术前外周血淋巴细胞与单核细胞比值评估直肠癌预后的价值

目的:探讨直肠癌患者术前外周血淋巴细胞与单核细胞比值（LMR）与预后的关系。方法:回顾性分析2007年1月至2012年1月我院收治的85例行直肠癌根治术患者的临床资料,根据受时间依赖受试者生存曲线（ROC）将患者分为高LMR组和低LMR组。分析直肠癌患者LMR水平与临床病理特征的相关性;采用Kaplan-Meier法进行单因素生存分析,Cox风险回归模型用于多因素分析。结果:根据ROC曲线,LMR最佳临界值为4.21,其中高LMR组58例,低LMR组27例,高LMR组与低LMR组之间的脉管癌栓发生率、癌胚抗原（CEA）水平和TNM分期有统计学差异（P<0.05）;年龄、性别、病理类型、术后是否接受放化疗等方面无统计学差异（P>0.05）。单因素分析显示临床分期、术前CEA水平、脉管癌栓、LMR水平是影响直肠癌患者5年总生存率和无疾病进展生存率的危险因素（P<0.05）;高LMR组与低LMR组的5年总生存率分别为72.4%和40.7%;无疾病进展生存率分别为58.6%和25.9%;Cox多因素分析结果显示临床分期和LMR是影响直肠癌术后患者的独立预后因素。结论:LMR与直肠癌患者的术后分期相关,且LMR是直肠癌术后患者预后的独立影响因素之一,与远期生存呈正比关系,具有良好的预测价值。     

Immune-related adverse events and prognosis in patients with upper gastrointestinal cancer treated with nivolumab

BackgroundImmune checkpoint inhibitors (ICIs) are increasingly being used for the treatment of upper gastrointestinal cancers [esophageal cancer and gastric cancer (GC)]. They cause imbalances in immunological tolerance, resulting in immune-related adverse events (irAEs). Although irAEs have been reported to be associated with the efficacy of ICIs in some cancers, the relationship between irAEs and prognosis of upper gastrointestinal cancers remains unknown. This study aimed to investigate the prognostic impact of irAEs in patients with advanced or recurrent upper gastrointestinal cancer treated with nivolumab.MethodsWe retrospectively divided the patients (n=96) who received nivolumab into two groups: the irAEs group (n=41) and non-irAEs group (n=55), according to the Common Terminology Criteria for Adverse Events ver. 5.0.ResultsirAEs were significantly associated with good performance status and high serum albumin levels (all P<0.05). The irAEs group had a significantly longer overall survival (OS) than the non-irAEs group [log-rank P=0.003; univariate hazard ratio (HR) =0.36, 95% confidence interval (CI) =0.21–0.65, P<0.01; multivariate HR =0.47, 95% CI =0.26–0.88, P=0.018]. Importantly, in both esophageal cancer and GC, the irAEs group experienced favorable clinical outcomes compared with the non-irAEs group. In the multivariate analysis, male sex (P<0.01), presence of irAEs (P=0.018), and good pretreatment performance status (P<0.01) were independent prognostic factors.ConclusionsAmong patients with upper gastrointestinal cancer treated with nivolumab, the prognosis of patients who developed irAEs was better than that of patients who did not develop irAEs. Long-term continuation of nivolumab by early detection of irAEs and an appropriate response to irAEs are important.     

Long‐term efficacy and predictive correlates of response to nivolumab in Japanese patients with esophageal cancer

