Association of body mass index and serum markers with immune-related adverse events in lung cancer patients receiving immune checkpoint inhibitors.

Background: In recent years, immune checkpoint inhibitors (ICIs) have been widely used in the treatment of various malignant tumors, offering the possibility of long-term survival to some patients. However, ICIs can cause unique adverse events, which may even result in the discontinuation of treatment. Thus, reliable predictive biomarkers for immune-related adverse events (irAEs) need to be identified. This retrospective study aims to examine the correlation between nutritional status and serum biomarkers and the occurrence and severity of irAEs in lung cancer patients who had received ICIs. Methods: A total of 140 stage III/IV lung cancer patients who had received at least one dose of ICI therapy were included in the study. The clinical and pathological characteristics of the patients, such as body mass index (BMI), serum albumin (ALB), serum creatinine, prognostic nutritional index (PNI), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR), were examined. Chi-squared tests were used to examine the relationships among the categorical variables. Logistic regression models were used to examine the effect of explanatory variables on binary outcomes. A survival analysis was performed using the Kaplan-Meier method and Cox model. Results: Of the 140 study patients, 66 (47.1%) experienced irAEs of any grade, and 15 (10.7%) experienced ≥ grade 3 (G3) irAEs. The patients with a low PLR (<135) showed a significantly higher incidence of irAEs than those with a high PLR (PLR ≥135) (P=0.007). Meanwhile, the patients with a baseline lymphocyte count ≥1.1×10 Conclusions: The PLR may serve as a useful predictor of irAE incidence.