Multimodal Model Predicts Treatment Efficacy and CIP Risk in Advanced NSCLC With Immunotherapy and Chemotherapy

Shanghai Zhongshan Hospital3,000 enrolled

Overview

Immunotherapy is a crucial first-line treatment for advanced non-small cell lung cancer (NSCLC) without gene mutations. However, chemotherapy-induced pneumonitis (CIP) is a common adverse effect of immunotherapy, with severe cases even posing a threat to life. Therefore, identifying effective biomarkers and models for predicting the efficacy of immunotherapy in NSCLC is of great significance. At present, there is still a lack of effective predictive indicators in clinical practice. This study aims to construct a multimodal model based on factors such as chest CT, pulmonary function, cellular immunity, and cytokine levels to accurately predict the efficacy of combined therapy and the occurrence of related adverse reactions in NSCLC, in order to provide a reference for individualized treatment.

This is an observational cross-sectional retrospective study.

Study Type

OBSERVATIONAL

Enrollment

3,000

Conditions

NSCLC

Interventions

This study is an observational study; the intervention is not applicable.OTHER

This study is an observational study; the intervention is not applicable.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Consistent with the "Chinese Medical Association Guidelines for the Diagnosis and Treatment of Lung Cancer (2018 Edition)," histologically confirmed as NSCLC; 2. According to the 8th edition of the AJCC TNM staging system, it is stage III B to IV and not suitable for surgery; 3. Age ≥18 years; 4. First-time recipients of immunotherapy combined with chemotherapy; 5. Baseline data within 1 month before the start of treatment is complete (at least including chest CT, pulmonary function, and laboratory tests); 6. At least 1 measurable lesion according to RECIST 1.1; 7. Receiving immune checkpoint inhibitor therapy for more than 2 cycles; 8. Clinical data is complete. Exclusion Criteria: 1. Presence of other malignant tumors; 2. Previous exposure to immunotherapy or systemic chemotherapy; 3. Patients with severe dysfunction of vital organs (heart, liver, lungs, kidneys) and bone marrow at baseline; 4. Presence of severe infectious diseases, active autoimmune diseases, or immune deficiencies that significantly affect immune function; 5. Organ transplantation; 6. Pregnant or lactating women; 7. Incomplete clinical treatment or follow-up information.

Outcomes

Primary Outcomes

Progression-free survival (PFS)

Time from the first dose of immune-checkpoint inhibitor plus chemotherapy to the earliest date of radiologic progression (per RECIST 1.1) or death from any cause.

Time frame: From first dose through 31 August 2025, corresponding to a maximum follow-up of approximately 5.5 years (~290 weeks).

Secondary Outcomes

The disease control rate (DCR)

Proportion of patients achieving complete response (CR), partial response (PR), or stable disease (SD) as best overall response per RECIST 1.1.

Time frame: Tumor response assessed every 6 weeks (±1 week) for up to 24 weeks or until progression/death/cut-off (31 Aug 2025); the proportion will be calculated from the best response recorded within the first 24 weeks (4 cycles) per RECIST 1.1.

Checkpoint inhibitor pneumonitis (CIP)

an immune-related adverse event (irAE) endpoint refers to new pulmonary infiltrates on chest imaging after immune checkpoint inhibitor (ICI) treatment, accompanied by dyspnea and/or other respiratory signs/symptoms (including cough and exertional dyspnea), excluding new pulmonary infections or tumor progression.

Time frame: Within 4 months after the initiation of immunotherapy combined with chemotherapy.