Ishibashi Y, Kobayashi H, Ando T, Okajima K, Oki T, Tsuda Y, Shinoda Y, Sawada R, Tanaka S. Prognostic factors in patients with bone metastasis of lung cancer after immune checkpoint inhibitors: A retrospective study. World J Orthop 2024; 15(12): 1155-1163 [DOI: 10.5312/wjo.v15.i12.1155]
Corresponding Author of This Article
Hiroshi Kobayashi, PhD, Department of Orthopaedic Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku 113-8655, Tokyo, Japan. hkobayashi-tky@umin.ac.jp
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Dec 18, 2024; 15(12): 1155-1163 Published online Dec 18, 2024. doi: 10.5312/wjo.v15.i12.1155
Table 1 Clinical characteristics of patients
Characteristic
Number
Age at bone metastasis
Median 70 (range: 42–87)
Sex
Male
29
Female
16
Histological type
Adenocarcinoma
37
Squamous
3
NOS
5
Bone metastases
Multiple
45
Single
0
Brain metastases
Yes
8
No
37
Adrenal metastasis
Yes
4
No
41
ECOG PS
1
29
2
13
3
3
4
0
Treatment before bone metastasis diagnosis
Yes
19
No
26
Chemotherapy before bone metastasis diagnosis
Yes
21
No
24
ICI use after bone metastasis diagnosis
Yes
28
No
17
Tumor proportion score
≥ 50%
15
< 50%
20
Not tested
10
Table 2 Types of immune checkpoint inhibitors used in patients (n = 28)
Type of immune checkpoint inhibitors
Number
Pembrolizumab
15
Nivolumab
2
Atezolizumab
3
Durvalumab
3
Ipilimumab
0
Pembrolizumab + atezolizumab
2
Pembrolizumab + durvalumab
1
Nivolumab + durvalumab
1
Nivolumab + ipilimumab
1
Table 3 Univariate analysis of overall survival in patients with bone metastasis of gene mutation-negative non-small cell lung cancer
Characteristic
n
Median OS
95%CI
P value
Age
0.51
≥ 70
23
14
7-not censored
< 70
22
19
10–54
Sex
0.72
Male
29
15
8–33
Female
16
16
8-not censored
Histological type
0.47
Adenocarcinoma
37
16
10–54
Others
8
14
1-not censored
Brain metastases
0.35
Yes
8
33
3–33
No
37
14
8–19
Adrenal metastasis
0.85
Yes
4
Not censored
4-not censored
No
41
16
8–33
ECOG PS
0.0079
≥ 2
16
8
3–33
≤ 1
29
19
13-not censored
Treatment before bone metastasis diagnosis
0.39
Yes
19
16
8-not censored
No
26
14
8–54
Chemotherapy before bone metastasis diagnosis
0.89
Yes
21
14
8–54
No
24
16
7–33
ICI use after bone metastasis diagnosis
0.031
Yes
28
22
8-not censored
No
17
13
5–16
Use of bone-modifying agent after bone metastasis diagnosis
0.027
Yes
36
16
12–54
No
9
5
2–33
Albumin
0.63
> 3.5
25
16
10-not censored
≤ 3.5
20
16
5–54
C-reactive protein
0.72
≥ 0.4
33
16
7–33
< 0.4
12
15
8-not censored
Lactate dehydrogenase
0.83
≥ 225
25
16
5–33
< 225
20
15
8–54
White blood cells
0.22
> 8500
20
14
5–22
≤ 8500
25
16
10–54
Neutrophil-to-lymphocyte ratio
0.47
≥ 5.0
21
16
8–33
< 5.0
24
15
8-not censored
Platelet-to-lymphocyte ratio
0.93
≥ 185
35
16
10–33
< 185
10
15
3–54
Table 4 Multivariate analysis of overall survival in patients with bone metastasis of gene mutation-negative non-small cell lung cancer
Characteristic
HR
95%CI
P value
Use of ICIs after bone metastasis diagnosis
Yes
0.35
0.14–0.86
0.023
Use of bone-modifying agent after bone metastasis diagnosis
Yes
0.43
0.16–1.2
0.12
ECOG PS
≤ 1
0.5
0.20–1.3
0.14
Table 5 Univariate analysis following the division of patients into three groups based on tumor proportion score and immune checkpoint inhibitors use
n
Median OS
95%CI
P value
TPS ≥ 50% and ICI use
12
54
3-not censored
0.079
TPS ≤ 49% or not tested and ICI use
16
19
8-not censored
No use of ICI
17
13
5–16
Citation: Ishibashi Y, Kobayashi H, Ando T, Okajima K, Oki T, Tsuda Y, Shinoda Y, Sawada R, Tanaka S. Prognostic factors in patients with bone metastasis of lung cancer after immune checkpoint inhibitors: A retrospective study. World J Orthop 2024; 15(12): 1155-1163