Complete blood count as a prognostic tool for NSCLC patients treated with immune checkpoint inhibitors.

Abstract

e20564 Background: Lung cancer accounts for 1.8 million deaths annually, making it the leading cause of cancer-related mortality, with 85% of cases diagnosed as non-small cell lung cancer (NSCLC). Immunotherapy, in particular the use of immune checkpoint inhibitors (ICIs), has undergone substantial advancement through the employment of monoclonal antibodies to regulate pivotal immune pathways. While ICIs have exhibited superior efficacy in comparison to conventional second-line chemotherapy regimens, the identification of reliable prognostic markers remains imperative. The study aimed to investigate the prognostic significance of complete blood count (CBC) values in NSCLC patients undergoing ICI therapy, focusing on associations with clinical outcomes such as overall survival (OS) and progression-free survival (PFS). Methods: A retrospective medical record review was conducted for patients with advanced NSCLC treated with ICIs at the Barretos Cancer Hospital. Demographic data were collected and blood count values were used to create the Score1= (RDW X erythrocyte). The primary outcomes of OS and PFS were assessed using SPSS software. Results: The study cohort included 105 patients, with adenocarcinoma representing the predominant histological type (57.0%). Of the participants, 58.0% were male, and 61.0% were diagnosed at stage IV. In terms of PD-L1 status, 62.9% tested positive, with 79.9% of these patients receiving anti-PD-1 therapy. Notably, only 11.0% of the patients were never smokers. The present study has revealed significant associations between CBC components measured post-cycle 3 (PC3) of ICI therapy and clinical outcomes in patients with NSCLC. Of particular note, elevated Score 1 levels (>5.4; p =0.042) were found to be significantly associated with reduced OS. Furthermore, an increase in Score 1 levels (>5.4; p =0.049) was associated with a decline in PFS. Conclusions: These findings underscore the critical importance of effective NSCLC treatment with ICIs. Furthermore, the potential of CBC values as cost-effective prognostic biomarkers is promising, offering a valuable tool to refine treatment strategies and improve patient outcomes.