Nivolumab kullanan metastatik küçük hücreli dışı akciğer kanserli hastalarda sağkalımı öngören prognostik risk faktörleri

Tanju Kapagan , Nilufer Bulut, Gokmen Umut Erdem

  • Tanju Kapagan: University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital
  • Nilufer Bulut: University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital
  • Gokmen Umut Erdem: University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital
  • Year : 2025
  • Vol : 41
  • Issue : 1
  •  Page : 29-35
Amaç: Küçük hücreli dışı akciğer kanseri (KHDAK), sık görülen ve ölümcül seyreden bir kanser türüdür. Bu çalışmanın amacı, platin bazlı tedavi sonrası ikinci basamak tedavi olarak nivolumab kullanılan metastatik KHDAK tanılı hastalarda, klinik, laboratuvar ve sistemik inflamatuar yanıt verilerinin hastalıksız sağkalım (PFS) ve genel sağkalım (OS) üzerindeki etkilerini incelemektir.
Gereçler ve Yöntemler: Çalışma retrospektif ve tek merkezli olarak yürütüldü. İkinci basamak tedavi olarak nivolumab kullanan 84 metastatik KHDAK tanılı hastaların demografik verileri, kanser tanısıyla ilişkili özellikleri ve nivolumab başlanmadan hemen öncesine ait hastaların laboratuvar parametreleri kaydedildi. C-reaktif protein/ albumin oranı (CAR), aspartat aminotransaminaz/alanin aminotransaminaz (De Ritis) oranı, Glasgow prognostik skoru (GPS), nötrofil/lenfosit oranı (NLR), platelet/ lenfosit oranı (PLR), prognostik nütrisyonel indeks (PNI) ve sistemik immün-inflamasyon indeksi (SII) parametreleri her hasta için ayrı ayrı hesaplandı.
Bulgular: Tüm katılımcılar için ortalama yaş 62.08±8.43 yıl idi. Medyan PFS ve OS süreleri sırasıyla 6.4 ve 13 ay olarak belirlendi. PFS açısından yapılan tek değişkenli risk analizinde, Doğu Kooperatif Onkoloji Grubu Performans Durumu (ECOG PS) (p=0.05) ve CAR (p=0.046) PFS açısından önemli birer prognostik risk faktörü olarak belirlendi. Ancak, çok değişkenli analiz bu iki parametrenin PFS ile ilişkisini desteklemedi. OS açısından yapılan analizde ise, tek değişkenli analizde ECOG PS (p=0.01), kemik metastazı (p=0.047), CAR (p=0.019) ve De Ritis oranı (p=0.051) prognostik risk faktörleri olarak belirlendi. Çok değişkenli analizde ise, ECOG PS (HR=0.45, %95 GA 0.22-0.94, P=0.035), kemik metastazı (HR=0.38, %95 GA 0.19-0.78, P=0.008) ve De Ritis oranı (HR=0.47, %95 GA 0.23-0.96, P=0.037) bağımsız risk faktörleri olarak tespit edildi.
Sonuç: Bu çalışmada, ikinci basamak tedavi olarak nivolumab kullanan metastatik KHDAK tanılı hastalarda, kötü ECOG performans durumu, kemik metastazı ve yüksek De Ritis oranı daha kısa OS süresiyle ilişkilendirilen birer bağımsız prognostik faktör olarak belirlendi. Bu faktörler, klinik pratikte hastaların prognozlarını değerlendirmede yardımcı olabilir.
Anahtar Kelimeler: Akciğer kanseri, nivolumab, prognostik faktörler, CAR, De ritis oranı
Cite this Article As : Kapagan T, Bulut N, Erdem GU. Prognostic Risk Factors Affecting Survival in Patients With Metastatic Non-Small Cell Lung Cancer Receiving Nivolumab As Second-Line Therapy. Selcuk Med J 2025;41(1): 29-35

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Conflict of interest : The authors declare that they have no conflict of interest.
This article is published under the CC BY-NC 4.0 license.
Selcuk Medical Journal
2025, Vol. 41 (1)
ISSN: 1017-6616
E-ISSN: 2149-8059
Received : , Accepted : , Published Online :

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Patient selection flow diagram.
Patient selection flow diagram.
Kaplan Meier survival curves for Overall Survival according to ECOG PS (A), Bone metastasis (B) and De Ritis (C).
Kaplan Meier survival curves for Overall Survival according to ECOG PS (A), Bone metastasis (B) and De Ritis (C).
Best objective response.
Best objective response.