Abstract
Background There has not been a definite study on the relationship between serum lipid and small cell lung cancer (SCLC) patients’ response to programed death-ligand 1 (PD-L1) inhibitor.
Objective The aim of this study was to explore the association between serum lipids levels and SCLC patients’ response to PD-L1 inhibitor as first-line treatment.
Methods This study included patients with SCLC who received at least one cycle of PD-L1inhibitor at Shanghai Pulmonary Hospital from August 2020 to December 2023. We collected the clinical data of the SCLC patients, including basic information and serum lipids levels, before immunotherapy.
Results Overall, 124 patients were included in this study. The incidence of immune related adverse events (irAEs) was 16.1%. In the multivariate analyzes, TG/HDL-C ratio was a remarkable independent predictor of irAEs (HR: 16.427, 95% CI: 1.046-258.092, p=0.046). Tumor response analysis indicated that an objective response rate (ORR) achieved 43.4% and a disease control rate (DCR) achieved 79.5%. Seventy-seven patients experienced any progression-free survival (PFS) event. The median PFS was longer in HDL-C-high group (10.03 months) than in HDL-C-low group (6.67 months) (p=0.043). In Cox regression analyses, HDL-C was a remarkable independent predictor for PFS (HR: 2.814, 95% CI: 1.413-5.602, p=0.003). Notably, the ORR significantly differed between patients who suffered from any irAEs and those who did not (p=0.0062).
Conclusion This study clarified that serum lipids levels might predict responses to anti-PD-L1 inhibitor as first-line treatment in SCLC.