Clinical predictors of prognosis in patients with advanced non-small cell lung cancer receiving immunotherapy

This study aimed to investigate clinical predictors of prognosis in patients with advanced non-small cell lung cancer (NSCLC) receiving immunotherapy. A total of 122 patients with stage IIIB to IV NSCLC who received immune checkpoint inhibitor-based therapy between August 2020 and August 2024 were retrospectively analyzed. Eligible patients were ≥18 years old and received at least 1 cycle of immune checkpoint inhibitor monotherapy or combination therapy. Baseline demographic, clinical, and laboratory data were collected, and patients were followed for 1 year after treatment initiation. Survivors were categorized into the favorable prognosis group (n = 86), and deceased patients into the poor prognosis group (n = 36). Univariate analysis identified age, smoking history, Eastern Cooperative Oncology Group (ECOG) performance status, line of therapy, serum albumin, neutrophil-to-lymphocyte ratio, C-reactive protein (CRP), and carcinoembryonic antigen (CEA) as significant prognostic factors. Multivariate logistic regression revealed that age >60 years, smoking history, ECOG score 2 to 3, hypoalbuminemia (<35 g/L), and elevated CEA (≥5 ng/mL) were independent predictors of poor prognosis. The predictive model demonstrated good discrimination, with an area under the receiver operating characteristic curve (area under the curve) of 0.783 (95% CI: 0.702–0.864) and a concordance index (C-index) of 0.776. Calibration was satisfactory according to the Hosmer–Lemeshow test ( P = .421). Clinical and laboratory parameters – including age, smoking status, ECOG performance status, albumin, and CEA – provide valuable prognostic information in patients with advanced NSCLC receiving immunotherapy. These factors may assist in risk stratification and individualized treatment planning.