Potential predictors of immunotherapy-induced pneumonitis in non small cell lung cancer patients (NSCLCs)

BACKGROUND: Immunotherapy (IT) represents the therapeutic frontier in non-oncogene addicted NSCLC. Immune-related adverse events (irAEs) are generally manageable but need early recognition and proper management to avoid severe outcomes. Clinical and molecular predictors for irAEs are under investigation. AIM: To identify potential predictors of IT-induced pneumonitis (ITP), in particular lab data, and long term outcomes in a cohort of NSCLC patients (pts). METHODS: Data of 597 IT-treated pts from 2014 to 2024 were systematically reviewed. Among these, 548 pts w/o toxicity and 49 with ITP were compared in preliminary analysis. RESULTS: in our analysis We compared peripheral blood parameters of patients with CIP with patients without CIP at baseline, within 30 days before initiation of immunotherapy. No significant difference in blood count was found in our analysis. Patients with ITP showed a significant probability of progression free survival (PFS) compared to patients w/o ITP (HR 2.7 CI 1.3-5.7; p=0.00071). Furthermore in terms of overall survival (OS), patients with ITP showed a better OS from initiation of immunotherapy in months (p=0.00013). CONCLUSIONS: preliminary data suggest that patients with ITP might have longer OS and PFS compared to patients without ITP, these data, along with the possible role of blood count in predicting immunotherapy related pneumonitis, must be confirmed by additional analyses on bigger cohorts.