The long‐term efficacy of nivolumab in esophageal squamous cell carcinoma and its association with disease biomarkers are currently not well known. Therefore, we investigated the association in Japanese patients with treatment‐refractory advanced esophageal cancer who participated in an open‐label, single‐arm, multicenter phase II study. Patients received nivolumab 3 mg/kg i.v. every 2 weeks until disease progression or unacceptable toxicity, and were followed up for 2 years after the initial dosing of the last patient. Archival tissue samples were collected before treatment and analyzed for programmed death ligand‐1 (PD‐L1) and CD8⁺ status of tumors and tumor‐infiltrating lymphocytes (TILs) and human leukocyte antigen class 1. Efficacy end‐points included objective response rate (ORR), overall survival (OS), progression‐free survival (PFS), time to response, and duration of response. Of 65 enrolled patients (83% male), 64 were evaluable for efficacy and 41 (63%) for biomarkers. The ORR, median OS, and survival rate were 17.2%, 10.78 months, and 17.2%, respectively. Time to response was 1.45 months and duration of response was 11.17 months. The PD‐L1 positivity of tumor cells was possibly associated with better PFS (2.04 vs 1.41 months, cut‐off 1%) and OS (11.33 vs 6.24 months, cut‐off 1%). Median OS was prolonged in patients with a median number of TILs greater than 63.75% vs 63.75% or less (11.33 vs 7.85 months). Nivolumab showed continued long‐term efficacy, as seen by the stability of PFS and OS, in Japanese patients with esophageal squamous cell carcinoma. Further investigation of PD‐L1 tumor expression and TILs as potential biomarkers for predicting patients likely to benefit from nivolumab therapy is warranted.     

Combination of platelet count and neutrophil to lymphocyte ratio is a useful predictor of postoperative survival in patients with colorectal cancer

Background:

This study investigated the usefulness of a novel inflammation-based prognostic system, named the COP-NLR (COmbination of Platelet count and Neutrophil to Lymphocyte Ratio), for predicting the postoperative survival of patients with colorectal cancer (CRC).

Methods:

The COP-NLR was calculated on the basis of data obtained on the day of admission: patients with both an elevated platelet count (>30 × 10⁴ mm⁻³) and an elevated NLR (>3) were allocated a score of 2, and patients showing one or neither were allocated a score of 1 or 0, respectively.

Results:

Four-hundred and eighty patients were enrolled. Multivariate analysis of clinical characteristics selected by univariate analysis showed that the COP-NLR (1, 2/0) (odds ratio, 0.464; 95% confidence interval, 0.267–0.807; P=0.007) had an association with cancer-specific survival, along with pathology, lymph node metastasis, the serum levels of carcinoembryonic antigen, C-reactive protein and albumin, and the Glasgow Prognostic Score. Kaplan–Meier analysis and log-rank test revealed that the COP-NLR was able to divide such patients into three independent groups (P<0.001).

Conclusion:

The COP-NLR is considered to be a useful predictor of postoperative survival in patients with CRC.     

淋巴细胞绝对计数与多发性骨髓预后的相关性分析

  目的  探讨淋巴细胞绝对计数与多发性骨髓瘤患者疾病进展和预后的相关性。  方法  收集102例初发多发性骨髓瘤患者的淋巴细胞绝对计数及各项临床指标,分析淋巴细胞绝对计数与多发性骨髓瘤患者疾病进展和预后的相关性。  结果  根据中位淋巴细胞绝对计数分组后得出,组1（淋巴细胞绝对计数＞1.51×109/L）发病年龄、血清乳酸脱氢酶和β2-微球蛋白明显低于组2（淋巴细胞绝对计数 < 1.51×109/L）,组1患者中位总生存期大于组2（P < 0.05）。但两组患者性别、白蛋白、D-S分期、ISS分期、分组和疗效差异无统计学意义（P>0.05）。  结论  初发时淋巴细胞绝对计数高的患者预后较好,淋巴细胞绝对计数低的患者预后较差。推测淋巴细胞绝对计数可能成为多发性骨髓瘤的独立预后因素之一。      

