Higher CD4/CD8 ratio of pleural effusion predicts better survival for lung cancer patients receiving immune checkpoint inhibitors.

Abstract

Pleural effusion is a rare immune-related adverse event for lung cancer patients receiving immune checkpoint inhibitors (ICIs). We enrolled 281 lung cancer patients treated with ICIs and 17 were analyzed. We categorized the formation of pleural effusion into 3 patterns: type 1, rapid and massive; type 2, slow and indolent; and type 3, with disease progression. CD4/CD8 ratio of 1.93 was selected as the cutoff threshold to predict survival. Most patients of types 1 and 2 effusions possessed pleural effusion with CD4/CD8 ratios ≥ 1.93. The median OS time in type 1, 2, and 3 patients were not reached, 24.8, and 2.6 months, respectively. The median PFS time in type 1, 2, and 3 patients were 35.5, 30.2, and 1.4 months, respectively. The median OS for the group with pleural effusion CD4/CD8 ≥ 1.93 and < 1.93 were not reached and 2.6 months. The median PFS of those with pleural effusion CD4/CD8 ≥ 1.93 and < 1.93 were 18.4 and 1.2 months. In conclusion, patients with type 1 and 2 effusion patterns had better survival than those with type 3. Type 1 might be interpreted as pseudoprogression of malignant pleural effusion. CD4/CD8 ratio ≥ 1.93 in pleural effusion is a good predicting factor for PFS.

• Authors: Po-Hsin Lee, Tsung-Ying Yang, Kun-Chieh Chen, Yen-Hsiang Huang, Jeng-Sen Tseng, Kuo-Hsuan Hsu, Yu-Chen Wu, Ko-Jiunn Liu, Gee-Chen Chang
• Journal: Scientific reports (Sci Rep) Vol. 11 Issue 1 Pg. 9381 (04 30 2021) ISSN: 2045-2322 [Electronic] England
• PMID: 33931705 (Publication Type: Journal Article)

Chemical References

• Biomarkers, Tumor
• Immune Checkpoint Inhibitors

Topics

• Aged
• Biomarkers, Tumor (analysis)
• CD4-CD8 Ratio
• CD8-Positive T-Lymphocytes (drug effects, immunology)
• Carcinoma, Non-Small-Cell Lung (drug therapy, immunology, mortality, pathology)
• Female
• Follow-Up Studies
• Humans
• Immune Checkpoint Inhibitors (therapeutic use)
• Lung Neoplasms (drug therapy, immunology, mortality, pathology)
• Male
• Middle Aged
• Pleural Effusion, Malignant (drug therapy, immunology, pathology)
• Prognosis
• Retrospective Studies
• Survival Rate