Risk factors and prognostic relationship between EGFR gene mutation and immunotherapy-related endocrine adverse events in lung cancer

Abstract

This study assesses risk factors of endocrine adverse events in lung cancer immunotherapy. 160 lung cancer patients who received immunotherapy between January 2020 and January 2022 were recruited as objects and general information was retrospectively analyzed. The number of cases with endocrine-related adverse events was divided into immune-related adverse events (irAEs) group and non-irAEs group. The patients were assigned into progressive disease (PD) and non-PD group. Among the 160 patients with lung cancer immunotherapy, 54 cases (33.75%) were included in irAEs group, 106 cases (66.25%) in non-irAEs group; 23 cases (14.38%) were included in PD group, and 137 cases (85.62%) in non-PD group. Compared with non-irAEs group, PD-L1 expression (positive) was significantly higher. Meanwhile, the expression of CYFRA21-1, NSE and RAC1 in irAEs group was higher than non-irAEs group, while miR-885-5p was lower (P <0.05). ECOG-PS score (≥3 points), number of treatment lines (third-line and above treatment), EGFR, ALK, RTK gene mutations, miR-885-5p and RAC1 were endocrine adverse events related to lung cancer immunotherapy (P <0.05). Compared with non-PD group, the ECOG-PS score and RAC1 level in PD group were significantly higher and miR-885-5p level was lower (P <0.5). ECOG-PS score, number of treatment lines, EGFR, ALK, RTK gene mutations, and RAC1 levels were positively correlated and miR-885-5p was negatively associated with prognosis and disease progression (P <0.05). ECOG-PS Score, number of treatment lines, EGFR, ALK, RTK mutations, and RAC1 levels were positively and miR-885-5p was negatively correlated with prognosis. The monitoring and intervention of risk factors can reduce endocrine irAEs and improve prognosis.