Abstract
BACKGROUND: Non-small cell lung cancer (NSCLC) accounts for 85% of lung cancer cases and is a leading cause of cancer-related mortality. Immune checkpoint inhibitors (ICIs) have revolutionized treatment, offering improved survival. However, immune-related adverse events (irAEs) are common, and their impact on treatment outcomes warrants further investigation. AIM: This study evaluates the relationship between irAEs and clinical outcomes, including progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and objective response rate (ORR), in NSCLC patients treated with ICIs. METHOD: A retrospective observational study including 174 NSCLC patients treated with ICIs between 2019 and 2023 was conducted. Survival outcomes were analyzed using Kaplan-Meier estimates and multivariable Cox proportional hazards models. Associations between irAEs and treatment response were evaluated using multivariable logistic regression. RESULTS: IrAEs were observed in 42.0% of patients, primarily grade 1-2 (83.6%). Patients with irAEs exhibited significantly improved PFS (32.3 vs. 6.2 months; HR 0.52) and OS (37.4 vs. 9.8 months; HR 0.57). DCR (89.3% vs. 64.6%; OR 3.21) and ORR (64.2% vs. 31.6%; OR 2.81) were also higher in this group. No significant differences in outcomes were noted by irAE grade or organ affected. CONCLUSION: The presence of irAEs is associated with enhanced survival and treatment response in NSCLC patients receiving ICIs. These findings underscore the potential of irAEs as predictive biomarkers, supporting personalized treatment strategies.