Post-treatment peripheral blood markers as predictive indicators for immune related thyroid dysfunction and outcome in non-small cell lung cancer patients receiving PD-1 inhibitor

Abstract Methods A retrospective study of 133 non-small cell lung cancer (NSCLC) patients treated with PD-1 inhibitors was performed. Medical records and haematological data were collected. The trends of NLR and PLR during treatment were analysed by the Mann-Whitney U test. Logistic regression was used to investigate the association of irTD, all immune-related adverse events (irAEs) with pre- and post-treatment NLR and PLR. The relationship of these predictive factors with tumour response and survival was estimated using the Chi-squared test or Kaplan‒Meier analysis. Results 30 patients (22.6%) developed irTDs. The NLR showed a significant decreasing trend during treatment. Patients with previous thyroid diseases and lower NLR 3w (NLR < 2.3) were significantly associated with irTDs. Pretreatment lower NLR and lower NLR 3w were associated with irAEs. There was no difference in tumor response between patients with and without irTDs. PFS was prolonged in patients with irTDs and with lower PLR 7w . Conclusions IrTD onset is common in patients receiving PD-1 inhibitors and is associated with prolonged PFS. The NLR 3w after receiving PD-1 inhibitors appears to be a factor for identifying NSCLC patients at high-risk of occurring irTD. Post-treatment lower PLR is associated with better PFS.