Treatment-Related Lymphopenia, Lung Cancer Outcomes

Patients with lung cancer who were treated with immune checkpoint inhibitors (ICIs) and developed treatment-related lymphopenia (TRL) had poorer survival than patients who did not experience the adverse event.

Ye Zhang and colleagues used the PubMed, Embase, Cochrane Library, and Web of Science databases to identify 10 cohort studies conducted in France, Korea, and the United States and published between 2019 and 2023 to include in their meta-analysis.

The review consisted of more than 1100 patients who received treatment with ICIs, and 37.8% (n=427) had TRL. Of the 10 studies, eight included patients who received a non-small cell lung cancer (NSCLC) diagnosis, and two included patients with small cell lung cancer.

The following ICIs were among the various therapies: nivolumab (Opdivo), pembrolizumab (Keytruda), durvalumab (Imfinzi), atezolizumab (Tecentriq), ipilimumab (Yervoy), and a nivolumab/ipilimumab combination.

Results of the analysis showed that the presence of TRL at the start of or during ICI treatment was associated with unfavorable progression-free survival (PFS) and OS in patients with lung cancer. Moreover, these findings remained consistent when focusing solely on studies involving patients with NSCLC.

“Collectively, these findings highly suggest the importance of monitoring lymphocyte count in peripheral circulating during the treatment with ICIs for patients with lung cancer,” the researchers said.