中性粒细胞/淋巴细胞比值血小板/淋巴细胞比值与TACE治疗肝癌患者预后的相关性

  目的  本研究探讨中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio,NLR）和血小板与淋巴细胞比值（platelet to lymphocyte ratio,PLR）与接受肝动脉栓塞化疗（transarterial chemoembolization,TACE）肝癌（hepatocellular carcinoma,HCC）患者术后生存期的相关性。  方法  回顾性分析2007年1月至2015年6月中山大学肿瘤防治中心肝胆胰科确诊为肝癌并行TACE治疗的216例患者。研究患者依照NLR和PLR的界值分成两组。分析并比较NLR和PLR在不同随访时间点的受试者工作曲线（ROC）下面积。单因素和多因素分析用于评价NLR和PLR与TACE术后肝癌患者预后的相关性。  结果  本研究中位随访时间为431.1 d。全体研究对象1、2、3年生存率分别为61.3%、44.2%和40.5%。中位生存时间为410.5 d。术前NLR＜1.77组和术前NLR≥1.77组1、2、3年生存率分别为81.6%、63.0%、45.7%和43.1%、27.0%、19.3%,差异具有统计学意义（P < 0.001）。术前PLR < 94.62组和术前PLR≥94.62组1、2、3年生存率分别为62.7%、47.0%、37.0%和46.8%、29.0%、18.5%,差异具有统计学意义（P=0.002）。多因素分析显示NLR≥1.77与TACE术后肝癌患者较差预后相关,是肝癌患者TACE治疗后的危险因素。  结论  TACE介入术前HCC患者的NLR水平,作为系统炎症的一个反应指标,是影响其预后的危险因素。      

Preoperative neutrophil:lymphocyte and platelet:lymphocyte ratios predict endometrial cancer survival

Background:

Variations in systemic inflammatory response biomarker levels have been associated with adverse clinical outcome in various malignancies. This study determined the prognostic significance of preoperative neutrophil:lymphocyte (NLR), platelet:lymphocyte (PLR) and monocyte:lymphocyte (MLR) ratios in endometrial cancer.

Methods:

Clinicopathological and 5-year follow-up data were obtained for a retrospective series of surgically treated endometrial cancer patients (n=605). Prognostic significance was determined for overall (OS) and cancer-specific survival (CSS) using Cox proportional hazards models and Kaplan–Meier analysis. Receiver–operator characteristic and log-rank functions were used to optimise cut-offs. NLR, PLR and MLR associations with clinicopathological variables were determined using non-parametric tests.

Results:

Applying cut-offs of ⩾2.4 (NLR), ⩾240 (PLR) and ⩾0.19 (MLR), NLR and PLR (but not MLR) had independent prognostic significance. Combining NLR and PLR scores stratified patients into low (NLR-low and PLR-low), intermediate (NLR-high or PLR-high) and high risk (NLR-high and PLR-high) groups: multivariable hazard ratio (HR) 2.51; P<0.001 (OS); HR 2.26; P<0.01 (CSS) for high vs low risk patients. Increased NLR and PLR were most strongly associated with advanced stage (P<0.001), whereas increased MLR was strongly associated with older age (P<0.001).

Conclusion:

Both NLR and PLR are independent prognostic indicators for endometrial cancer, which can be combined to provide additional patient stratification.     

Delayed cutaneous hypersensitivity,lymphocyte count,and blood tests in patients with breast carcinoma

General immunocompetence was examined in 125 patients with various stages of breast cancer. Tests include peripheral blood lymphocyte count, serum protein electrophoresis, quantitative immunoglobulins, CEA level, and delayed cutaneous hypersensitivity (DCH) reaction to six recall antigens (PPD, Monilia, mumps, Varidase, histoplasmin, and coccidioidin). About one third of the patients responded positively to each of the first four antigens, whereas 12% reacted to histoplasmin and 4% to coccidioidin. In this study, DCH to recall antigens had no prognostic value because the distributions of skin test reactivity were similar among patients with different stages of breast carcinoma. And among patients with similar stage of disease the relapse rates were similar for those who reacted and those who were anergic. But peripheral lymphocyte count had definite prognostic value because patients with advanced stage (group III/IV) and those who were anergic had significantly lower lymphocyte counts. Among patients with relatively early stages of breast carcinoma (group I/II), those who had higher lymphocyte count (≧ 2,000/mm³) had lower chance of having relapse up to 5 years after mastectomy.     

