The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC
PurposeThis study aims to investigate the specific effects of glucocorticoids (GC) on the efficacy of immune checkpoint inhibitors (ICIs), and whether this effect is influenced by the timing and dosage of GC administration. Changes in the neutrophil percentage and the helper/suppressor T lymphocyte...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1533556/full |
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| author | Yifan Wang Yifan Wang Jianying Zhou Simin Peng Simin Peng Zhao Cui Zhao Cui Weiqi Wang Weiqi Wang Wenqin Zeng Wenqin Zeng Tingting Qiu Zhentian Liu |
| author_facet | Yifan Wang Yifan Wang Jianying Zhou Simin Peng Simin Peng Zhao Cui Zhao Cui Weiqi Wang Weiqi Wang Wenqin Zeng Wenqin Zeng Tingting Qiu Zhentian Liu |
| author_sort | Yifan Wang |
| collection | DOAJ |
| description | PurposeThis study aims to investigate the specific effects of glucocorticoids (GC) on the efficacy of immune checkpoint inhibitors (ICIs), and whether this effect is influenced by the timing and dosage of GC administration. Changes in the neutrophil percentage and the helper/suppressor T lymphocyte ratio [NEUT %/(CD4+/CD8+)] during GC administration were monitored.MethodsThe clinical results of 130 patients with advanced non-small cell lung cancer (NSCLC) treated with ICIs were analyzed and compared with those of patients who did not use GC. Cox proportional hazards regression model and Logistic regression analysis were used to analyze the factors affecting ORR and PFS, and t test was used to analyze the changes of NEUT %/(CD4 +/CD8 +) during GC use.ResultsMultivariate Logistic analysis showed that GC use was associated with a higher ORR in 130 patients treated with ICIs [HR = 3.07,95% CI (1.31-7.21), P = 0.010]. Univariate Cox analysis showed that GC use was not significantly correlated with PFS [HR = 0.926,95% CI (0.603-1.420), P = 0.710]. Patients who used GC during the baseline period of ICIs treatment had a higher ORR than those who used GC at the early stage of ICIs treatment (65.4% vs 30.8%, p = 0.024). Multivariate Cox analysis showed that GC use had longer PFS [HR = 0.37,95% CI (0.17-0.78), p = 0.009]. The timing of GC use was different, and there was a difference in NEUT %/(CD4 +/CD8 +) levels before and after treatment. There was no significant difference in ORR and PFS between GC duration and dose.ConclusionThe use of GC helps to enhance the efficacy of immunotherapy. In particular, GC use during the baseline period leads to higher ORR and PFS, regardless of the dose or duration of GC use. The levels of NEUT %/(CD4+/CD8+) varied depending on the timing of GC administration. |
| format | Article |
| id | doaj-art-16990b40a2974ed9964fa80664c08d01 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-16990b40a2974ed9964fa80664c08d012025-01-23T05:10:25ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-01-011510.3389/fonc.2025.15335561533556The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLCYifan Wang0Yifan Wang1Jianying Zhou2Simin Peng3Simin Peng4Zhao Cui5Zhao Cui6Weiqi Wang7Weiqi Wang8Wenqin Zeng9Wenqin Zeng10Tingting Qiu11Zhentian Liu12Department of Thoracic Medical Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Thoracic Medical Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, ChinaDepartment of Thoracic Medical Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Thoracic Medical Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Thoracic Medical Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Thoracic Medical Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Thoracic Medical Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, ChinaDepartment of Thoracic Medical Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, ChinaPurposeThis study aims to investigate the specific effects of glucocorticoids (GC) on the efficacy of immune checkpoint inhibitors (ICIs), and whether this effect is influenced by the timing and dosage of GC administration. Changes in the neutrophil percentage and the helper/suppressor T lymphocyte ratio [NEUT %/(CD4+/CD8+)] during GC administration were monitored.MethodsThe clinical results of 130 patients with advanced non-small cell lung cancer (NSCLC) treated with ICIs were analyzed and compared with those of patients who did not use GC. Cox proportional hazards regression model and Logistic regression analysis were used to analyze the factors affecting ORR and PFS, and t test was used to analyze the changes of NEUT %/(CD4 +/CD8 +) during GC use.ResultsMultivariate Logistic analysis showed that GC use was associated with a higher ORR in 130 patients treated with ICIs [HR = 3.07,95% CI (1.31-7.21), P = 0.010]. Univariate Cox analysis showed that GC use was not significantly correlated with PFS [HR = 0.926,95% CI (0.603-1.420), P = 0.710]. Patients who used GC during the baseline period of ICIs treatment had a higher ORR than those who used GC at the early stage of ICIs treatment (65.4% vs 30.8%, p = 0.024). Multivariate Cox analysis showed that GC use had longer PFS [HR = 0.37,95% CI (0.17-0.78), p = 0.009]. The timing of GC use was different, and there was a difference in NEUT %/(CD4 +/CD8 +) levels before and after treatment. There was no significant difference in ORR and PFS between GC duration and dose.ConclusionThe use of GC helps to enhance the efficacy of immunotherapy. In particular, GC use during the baseline period leads to higher ORR and PFS, regardless of the dose or duration of GC use. The levels of NEUT %/(CD4+/CD8+) varied depending on the timing of GC administration.https://www.frontiersin.org/articles/10.3389/fonc.2025.1533556/fullglucocorticoidsimmune checkpoint inhibitorsefficacytiming of useNEUT%/(CD4+/CD8+)non-small cell lung cancer |
| spellingShingle | Yifan Wang Yifan Wang Jianying Zhou Simin Peng Simin Peng Zhao Cui Zhao Cui Weiqi Wang Weiqi Wang Wenqin Zeng Wenqin Zeng Tingting Qiu Zhentian Liu The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC Frontiers in Oncology glucocorticoids immune checkpoint inhibitors efficacy timing of use NEUT%/(CD4+/CD8+) non-small cell lung cancer |
| title | The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC |
| title_full | The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC |
| title_fullStr | The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC |
| title_full_unstemmed | The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC |
| title_short | The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC |
| title_sort | effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced nsclc |
| topic | glucocorticoids immune checkpoint inhibitors efficacy timing of use NEUT%/(CD4+/CD8+) non-small cell lung cancer |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1533556/full |
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