Background/Aim: Chronic obstructive pulmonary disease coexisting with non-small-cell lung cancer (NSCLC) was reported to be associated with a longer progression-free survival (PFS) in patients treated with immune checkpoint inhibitors (ICIs). In the present study, we investigated the impact of emphysematous change on the treatment response to ICIs in patients with NSCLC. Patients and Methods: A total of 153 patients with advanced NSCLC who received ICIs (nivolumab, pembrolizumab, or atezolizumab) at our hospital from January 2016 to May 2019 were retrospectively enrolled. Results: According to the Goddard scoring system, 71 (46.4%) patients were classified as having emphysema and 82 (53.6%) as having no emphysema. Multivariate analysis showed that a good performance status and coexisting emphysema (hazard ratio=0.49; 95% confidence intervaI=0.28-0.84; p=0.010) were independent predictors of a better PFS. Conclusion: Recognizing emphysema coexisting with NSCLC may help predict the therapeutic efficacy of ICIs in such patients.

中文翻译：

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肺气肿与非小细胞肺癌共存预测免疫检查点抑制剂的治疗效果

背景/目的：据报道，在接受免疫检查点抑制剂 (ICI) 治疗的患者中，慢性阻塞性肺疾病与非小细胞肺癌 (NSCLC) 共存与更长的无进展生存期 (PFS) 相关。在本研究中，我们调查了肺气肿变化对 NSCLC 患者对 ICI 治疗反应的影响。患者与方法：回顾性纳入2016年1月至2019年5月在我院接受ICIs（纳武单抗、派姆单抗或阿特珠单抗）治疗的153例晚期NSCLC患者。结果：根据Goddard评分系统，71例（46.4%）患者被分类为有肺气肿，82例（53.6%）患者没有肺气肿。多变量分析显示良好的体能状态和共存的肺气肿（风险比 = 0.49；95% 置信区间 = 0.28-0. 84; p=0.010) 是更好 PFS 的独立预测因子。结论：识别NSCLC合并肺气肿可能有助于预测ICIs在此类患者中的治疗效果。