回顾性性质以及缺乏BLI细菌类型和水平的数据，这些可能会影响治疗结果。版权所有©2023年Cao, Wu, Chen, Wei, You, Qiang and Cao。

To find out how bacterial lung infections (BLI) affect the effectiveness of therapy and the rate of pneumonia caused by pneumonia related to checkpoint inhibitors (CIP) in patients with non-small cell lung cancer (NSCLC) who are getting immunotherapy with checkpoint inhibitors (ICIs).507 NSCLC patients who received at least two ICI treatments between June 2020 and December 2022 at the Affiliated Hospital of Kunming University of Science and Technology(AHKUST) were included in a retrospective cohort study. Based on whether there was a concurrent BLI diagnosis from high-resolution CT scans of the chest, the patients were divided into two groups: 238 in the NSCLC with BLI group (NSCLC-BLI group), and 269 in the NSCLC alone group. The collected therapeutic outcome measures included the objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and the incidence rate of CIP. We analyzed the effect of BLI on the therapeutic efficacy of ICI treatment and the incidence rate of CIP in NSCLC patients.Inclusion criteria based on NSCLC patients staged I to IV according to the 8th edition of the International Association for Lung Cancer Research (IASLC).The NSCLC-BLI group showed superior ORR to the NSCLC group when treated with ICIs. Multifactorial logistic regression and Cox analyses, adjusted for confounders, identified BLI as an independent positive prognostic factor for ORR (HR=0.482, 95%CI: 0.391-0.550; P<0.001) and PFS (HR=0.619; 95%CI: 0.551-0.771; P<0.001). No correlation between BLI and OS was found. Out of 26 cases of CIP, 12 were in the NSCLC-BLI group and 14 in the NSCLC group, with no significant difference in incidence (P=0.145).NSCLC patients with BLI receiving ICI treatment show superior ORR and PFS compared to NSCLC alone without an increased CIP risk, positioning BLI as a predictive factor for improved outcomes in NSCLC patients receiving ICIs. However, the study has limitations including its retrospective nature and lacking data on BLI bacteria types and levels, which could influence therapy outcomes.Copyright © 2023 Cao, Wu, Chen, Wei, You, Qiang and Cao.