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Effects of PD-1 monoclonal antibody combined with chemotherapy on lymphocyte subsets and their correlation with treatment efficacy and prognosis in non-small cell lung cancer
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Abstract:
[Abstract] Objective: To explore the value of lymphocyte subsets in predicting the efficacy and prognosis of non-small cell lung cancer (NSCLC) patients receiving programmed death receptor 1 (PD-1) monoclonal antibody (mAb) combined with chemotherapy. Methods: A retrospective analysis was conducted on the clinical data of 50 NSCLC patients diagnosed and treated with PD-1 mAb combined with chemotherapy at the Second Hospital of Lanzhou University from January 2022 to December 2023. Peripheral blood lymphocyte subsets (including total T cells, CD4+ T cells, CD8+ T cells, NK cells, total B lymphocytes, and CD4+ /CD8+ T cell ratio) were collected before and after two cycles of treatment. After two cycles of treatment, imaging examination was performed to evaluate the therapeutic efficacy, dividing patients into disease control (DC) group and disease progression (PD) group. The relationship between lymphocyte subset levels and the short-term efficacy in NSCLC patients was analyzed using chi-square test, rank sum test, and Logistic regression analysis. The value of lymphocyte subsets in predicting patients’ progression-free survival (PFS) was explored using KaplanMeier method. Results: PD-1 mAb combined with chemotherapy significantly influenced the immune status of NSCLC patients. After treatment, the peripheral blood CD4+ T cells and CD4+ /CD8+ T cell ratio significantly increased (both P < 0.01), while the level of CD8+ T cells decreased. In terms of short-term efficacy, the proportion of CD4+ T cells and the CD4+ /CD8+ T cell ratio in the DC group were significantly higher than those in the PD group (both P < 0.01). Logistic multivariate analysis showed that the CD4+ /CD8+ T cell ratio was an independent factor affecting the efficacy of PD-1 mAb combined with chemotherapy. ROC curve analysis showed that the area under the curve (AUC) for CD4?/CD8? T cell ratio variation was 0.820 (> 0.5), with a cut-off value of 0.15. Patients with a the CD4+/CD8+ T cell ratio increase of ≥ 0.15 had a longer PFS. Conclusion: The proportion of CD4+ T cells, CD8+ T cells, and the CD4+/CD8+ T cell ratio in peripheral blood can predict the efficacy and prognosis of PD-1 mAb combined with chemotherapy in advanced NSCLC patients.
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