骨转移 (BoM) 在转移性非小细胞肺癌 (NSCLC) 患者中普遍存在，然而，详细说明 BoM 如何响应免疫检查点抑制剂 (ICIs) 的数据有限。本研究的目的是比较 BoM 对内脏转移的 ICI 的影像学反应，并评估 BoM 对生存的影响。一项回顾性、多中心队列研究在加拿大艾伯塔省接受纳武单抗或派姆单抗治疗的 NSCLC 患者中进行2015 年至 2020 年。主要终点是骨转移与内脏转移的真实器官特异性无进展生存期 (osPFS)。内脏转移分为肾上腺、脑、肝、肺、淋巴结或其他腹腔内病变。次要结局是有和没有 BoM 的患者的总生存期 (OS)。总共纳入 573 名患者，其中所有患者都有内脏转移，243 名患者 (42.4%) 有 BoM。在 268 名患者 (46.8%) 中发现了高 PD-L1 表达。骨、肝脏和腹腔内转移之间的 osPFS 没有观察到显着差异（分别为 p=0.20 和 p=0.76），所有这些都显示出比其他疾病部位更短的 osPFS。 PD-L1 高表达患者的胸外疾病部位的 osPFS 没有差异。 ICI 的内脏疾病反应和骨疾病反应之间存在显着不一致 (p=0.047)。 BoM 的存在是 OS 的一个独立不良预后因素（HR 1.26，95%CI：1.05-1.53​​，p=0.01）。与其他部位相比，转移性骨、肝和腹内病变对 ICI 的临床反应较差疾病。此外，骨和肝转移的存在是总体生存率的独立不良预后因素。这一真实数据表明，BoM 对 ICI 反应不佳，可能需要辅助治疗来控制疾病。版权所有 © 2024 Abbott、Meyers、Elmi-Assadzadeh、Stukalin、Marro、Puloski、Morris、Cheung 和 Monument。

Bone metastases (BoMs) are prevalent in patients with metastatic non-small-cell lung cancer (NSCLC) however, there are limited data detailing how BoMs respond to immune checkpoint inhibitors (ICIs). The purpose of this study was to compare the imaging response to ICIs of BoMs against visceral metastases and to evaluate the effect of BoMs on survival.A retrospective, multicentre cohort study was conducted in patients with NSCLC treated with nivolumab or pembrolizumab in Alberta, Canada from 2015 to 2020. The primary endpoint was the real-world organ specific progression free survival (osPFS) of bone versus visceral metastases. Visceral metastases were categorized as adrenal, brain, liver, lung, lymph node, or other intra-abdominal lesions. The secondary outcome was overall survival (OS) amongst patients with and without BoMs.A total of 573 patients were included of which all patients had visceral metastases and 243 patients (42.4%) had BoMs. High PD-L1 expression was identified in 268 patients (46.8%). No significant difference in osPFS was observed between bone, liver, and intra-abdominal metastases (p=0.20 and p=0.76, respectively), with all showing shorter osPFS than other disease sites. There was no difference in the osPFS of extra-thoracic sites of disease in patients with high PD-L1 expression. There was significant discordance between visceral disease response and bone disease response to ICI (p=0.047). The presence of BoMs was an independent poor prognostic factor for OS (HR 1.26, 95%CI: 1.05-1.53, p=0.01).Metastatic bone, liver, and intra-abdominal lesions demonstrated inferior clinical responses to ICI relative to other sites of disease. Additionally, the presence of bone and liver metastases were independent poor prognostic factors for overall survival. This real-world data suggests that BoMs respond poorly to ICI and may require treatment adjuncts for disease control.Copyright © 2024 Abbott, Meyers, Elmi-Assadzadeh, Stukalin, Marro, Puloski, Morris, Cheung and Monument.