AUTHOR=Yang Xin , Li Qiao , Zeng Tianyang 

TITLE=Peripheral CD4+ T cells correlate with response and survival in patients with advanced non-small cell lung cancer receiving chemo-immunotherapy

JOURNAL=Frontiers in Immunology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1364507

DOI=10.3389/fimmu.2024.1364507

ISSN=1664-3224

ABSTRACT=<sec><title>Background</title><p>The aim of the present study was to explore the potential of peripheral immune cells in predicting the response and prognosis of patients with advanced non-small cell lung cancer (NSCLC) receiving anti-PD-1 immunotherapy and platinum-based chemotherapy.</p></sec><sec><title>Participants and Methods</title><p>We utilized flow cytometry to examine the levels and dynamics of blood immune cells in 79 advanced NSCLC patients treated with the chemoimmunotherapy between December 2019 and January 2022. The pre- and post-treatment blood samples were collected within 3 days prior to the initiation of the first and third cycle of combination treatment, respectively. Progression-free survival (PFS) and overall survival (OS) analyses were conducted using Kaplan-Meier method and Cox regression models.</p></sec><sec><title>Results</title><p>The pre-treatment CD4<sup>+</sup>/Total T cells ratio was significantly higher in responders than non-responders (<italic>P &lt;</italic> 0.05). The levels of pre-treatment total lymphocytes (<italic>P =</italic> 0.012), total B lymphocytes (<italic>P =</italic> 0.025), and NK cells (<italic>P =</italic> 0.022), and post-treatment NK cells (<italic>P =</italic> 0.011) and NKT cells (<italic>P =</italic> 0.035) were significantly associated with OS. Post-treatment CD8<sup>+</sup>/Total T cells ratio was positively correlated with OS (<italic>P =</italic> 0.038). In multivariate analysis, post-treatment NK cells and post-treatment CD4<sup>+</sup>CD8<sup>+</sup>/Total T cells ratio were negatively associated with OS (hazard ratio [HR] = 10.30, <italic>P =</italic> 0.038) and PFS (HR = 1.95, <italic>P =</italic> 0.022), respectively. Notably, significantly positive correlations were observed between CD4<sup>+</sup>/Total T cells ratio and prognosis both before and after treatment (<italic>P &lt;</italic> 0.05).</p></sec><sec><title>Conclusion</title><p>To summarize, our finding reveals that high CD4<sup>+</sup>/total T cells ratio was associated with favorable response and prognosis, highlighting its potential as a predictive biomarker to guide the selection of likely responders to platinum and anti-PD-1 combination therapy.</p></sec>