Authors
Wenfang Jin, Ying Zhao, Yanling Lv, Yu Yao, Xin Su
Published in
Frontiers in medicine. Volume 13. Pages 1829572. Epub Jun 08, 2026.
Abstract
We determined whether the baseline peripheral blood CD4/CD8 ratio predicts grade ≥2 immune-related adverse events (irAEs) within 30 days of initiating single-agent PD-1/PD-L1 blockade in advanced lung cancer.
In this single-center retrospective study (January 2022-December 2025), we included adults with pathologically confirmed advanced NSCLC who received first-line treatment with pembrolizumab, tislelizumab, sintilimab, and camrelizumab. Baseline flow cytometry performed within 7 days before cycle 1 was required. The primary endpoint was grade ≥2 irAEs within 30 days. Multivariate logistic regression was used to identify independent predictors and evaluate model performance (area under the curve [AUC]).
Among 202 patients, 51 (25%) developed grade ≥2 irAEs. Median onset ranged from 2.1 weeks (rash) to 3.0 weeks (endocrine). Baseline CD4/CD8 ratio < 1.65 remained was present in 63% of patients with early irAE vs. 36% of controls (p < 0.001). After adjustment, ratio <1.65 remained the predictor (odds ratio [OR] 3.03; 95% confidence interval [CI] 1.57-5.84), while hypertension (OR 4.37) and diabetes (OR 4.08) added modest risk. The final model achieved an AUC of 0.78 (95% CI 0.71-0.85).
A pre-treatment CD4/CD8 ratio <1.65 remained is a simple, inexpensive biomarker that identifies lung cancer patients at high risk for early irAEs during single-agent PD-1/PD-L1 blockade. Prospective, multicenter validation is warranted.
PMID:
42338947
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.
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