Additional diagnostic value of the monocyte to red blood cell count ratio and the product of lymphocyte count and albumin concentration in lung cancer management

The present study aimed to evaluate the potential of the monocyte to red blood cell count ratio (MRR), the neutrophil to red blood cell count ratio (NRR), the lymphocyte to red blood cell count ratio (LRR) and the product of lymphocyte count and albumin concentration (LA) for the diagnosis of lung cancer. The cases of 216 patients with newly diagnosed lung cancer and 184 healthy volunteers were retrospectively analysed. The MRR and NRR were found to be higher in patients with lung cancer compared with those in healthy controls, while the LRR and LA were lower. The receiver operating characteristic curve analysis revealed that of the four markers, the MRR and LA yielded a higher area under the curve (AUC) (MRR: AUC, 0.810; 95% CI, 0.768-0.847; and LA: AUC, 0.721; 95% CI, 0.674-0.764). The combination of MRR, LA, carcinoembryonic antigen (CEA) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) achieved the highest diagnostic value when compared with other single or combined markers (AUC, 0.882; 95% CI, 0.846-0.912; sensitivity, 81.9%; specificity, 81.0%). As the disease progressed, the MRR tended to increase, while LA exhibited a decreasing trend. Binary logistic regression analysis revealed an increase in the MRR, as well as in CEA and CYFRA21-1 concentrations, and a decrease in the LA, which could all be possible risk factors for lung cancer. Differences in the MRR and LA between patients with early stage (IA-IIIA) lung cancer and healthy controls were observed. Further analysis revealed that the MRR also exhibited the potential to detect early stage (IA-IIIA) lung cancer in the model. The present findings demonstrated that the MRR and LA may be used as auxiliary biomarkers for the diagnosis of lung cancer and could partly indicate disease progression.     

Predictive value of pretreatment lymphocyte count in stage II colorectal cancer and in high-risk patients treated with adjuvant chemotherapy

Pretreatment lymphocyte count (LC) has been associated with prognosis and chemotherapy response in several cancers. The predictive value of LC for stage II colorectal cancer (CRC) and for high-risk patients treated with adjuvant chemotherapy (AC) has not been determined. A retrospective review of prospectively collected data from 1332 consecutive stage II CRC patients who underwent curative tumor resection was conducted. A pretreatment LC value <1.3 Giga/L(28.1%, 373/1332) was defined as low LC. A total of 738 patients (55.4%) were considered high-risk, 459 (62.2%) of whom received AC. Patients with low LCs had significantly worse 5-year OS (74.6% vs. 90.2%, p < 0.001) and DFS (61.3% vs. 84.6%, p < 0.001). High-risk patients with low LCs had the poorest DFS (p < 0.001). Multivariate analysis indicated that low LC value or combined with high-risk status were both independent prognostic factors(p <0.001). High-risk, AC-treated patients with high LCs had significantly longer DFS than untreated patients (HR, 0.594; 95% CI, 0.364–0.970; p = 0.035). There was no difference or trend for DFS or OS in patients with low LCs, regardless of the use of AC (DFS, p = 0.692; OS, p = 0.522). Low LC was also independently associated with poorer DFS in high-risk, AC-treated patients (HR, 1.885; 95% CI, 1.112–3.196; p = 0.019). CONCLUSIONS: Pretreatment LC is an independent prognostic factor for survival in stage II CRC. Furthermore, pretreatment LC reliably predicts chemotherapeutic efficacy in high-risk patients with stage II CRC.     

术前中性粒细胞与淋巴细胞比值联合癌胚抗原检测对直肠癌患者预后的评估价值

目的探讨术前中性粒细胞与淋巴细胞比值(NLR)联合癌胚抗原(CEA)对直肠癌预后的评估价值。方法选取268例直肠癌患者,依据术后5年生存情况,分为生存组和死亡组,比较两组患者的临床特征,影响直肠癌患者预后的独立影响因素采用Cox回归分析,采用受试者工作特征(ROC)曲线和曲线下面积(AUC)评估NLR及CEA单独及联合检测对直肠癌预后的评估价值。结果随访结束,268例直肠癌患者中,生存156例,病死112例,直肠癌患者术后5年生存率为58.21%。将生存患者和病死患者分别作为生存组和死亡组,生存组和死亡组直肠癌患者性别、年龄比较,差异均无统计学意义(P﹥0.05);生存组和死亡组直肠癌患者TNM分期、分化程度、肿瘤直径、神经侵犯情况、浸润深度、远处转移情况、淋巴结转移情况、CEA水平及NLR比较,差异均有统计学意义(P﹤0.05)。Cox回归分析结果显示,TNM分期、肿瘤直径、远处转移、CEA水平和NLR是直肠癌患者预后不良的独立危险因素(P﹤0.05)。CEA、NLR及二者联合预测直肠癌预后的AUC分别为0.991、0.923、0.997,CEA和NLR联合检测对直肠癌患者的预后评估具有较高的准确性,二者联合检测的AUC高于单独预测的AUC(P﹤0.05)。结论术前NLR联合CEA检测对直肠癌预后具有较高的预估价值,二者联合能够为评估直肠患者预后提供重要的参考信息。     

