ArticleCancer medicine2025
Delta-He as a Novel Predictive and Prognostic Biomarker in Patients With NSCLC Treated With PD-1/PD-L1 Inhibitors.
Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Noninvasive prediction of ALK fusion status in non-small cell lung cancer by a machine learning model combining CT images and clinical information.Journal of thoracic disease · 2026Article
- Integration of single-cell and bulk transcriptomics to explore prognostic and immunotherapeutic characteristics of sodium overload-induced cell death in lung adenocarcinoma.Translational cancer research · 2025Article
- Prediction of bone oligometastases in breast cancer using models based on deep learning radiomics of PET/CT imaging.Frontiers in oncology · 2025Article
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Abstract
backgroundLung cancer treatment has rapidly advanced, particularly with immune checkpoint inhibitors (ICIs) targeting PD-1 and PD-L1. However, there are variable responses, such as immune-related adverse events. Several factors predicting the prognosis of lung cancer ICI treatment have been studied so far, but they have limitations, leaving an unmet need. This study aims to investigate delta-He, a novel marker reflecting the iron availability and inflammation through the difference in hemoglobin content between reticulocytes and erythrocytes, as a potential prognostic factor in patients with NSCLC undergoing PD-1/PD-L1 inhibitor therapy.
methodsThis research was conducted at Chungnam National University Hospital, analyzing 79 advanced NSCLC patients treated with PD-1/PD-L1 inhibitors. The study population had a mean age of 70 years, with the majority being male (82.3%) and former or current smokers (84.8%). Blood samples collected before therapy initiation were examined for hematological parameters, including delta-He, using Sysmex XN-550 and XN-20 analyzers. The study employed receiver operating characteristic (ROC) curves and Kaplan-Meier curves for the statistical analysis, using SPSS version 26 (IBM Corp., USA) and MedCalc version 22 (MedCalc Software Ltd., Belgium) to evaluate the sensitivity and specificity of delta-He, and to analyze progression-free survival (PFS) and overall survival (OS).
resultsThe study revealed that delta-He is a significant prognostic marker in patients with NSCLC treated with PD-1/PD-L1 inhibitors. A delta-He cutoff value of 3.3 pg was identified based on ROC analysis. Patients with high delta-He values (> 3.3 pg) showed significantly longer median PFS (9.6 vs. 3.0 months, p = 0.024) and OS (not reached vs. 12.2 months, p = 0.010) than those with low values. The high delta-He group also had higher objective response rate (41.4% vs. 26.0%) and disease control rate (86.2% vs. 52.0%). Multivariate analysis highlighted higher delta-He (> 3.3 pg), along with other factors such as FEV1 and smoking status, as important predictors of survival, underscoring its potential role in guiding therapeutic decisions of ICIs in NSCLC (PFS: HR 0.874, 95% CI 0.264-0.874, p = 0.016; OS: HR 0.327, 95% CI 0.150-0.715, p = 0.005).
conclusionOur study shows delta-He as a promising prognostic biomarker for lung cancer patients treated with PD-1/PD-L1 inhibitors, highlighting its potential to guide therapeutic decisions and improve patient management in a non-invasive manner. Further research is necessary to validate delta-He's predictive and prognostic value across broader populations and in combination with other biomarkers, emphasizing its role in advancing personalized oncology.
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