Analysis of the Status and Influencing Factors of Immune-Related Adverse Events in Advanced Non-Small-Cell Lung Cancer Patients

Objective To investigate the incidence and influencing factors of immune-related adverse events in advanced non-small-cell lung cancer patients receiving programmed cell death 1(PD-1)immune checkpoint inhibitors therapy.

Methods A cross-sectional survey was conducted on 261 advanced non-small-cell lung cancer patients in Guangdong Provincial People's Hospital by the general data questionnaire using the Common Terminology Criteria for Adverse Events(CTCAE), and the influencing factors of immune-related adverse events were analyzed.

Results 139 cases(53.3%)of 261 had related adverse events, among which fatigue, nausea, rash, pruritus, and pneumonia were common. Logistic regression analysis results showed that smoking status odds ratio (OR)=2.75, 95% confidence interval(CI)1.59~4.75, P < 0.001, 2 cycles of immune checkpoint inhibitors therapy(OR=6.84, 95%CI 2.47~18.95, P < 0.001), 3 cycles and above of immune checkpoint inhibitors therapy(OR=4.51, 95%CI 1.71~11.89, P=0.002), and the PD-1 immune checkpoint inhibitors therapy combined with targeted therapy(OR=34.11, 95%CI 4.21~276.18, P= 0.001)were the risk factors of immune-related adverse events.

Conclusions Patients with advanced non-small cell lung cancer have a higher incidence of immune-related adverse events during treatment with immune checkpoint inhibitors. Medical staff should pay more attention to patients with a history of smoking, a 2-cycle immune checkpoint inhibitors treatment combined with other treatments, and provide targeted observation and preventive treatment to reduce the occurrence of immune-related adverse events.