系统性炎症相关指标中性粒细胞/淋巴细胞比值及血小板/淋巴细胞比值在根治性切除术后的胃癌患者的预后意义

目的 比较胃癌患者术前不同系统性炎症性评分指标:中性粒细胞/淋巴细胞比值(Neutrophil lymphocyte ratio,NLR)、血小板/淋巴细胞比值(Platelet lymphocyte ratio,PLR)的短期及长期预后意义。方法 回顾性分析2009年1月—2009年12月上海仁济医院行根治性手术治疗的240例胃癌患者的临床资料,比较NLR、PLR和格拉斯哥预后评分(Glasgow prognostic score,GPS)与临床病理特征和围手术期并发症的关系,生存分析采用Kaplan-Meier方法、Log-rank法检验差异显著性,多因素分析采用Cox回归风险模型进行。结果 高NLR和高PLR组患者年龄大、GPS高、肿瘤浸润深度深、淋巴结转移多、TNM分期晚(P＜0.05)。高NLR组切缘阳性比例高(P＜0.05)。高NLR和高PLR组患者术中需要输血比例明显高于低NLR和低PLR组(P＜0.05),高NLR组具有更多的术后并发症(P＜0.05)。单因素分析显示,年龄、GPS、肿瘤部位、肿瘤浸润深度、淋巴结转移状态、TNM分期、脉管癌栓、神经浸润、NLR和PLR均与胃癌患者术后生存期相关(P＜0.05);高NLR组和高PLR组的总生存期(Overall survival,OS)低于低NLR和低PLR组(P=0.018和P＜0.001);COX多因素分析显示,GPS和淋巴结转移状态是影响OS的独立预后因素(P＜0.001和P=0.002)。结论 术前系统性炎症性评分指标NLR、PLR是影响胃癌围手术期临床转归的预后因素,建议可与临床常规应用的其他预后指标联合用于胃癌根治术后患者的预后评估。     

Absolute lymphocyte count is a novel prognostic indicator in ALL and AML: implications for risk stratification and future studies

BACKGROUND: Leukemia is the leading cause of disease-related death in children, despite significant improvement in survival and modern risk stratification. The prognostic significance of absolute lymphocyte counts (ALC) was evaluated in young patients with acute myeloblastic leukemia (AML) and acute lymphoblastic leukemia (ALL). METHODS: In all, 171 consecutive de novo cases of AML and ALL, age 350 cells/microL carries an excellent prognosis, with a 5-year overall survival (OS) of 85% (HR 0.2, P= .012). Similarly in ALL, an ALC-15 <350 cells/microL predicts poor survival, with a 6-year RFS of 43% (HR 4.5, P= .002), whereas an ALC-15 >350 cells/microL predicts excellent outcome, with a 6-year OS of 87% (HR 0.2, P= .018). Importantly, ALC remains a strong predictor in multivariate analysis with known prognostic factors. CONCLUSIONS: ALC is a simple, statistically powerful measurement for patients with de novo AML and ALL. The results, when combined with previous studies, demonstrate that ALC is a powerful new prognostic factor for a range of malignancies. These findings suggest a need for further exploration of postchemotherapy immune status and immune-modulating cancer therapies.     

