Xiuqiong Chen1,2,3,4, Zhaona Li1,2,3,4, Xinyue Wang1,2,3,4, Jing Zhou1,2,3,4, Qianhui Wei1,2,3,4, Richeng Jiang5,6,7,8. 1. Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China. 2. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China. 3. Tianjin's Clinical Research Center for Cancer, Tianjin, China. 4. Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin Medical University, Tianjin, China. 5. Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China. jiangricheng@tjmuch.com. 6. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China. jiangricheng@tjmuch.com. 7. Tianjin's Clinical Research Center for Cancer, Tianjin, China. jiangricheng@tjmuch.com. 8. Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin Medical University, Tianjin, China. jiangricheng@tjmuch.com.
Abstract
BACKGROUND AND AIM: Many pieces of literature have evaluated the predictive value of pre-existing lung interstitial changes for immunotherapy-related pneumonia in patients with non-small cell lung cancer (NSCLC), but the results of studies are still controversial. The purpose of this article is to explore whether pre-existing lung interstitial changes can predict the occurrence of immunotherapy-related pneumonia. METHODS: PubMed, Web of Science, and Embase were used to search for relevant documents. Two investigators respectively carried out literature screening, quality evaluation, and data extraction strictly according to the inclusion criteria. Odds ratios (ORs) and the corresponding 95% CIs were applied to assess the predictive value of interstitial lung disease (ILD), interstitial lung abnormalities (ILA), and radiation pneumonitis (RP). Stata 12.0 software was used for the statistical analysis of data. RESULTS: Seventeen studies involving 2758 patients were included in the final analysis. NSCLC patients with pulmonary interstitial changes were more likely to develop immune-related pneumonia after immunotherapy (OR = 3.68, 95% CI: 2.49-5.44). Subgroup analysis revealed that ILD (OR = 3.59, 95% CI: 2.22-5.82), RP (OR = 3.63, 95% CI: 1.80-7.30), and ILA (OR = 6.64, 95% CI: 1.78-24.8) were all predictors of immune-related pneumonia. As the preliminary screening of other risk factors, gender, neutrophilic lymphocyte ratio (NLR), actual eosinophil count (AEC), and drug type may have potential predictive value for immunotherapy-related pneumonia. There was no significant statistical heterogeneity and publication bias in our study. Further research is needed to update and validate our results. CONCLUSION: Pulmonary interstitial changes can be considered as a predictive factor of immune-related pneumonia after immunotherapy in NSCLC patients.
BACKGROUND AND AIM: Many pieces of literature have evaluated the predictive value of pre-existing lung interstitial changes for immunotherapy-related pneumonia in patients with non-small cell lung cancer (NSCLC), but the results of studies are still controversial. The purpose of this article is to explore whether pre-existing lung interstitial changes can predict the occurrence of immunotherapy-related pneumonia. METHODS: PubMed, Web of Science, and Embase were used to search for relevant documents. Two investigators respectively carried out literature screening, quality evaluation, and data extraction strictly according to the inclusion criteria. Odds ratios (ORs) and the corresponding 95% CIs were applied to assess the predictive value of interstitial lung disease (ILD), interstitial lung abnormalities (ILA), and radiation pneumonitis (RP). Stata 12.0 software was used for the statistical analysis of data. RESULTS: Seventeen studies involving 2758 patients were included in the final analysis. NSCLC patients with pulmonary interstitial changes were more likely to develop immune-related pneumonia after immunotherapy (OR = 3.68, 95% CI: 2.49-5.44). Subgroup analysis revealed that ILD (OR = 3.59, 95% CI: 2.22-5.82), RP (OR = 3.63, 95% CI: 1.80-7.30), and ILA (OR = 6.64, 95% CI: 1.78-24.8) were all predictors of immune-related pneumonia. As the preliminary screening of other risk factors, gender, neutrophilic lymphocyte ratio (NLR), actual eosinophil count (AEC), and drug type may have potential predictive value for immunotherapy-related pneumonia. There was no significant statistical heterogeneity and publication bias in our study. Further research is needed to update and validate our results. CONCLUSION: Pulmonary interstitial changes can be considered as a predictive factor of immune-related pneumonia after immunotherapy in NSCLC patients.
Authors: Hiroto Hatabu; Gary M Hunninghake; Luca Richeldi; Kevin K Brown; Athol U Wells; Martine Remy-Jardin; Johny Verschakelen; Andrew G Nicholson; Mary B Beasley; David C Christiani; Raúl San José Estépar; Joon Beom Seo; Takeshi Johkoh; Nicola Sverzellati; Christopher J Ryerson; R Graham Barr; Jin Mo Goo; John H M Austin; Charles A Powell; Kyung Soo Lee; Yoshikazu Inoue; David A Lynch Journal: Lancet Respir Med Date: 2020-07 Impact factor: 30.700