Early C-reactive protein reduction predicts survival in real-world extensive-stage small cell lung cancer treated with first-line adebrelimab-based immunotherapy

作者：Wang J, Zhang X, Gao Q, Chen J · 发表于：Frontiers in oncology · 年份：2025 · DOI：10.3389/fonc.2025.1709336 · 被引用次数：25 · 研究领域：C-reactive protein、adebrelimab、extensive-stage small cell lung cancer、prognostic biomarker、real-world evidence

BACKGROUND: Extensive-stage small cell lung cancer (ES-SCLC) remains an aggressive malignancy with limited biomarkers for predicting outcomes in real-world settings. While baseline systemic inflammation correlates with prognosis, the role of longitudinal inflammation dynamics during PD-L1 inhibitor-based therapy is unexplored. This study investigated whether early changes in systemic inflammation markers, particularly C-reactive protein (CRP), predict clinical efficacy in ES-SCLC patients receiving first-line adebrelimab plus chemotherapy. METHODS: In this retrospective, single-center study, 35 ES-SCLC patients (median age: 72 years) treated with adebrelimab plus platinum-etoposide or platinum-irinotecan chemotherapy were analyzed. Ten systemic inflammation markers (NLR, PLR, LMR, PAR, SII, NPR, CAR, CLR, CRP, LDH) were assessed at baseline and after 2 months of therapy. Inflammatory trends were quantified as the ratio of 2-month to baseline values. Associations between inflammation dynamics and survival (OS from 2 months, OS2) or radiologic response (RECIST 1.1) were evaluated using Kaplan-Meier analysis, Cox regression, and Spearman's correlation. RESULTS: The cohort showed robust real-world efficacy (median OS: 15.0 months; ORR: 62.8%). Among ten inflammation markers analyzed, only CRP dynamics were significantly associated with OS in univariate analysis. Patients achieving CRP reduction (trend ratio <1) at 2 months had significantly longer median OS (16.2 months) versus...