The impact of concurrent bacterial lung infection on immunotherapy in patients with non-small cell lung cancer: a retrospective cohort study
ObjectiveTo find out how bacterial lung infections (BLI) affect the effectiveness of therapy and the rate of pneumonia caused by pneumonia related to checkpoint inhibitors (CIP) in patients with non-small cell lung cancer (NSCLC) who are getting immunotherapy with checkpoint inhibitors (ICIs).Patien...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-08-01
|
| Series: | Frontiers in Cellular and Infection Microbiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1257638/full |
| _version_ | 1797732834668969984 |
|---|---|
| author | Qiang Cao Qiang Cao Xinyan Wu Yuquan Chen Qi Wei Yanwei You Yi Qiang Guangzhu Cao |
| author_facet | Qiang Cao Qiang Cao Xinyan Wu Yuquan Chen Qi Wei Yanwei You Yi Qiang Guangzhu Cao |
| author_sort | Qiang Cao |
| collection | DOAJ |
| description | ObjectiveTo find out how bacterial lung infections (BLI) affect the effectiveness of therapy and the rate of pneumonia caused by pneumonia related to checkpoint inhibitors (CIP) in patients with non-small cell lung cancer (NSCLC) who are getting immunotherapy with checkpoint inhibitors (ICIs).Patients and methods507 NSCLC patients who received at least two ICI treatments between June 2020 and December 2022 at the Affiliated Hospital of Kunming University of Science and Technology(AHKUST) were included in a retrospective cohort study. Based on whether there was a concurrent BLI diagnosis from high-resolution CT scans of the chest, the patients were divided into two groups: 238 in the NSCLC with BLI group (NSCLC-BLI group), and 269 in the NSCLC alone group. The collected therapeutic outcome measures included the objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and the incidence rate of CIP. We analyzed the effect of BLI on the therapeutic efficacy of ICI treatment and the incidence rate of CIP in NSCLC patients.Inclusion criteria based on NSCLC patients staged I to IV according to the 8th edition of the International Association for Lung Cancer Research (IASLC)ResultsThe NSCLC-BLI group showed superior ORR to the NSCLC group when treated with ICIs. Multifactorial logistic regression and Cox analyses, adjusted for confounders, identified BLI as an independent positive prognostic factor for ORR (HR=0.482, 95%CI: 0.391-0.550; P<0.001) and PFS (HR=0.619; 95%CI: 0.551-0.771; P<0.001). No correlation between BLI and OS was found. Out of 26 cases of CIP, 12 were in the NSCLC-BLI group and 14 in the NSCLC group, with no significant difference in incidence (P=0.145).ConclusionNSCLC patients with BLI receiving ICI treatment show superior ORR and PFS compared to NSCLC alone without an increased CIP risk, positioning BLI as a predictive factor for improved outcomes in NSCLC patients receiving ICIs. However, the study has limitations including its retrospective nature and lacking data on BLI bacteria types and levels, which could influence therapy outcomes. |
| first_indexed | 2024-03-12T12:19:17Z |
| format | Article |
| id | doaj.art-04deef73c7574de7800a7da942e8332a |
| institution | Directory Open Access Journal |
| issn | 2235-2988 |
| language | English |
| last_indexed | 2024-03-12T12:19:17Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj.art-04deef73c7574de7800a7da942e8332a2023-08-30T06:01:26ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882023-08-011310.3389/fcimb.2023.12576381257638The impact of concurrent bacterial lung infection on immunotherapy in patients with non-small cell lung cancer: a retrospective cohort studyQiang Cao0Qiang Cao1Xinyan Wu2Yuquan Chen3Qi Wei4Yanwei You5Yi Qiang6Guangzhu Cao7Department of Earth Sciences, Kunming University of Science and Technology, Kunming, ChinaSchool of Medicine, Macao University of Science and Technology, Macao, Macao SAR, ChinaCollege of Veterinary Medicine, Sichuan Agricultural University, Chengdu, ChinaInstitute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, ChinaSchool of Medicine, Macao University of Science and Technology, Macao, Macao SAR, ChinaDivision of Sports Science & Physical Education, Tsinghua University, Beijing, ChinaDepartment of Earth Sciences, Kunming University of Science and Technology, Kunming, ChinaDepartment of Earth Sciences, Kunming University of Science and Technology, Kunming, ChinaObjectiveTo find out how bacterial lung infections (BLI) affect the effectiveness of therapy and the rate of pneumonia caused by pneumonia related to checkpoint inhibitors (CIP) in patients with non-small cell lung cancer (NSCLC) who are getting immunotherapy with checkpoint inhibitors (ICIs).Patients and methods507 NSCLC patients who received at least