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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1533556
This article is part of the Research Topic Advancing NSCLC Treatment: Overcoming Challenges in Immune Checkpoint Inhibitor Therapy View all 3 articles

The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC

Provisionally accepted
Zhentian Liu Zhentian Liu 1*Yifan Wang Yifan Wang 1,2Jianying Zhou Jianying Zhou 1Simin Peng Simin Peng 1,2Zhao Cui Zhao Cui 1,2Wenqin Zeng Wenqin Zeng 1,2Weiqi Wang Weiqi Wang 1,2Tingting Qiu Tingting Qiu 1
  • 1 Jiangxi Provincial Cancer Hospital, Nanchang, China
  • 2 Faculty of Medicine, Nanchang University, Nanchang, Jiangxi Province, China

The final, formatted version of the article will be published soon.

    This study aims to investigate the specific effects of glucocorticoids (GC) on the efficacy of immune checkpoint inhibitors (ICIs), and whether this effect is influenced by the timing and dosage of GC administration. Changes in the neutrophil percentage and the helper/suppressor T lymphocyte ratio [NEUT % / (CD4+ / CD8+)] during GC administration were monitored. Methods: The clinical results of 130 patients with advanced NSCLC treated with ICIs were analyzed and compared with those of patients who did not use GC. Cox proportional hazards regression model and Logistic regression analysis were used to analyze the factors affecting ORR and PFS, and t test was used to analyze the changes of NEUT % / ( CD4 + / CD8 + ) during GC use. Results: Multivariate Logistic analysis showed that GC use was associated with a higher ORR in 130 patients treated with ICIs [ HR = 3.07,95 % CI ( 1.31-7.21 ), P = 0.010 ]. Univariate Cox analysis showed that GC use was not significantly correlated with PFS [ HR = 0.926,95 % CI ( 0.603-1.420 ), P = 0.710 ]. Patients who used GCduring the baseline period of ICIs treatment had a higher ORR than those who used GC at the early stage of ICIs treatment ( 65.4 % vs 30.8 %, p = 0.024 ). Multivariate Cox analysis showed that GC use had longer PFS [ HR = 0.37,95 % CI ( 0.17-0.78 ), p = 0.009 ]. The timing of GC use was different, and there was a difference in NEUT % / ( CD4 + / CD8 + ) levels before and after treatment. There was no significant difference in ORR and PFS between GC duration and dose.The use of GC helps to enhance the efficacy of immunotherapy. In particular, GC use during the baseline period leads to higher ORR and PFS, regardless of the dose or duration of GC use. The levels of NEUT % / (CD4+ / CD8+) varied depending on the timing of GC administration.

    Keywords: Glucocorticoids, immune checkpoint inhibitors, efficacy, Timing of use, NEUT%/(CD4+/CD8+), Non-small cell lung cancer

    Received: 24 Nov 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 Liu, Wang, Zhou, Peng, Cui, Zeng, Wang and Qiu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zhentian Liu, Jiangxi Provincial Cancer Hospital, Nanchang, China

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