建立和验证非小细胞肺癌PD-1/PD-L1抑制剂相关不良反应的风险预测模型

邱晴; 吴呈昊; 唐文潇; 嵇龙飞; 代广卫; 高瑜振; 陈恩国; 蒋汉梁; 谢鑫友; 张钧

doi:10.1631/jzus.B2200631

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建立和验证非小细胞肺癌PD-1/PD-L1抑制剂相关不良反应的风险预测模型

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Correspondence | Updated：2023-09-25

建立和验证非小细胞肺癌PD-1/PD-L1抑制剂相关不良反应的风险预测模型
Development and validation of a risk-prediction model for immune-related adverse events in patients with non-small-cell lung cancer receiving PD-1/PD-L1 inhibitors
浙江大学学报（英文版）（B辑：生物医学和生物技术） 2023年24卷第10期页码：935-942
Affiliations：

1.Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
2.Department of Clinical Laboratory, Zhejiang Rongjun Hospital, Jiaxing 314000, China
3.Department of Clinical Laboratory, Huzhou First People Hospital, Huzhou 313000, China
4.Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou 310016, China
5.Department of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
Funds：

the National Natural Science Foundation of China(81972012)
DOI：10.1631/jzus.B2200631
中图分类号：
CSTR：

邱晴, 吴呈昊, 唐文潇, 等. 建立和验证非小细胞肺癌PD-1/PD-L1抑制剂相关不良反应的风险预测模型[J]. 浙江大学学报（英文版）（B辑：生物医学和生物技术）, 2023,24(10):935-942.

Qing QIU, Chenghao WU, Wenxiao TANG, et al. Development and validation of a risk-prediction model for immune-related adverse events in patients with non-small-cell lung cancer receiving PD-1/PD-L1 inhibitors[J]. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2023,24(10):935-942.
邱晴, 吴呈昊, 唐文潇, 等. 建立和验证非小细胞肺癌PD-1/PD-L1抑制剂相关不良反应的风险预测模型[J]. 浙江大学学报（英文版）（B辑：生物医学和生物技术）, 2023,24(10):935-942. DOI： 10.1631/jzus.B2200631.

Qing QIU, Chenghao WU, Wenxiao TANG, et al. Development and validation of a risk-prediction model for immune-related adverse events in patients with non-small-cell lung cancer receiving PD-1/PD-L1 inhibitors[J]. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2023,24(10):935-942. DOI： 10.1631/jzus.B2200631.

摘要

Abstract

在非小细胞肺癌（NSCLC）患者中，程序性细胞死亡蛋白-1/程序性细胞死亡蛋白-配体1（PD-1/PD-L1）抑制剂治疗后的免疫相关不良事件（irAEs）已被广泛报道。然而，在NSCLC患者中缺少PD-1/PD-L1抑制剂使用后发生irAEs的预测模型。本回顾性研究纳入了357例接受PD-1/PD-L1抑制剂治疗的NSCLC患者，从电子病历系统中收集了治疗前一周内患者的基线人口统计学特征和实验室参数。通过随访采集患者PD-1/PD-L1抑制剂治疗后发生irAEs的情况及长期预后，包括无进展生存期（PFS）和总生存期（OS）。首先，应用Cox比例风险回归模型探究irAEs（≥2级）与长期预后的相关性。然后，构建并验证irAEs（≥2级）的预测模型，按照入组时间顺序以6∶4的比例将患者分为训练集和验证集。在训练集中，通过Cox回归模型筛选出与PD-1/PD-L1抑制剂治疗后发生irAEs（≥2级）相关的变量。根据回归系数确定每个变量的得分并构建irAEs风险预测模型。最后，在训练集和验证集中分别使用受试者工作特征曲线和校准曲线评估预测模型的判别能力和校准度。使用Kaplan-Meier曲线和Cox模型评估irAEs（≥2级）风险预测模型与长期预后（PFS和OS）的相关性。我们建立并验证了基于全身免疫炎症指数、身体质量指数和年龄的irAEs风险预测模型，以帮助医生早期评估接受PD-1/PD-L1抑制剂的NSCLC患者发生irAEs（≥2级）的风险，且发生irAEs（≥2级）与患者的较好的PFS和OS明显相关。

关键词

非小细胞肺癌PD-1/PD-L1抑制剂免疫相关性不良事件全身免疫炎症指数身体质量指数年龄

Keywords

references

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