ArticleJournal of thoracic disease2025
Lower r-FEV1 as a predictor of treatment response and survival in NSCLC patients receiving neoadjuvant immunochemotherapy.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
Background: Although neoadjuvant immunochemotherapy (nICT) demonstrates considerable promise in improving survival rates for patients with non-small cell lung cancer (NSCLC), responses among individual patients can vary significantly, and not all patients attain optimal therapeutic outcomes. Our research seeks to discover a simple and cost-effective indicator for the dynamic evaluation of NSCLC patients' responses to nICT. Methods: We enrolled 188 patients with surgically resectable NSCLC who received two to four cycles of nICT from January 1, 2021, and December 31, 2023, at Zhejiang Cancer Hospital. Subsequently, we analyzed the performance of the relative change in forced expiratory volume in one second (r-FEV1) and the relative change in carbon monoxide transfer factor (r-TLCO) as predictors of nICT efficacy. We employed binary logistic regression to assess the relationship between predictors and major pathological response (MPR). Kaplan-Meier (K-M) analysis and Cox regression were utilized to identify factors that predict prognosis. The primary endpoint of this study was event-free survival (EFS). Results: The male sex [odds ratios (OR) 8.86, 95% confidence interval (CI): 2.45-32.06, P<0.001], smoking history (OR 3.92, 95% CI: 2.01-7.64, P<0.001), radiological response evaluation (complete response/partial response Conclusions: This study demonstrates that low r-FEV1 is a predictor of non- MPR and shorter EFS in patients with locally advanced NSCLC undergoing nICT. These findings support the use of r-FEV1 as a clinically actionable marker for predicting the efficacy of nICT. The integration of routine lung function tests (LFTs), particularly r-FEV1, into standard pretreatment evaluation protocols has the potential to improve risk stratification and inform therapeutic decision-making for patients with locally advanced NSCLC.
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