Coexistence of Emphysema With Non-small-cell Lung Cancer Predicts the Therapeutic Efficacy of Immune Checkpoint Inhibitors

Yusuke Takayama; Takashi Nakamura; Yuki Fukushiro; Shohei Mishima; Ken Masuda; Hiroyasu Shoda

doi:10.21873/invivo.12280

Coexistence of Emphysema With Non-small-cell Lung Cancer Predicts the Therapeutic Efficacy of Immune Checkpoint Inhibitors

In Vivo. 2021 Jan-Feb;35(1):467-474. doi: 10.21873/invivo.12280.

Authors

Yusuke Takayama¹, Takashi Nakamura², Yuki Fukushiro³, Shohei Mishima³, Ken Masuda³, Hiroyasu Shoda³

Affiliations

¹ Department of Respiratory Medicine, Hiroshima Citizens Hospital, Hiroshima, Japan; highmt@city-hosp.naka.hiroshima.jp.
² Department of Respiratory Medicine, Hiroshima General Hospital, Hatsukaichi, Japan.
³ Department of Respiratory Medicine, Hiroshima Citizens Hospital, Hiroshima, Japan.

Abstract

Background/aim: Chronic obstructive pulmonary disease coexisting with non-small-cell lung cancer (NSCLC) was reported to be associated with a longer progression-free survival (PFS) in patients treated with immune checkpoint inhibitors (ICIs). In the present study, we investigated the impact of emphysematous change on the treatment response to ICIs in patients with NSCLC.

Patients and methods: A total of 153 patients with advanced NSCLC who received ICIs (nivolumab, pembrolizumab, or atezolizumab) at our hospital from January 2016 to May 2019 were retrospectively enrolled.

Results: According to the Goddard scoring system, 71 (46.4%) patients were classified as having emphysema and 82 (53.6%) as having no emphysema. Multivariate analysis showed that a good performance status and coexisting emphysema (hazard ratio=0.49; 95% confidence intervaI=0.28-0.84; p=0.010) were independent predictors of a better PFS.

Conclusion: Recognizing emphysema coexisting with NSCLC may help predict the therapeutic efficacy of ICIs in such patients.

Keywords: Goddard scoring system; emphysema; immune checkpoint inhibitors; non-small-cell lung cancer.

MeSH terms

Antineoplastic Agents, Immunological* / therapeutic use
Carcinoma, Non-Small-Cell Lung* / complications
Carcinoma, Non-Small-Cell Lung* / drug therapy
Emphysema*
Humans
Immune Checkpoint Inhibitors
Lung Neoplasms* / complications
Lung Neoplasms* / drug therapy
Retrospective Studies

Substances

Antineoplastic Agents, Immunological
Immune Checkpoint Inhibitors