two ICI treatments between June 2020 and December 2022 at the Affiliated Hospital of Kunming University of Science and Technology(AHKUST) were included in a retrospective cohort study. Based on whether there was a concurrent BLI diagnosis from high-resolution CT scans of the chest, the patients were divided into two groups: 238 in the NSCLC with BLI group (NSCLC-BLI group), and 269 in the NSCLC alone group. The collected therapeutic outcome measures included the objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and the incidence rate of CIP. We analyzed the effect of BLI on the therapeutic efficacy of ICI treatment and the incidence rate of CIP in NSCLC patients.Inclusion criteria based on NSCLC patients staged I to IV according to the 8th edition of the International Association for Lung Cancer Research (IASLC)ResultsThe NSCLC-BLI group showed superior ORR to the NSCLC group when treated with ICIs. Multifactorial logistic regression and Cox analyses, adjusted for confounders, identified BLI as an independent positive prognostic factor for ORR (HR=0.482, 95%CI: 0.391-0.550; P<0.001) and PFS (HR=0.619; 95%CI: 0.551-0.771; P<0.001). No correlation between BLI and OS was found. Out of 26 cases of CIP, 12 were in the NSCLC-BLI group and 14 in the NSCLC group, with no significant difference in incidence (P=0.145).ConclusionNSCLC patients with BLI receiving ICI treatment show superior ORR and PFS compared to NSCLC alone without an increased CIP risk, positioning BLI as a predictive factor for improved outcomes in NSCLC patients receiving ICIs. However, the study has limitations including its retrospective nature and lacking data on BLI bacteria types and levels, which could influence therapy outcomes.https://www.frontiersin.org/articles/10.3389/fcimb.2023.1257638/fullnon-small cell lung cancerbacterial lung infectionmicrobial infectionlung cancerretrospective cohort studyand immunotherapy |
| spellingShingle | Qiang Cao Qiang Cao Xinyan Wu Yuquan Chen Qi Wei Yanwei You Yi Qiang Guangzhu Cao The impact of concurrent bacterial lung infection on immunotherapy in patients with non-small cell lung cancer: a retrospective cohort study Frontiers in Cellular and Infection Microbiology non-small cell lung cancer bacterial lung infection microbial infection lung cancer retrospective cohort study and immunotherapy |
| title | The impact of concurrent bacterial lung infection on immunotherapy in patients with non-small cell lung cancer: a retrospective cohort study |
| title_full | The impact of concurrent bacterial lung infection on immunotherapy in patients with non-small cell lung cancer: a retrospective cohort study |
| title_fullStr | The impact of concurrent bacterial lung infection on immunotherapy in patients with non-small cell lung cancer: a retrospective cohort study |
| title_full_unstemmed | The impact of concurrent bacterial lung infection on immunotherapy in patients with non-small cell lung cancer: a retrospective cohort study |
| title_short | The impact of concurrent bacterial lung infection on immunotherapy in patients with non-small cell lung cancer: a retrospective cohort study |
| title_sort | impact of concurrent bacterial lung infection on immunotherapy in patients with non small cell lung cancer a retrospective cohort study |
| topic | non-small cell lung cancer bacterial lung infection microbial infection lung cancer retrospective cohort study and immunotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1257638/full |
| work_keys_str_mv | AT qiangcao theimpactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT qiangcao theimpactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT xinyanwu theimpactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT yuquanchen theimpactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT qiwei theimpactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT yanweiyou theimpactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT yiqiang theimpactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT guangzhucao theimpactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT qiangcao impactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT qiangcao impactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT xinyanwu impactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT yuquanchen impactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT qiwei impactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT yanweiyou impactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT yiqiang impactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy AT guangzhucao impactofconcurrentbacteriallunginfectiononimmunotherapyinpatientswithnonsmallcelllungcanceraretrospectivecohortstudy |