先前对非小细胞肺癌（NSCLC）的研究表明，具有特定驱动突变的肿瘤可能不太可能对免疫检查点抑制剂（ICI）产生反应。在这项分析中，我们评估了对 ICI 具有持久临床获益 (DCB) 的患者与没有持久临床获益 (NDB) 的患者的特征，重点关注 EGFR、ALK 和 ROS1 以及治疗前中性粒细胞的分子改变的作用。我们回顾性收集了 2015 年 4 月至 2018 年 5 月期间在斯坦福大学开始 ICI 单药治疗晚期 NSCLC 患者的临床特征和结果。如果 ICI 治疗时间大于或等于，则患者被归类为 DCB至 180 天，或 NDB（如果少于 180 天）。结果包括接受 ICI 时的最佳放射学获益以及从​​ ICI 开始时起的生存期。在 123 名接受 ICI 治疗的 NSCLC 患者中，28 名患者接受 DCB (23%)，而 95 名患者接受 NDB (77%)。在 33 名 EGFR (n = 31)、ALK 或 ROS1 分子改变且 NLR 为 5.9 或更高的患者中，从开始 ICI 起的中位总生存期为 2.0 个月，而具有这些基因组改变且 NLR 小于或等于 5.9 的患者的中位总生存期为 8.1 个月。 5.9. EGFR、ALK 或 ROS1 未发生改变且 NLR 为 5.9 或更高的患者的中位总生存期为 4.3 个月，而 NLR 小于 5.9 的患者的中位总生存期为 12.1 个月 (P = 0.023)。治疗前 NLR 的升高与显着相关。从 ICI 开始起，总体中位生存期较低，特别是与 EGFR、ALK 或 ROS1 改变的 NSCLC 合并使用时。这一发现可能会影响临床实践，因为 NLR 可通过常规血液检测轻松获得。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Prior research in non-small cell lung cancer (NSCLC) has shown that tumors with specific driver mutations may be less likely to respond to immune checkpoint inhibitors (ICI). In this analysis, we evaluated the characteristics of patients with durable clinical benefit (DCB) to ICI compared to those with no durable clinical benefit (NDB), with emphasis on the role of molecular alterations in EGFR, ALK, and ROS1 and pretreatment neutrophil-to-lymphocyte ratio (NLR).We retrospectively collected clinical characteristics and outcomes for patients who initiated ICI monotherapy for advanced NSCLC at Stanford University between April 2015 and May 2018. Patients were classified as having DCB if time on ICI therapy was greater than or equal to 180 days, or NDB if less than 180 days. Outcomes included best radiographic benefit while on ICI and survival from time of ICI initiation.Of 123 patients treated with ICI for NSCLC, 28 patients had DCB (23%), while 95 had NDB (77%). Median overall survival from initiation of ICI in the 33 patients with molecular alterations in EGFR (n = 31), ALK, or ROS1 and NLR of 5.9 or higher was 2.0 months, compared to 8.1 months in patients with these genomic alterations and NLR less than 5.9. Median overall survival in patients without alterations in EGFR, ALK, or ROS1 and NLR of 5.9 or higher was 4.3 months, compared to 12.1 months in patients with NLR less than 5.9 (P = .023).Elevation in pretreatment NLR was associated with significantly lower overall median survival from initiation of ICI, particularly when in combination with NSCLC with alterations in EGFR, ALK, or ROS1. This finding could influence clinical practice as NLR is readily available through routine blood testing.Copyright © 2024 Elsevier Inc. All rights reserved.