Prognostic factors in patients with bone metastasis of lung cancer after immune checkpoint inhibitors: A retrospective study

Background: Accurate data on the prognosis of bone metastases are necessary for appropriate treatment. Immune checkpoint inhibitors (ICIs) are widely used in the treatment of gene mutation-negative non-small cell lung cancer (GMN-NSCLC).

Aim: To investigate the prognostic factors in patients with bone metastases from GMN-NSCLC following ICI use.

Methods: This retrospective cohort study included 45 patients with GMN-NSCLC who were treated for bone metastases from 2017 to 2022 and received chemotherapy after diagnosis. Using Kaplan-Meier curves and Cox proportional hazards models, we evaluated the association between overall survival (OS) and clinical parameters, including serum biochemical concentrations and blood cell count.

Results: Univariate analysis showed that Eastern Cooperative Oncology Group performance status ≤ 1 and the use of ICIs and bone-modifying agents after bone metastasis diagnosis were significantly associated with a favorable OS. Multivariate analysis revealed that ICI use after bone metastasis diagnosis was significantly associated with a favorable OS.

Conclusion: ICI use after bone metastasis diagnosis may be a favorable prognostic factor in patients with bone metastases of GMN-NSCLC. Consideration of ICI treatment for bone metastasis and GMN-NSCLC is warranted to establish a more accurate predictive nomogram for patients with bone metastasis.