血常规相关指标与食管癌患者治疗效果和预后的关系

炎症在恶性肿瘤的发生、进展、转移中扮演着重要的角色,在食管癌病程进展中的作用也逐渐引起人们重视。近年来食管癌患者血常规检查中相关指标与其治疗疗效和预后的关系逐步成为研究热点。现就EC患者血常规检查中一些指标与其治疗疗效和预后的关系进行概述,并主要介绍血常规中炎症复合标记物与EC患者治疗疗效和预后关系的研究进展。     

术前中性粒细胞／淋巴细胞比值与卵巢癌患者预后的关系

目的 探讨术前中性粒细胞／淋巴细胞比值（NLR）与卵巢癌患者的临床病理特征及预后的关系。方法 回顾性分析2000年1月至2012年12月本院165例初治卵巢癌患者的临床资料,根据术前NLR值,将患者分为高NLR组（NLR＞3）和低NLR组（NLR≤3）,比较两组患者的临床病理特征及无进展生存期（PFS）和总生存期（OS）。采用Cox回归模型分析影响卵巢癌患者预后的独立因素。结果 卵巢癌患者术前NLR的增高与肿瘤分期晚、恶性腹水、CA125升高、手术减瘤不满意、血红蛋白降低、淋巴细胞减少以及白细胞、中性粒细胞和血小板增多有关（P＜0.05）。高NLR组与低NLR组患者的中位PFS分别为 10个月和22个月,差异有统计学意义（P＜0.01）;两组患者的中位OS分别为28个月和63个月,差异亦有统计学意义（P＜0.01）。单因素分析显示FIGO分期、手术减瘤程度、腹水、NLR是影响OS和PFS的因素（P＜0.05）。Cox多因素分析显示除FIGO分期和手术减瘤满意度外,术前NLR水平增高也是影响卵巢癌患者PFS （HR：1.130,95％CI： 1.053～1.213,P=0.001）和OS （HR：1.190,95％CI：1.100～1.288,P＜0.001） 的独立预后因素。结论 术前NLR值可作为卵巢癌患者的独立预后因素。     

A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer

Background:

The neutrophil lymphocyte ratio (NLR) has prognostic value in patients with a variety of cancers. Many chemotherapeutic trial databases hold information on white cell and neutrophil counts only. The aim of the present study was to compare the prognostic value of the NLR with a derived score (dNLR), composed of white cell and neutrophil counts.

Methods:

Patients (n=27 031) who were sampled incidentally between 2000 and 2007 for neutrophil, lymphocyte and white cell counts, and also had a diagnosis of cancer (Scottish Cancer Registry), were identified. Of this group, 12 118 patients who had been sampled within 2 years of their cancer diagnosis were studied.

Results:

On follow-up, there were 7366 deaths, of which 6198 (84%) were cancer deaths. The median time from blood sampling to diagnosis was 2.1 months. The area under the receiver-operating characteristic (ROC) curve for cancer-specific survival was 0.650 for the NLR and 0.640 for the dNLR. The NLR and dNLR were independently associated with survival in all cancers studied (all P<0.001). The optimal thresholds, on the basis of hazard ratios and area under the curve, were 4 : 1 for the NLR and 2 : 1 for the dNLR.

Conclusion:

The results of the present study show that the dNLR has similar prognostic value to the NLR. Therefore, the universally available dNLR is to be commended for use in the risk stratification of patients undergoing chemotherapy.     

应用放射组学和剂量学特征预测食管癌放射治疗后的两年生存情况

目的:使用放射组学与剂量学特征参数,建立机器学习预测模型,预测食管癌患者放射治疗后两年的生存情况。方法:回顾性分析2013年1月至2017年12月在天津医科大学肿瘤医院接受放射治疗的食管癌患者共579例。从食管癌患者的放射治疗计划中提取GTV的放射组学和剂量学的特征,使用最大相关最小冗余与人工方法对特征参数进行筛选,分别选取14项放射组学和14项剂量学特征,并将特征变量进行标准化归一至[0,1]范围。建立支持向量机、逻辑回归和随机森林等机器学习模型,先使用14项放射组学特征,再使用28项放射组学和剂量学混合特征参数进行训练和测试,来预测食管癌放射治疗患者的两年生存情况。结果:仅使用放射组学特征预测放射治疗后两年生存情况时,支持向量机、逻辑回归和随机森林模型的准确率分别为84.98%、85.92%和84.51%。使用放射组学和剂量学的混合特征参数进行预测时,支持向量机、逻辑回归和随机森林模型的准确率分别为86.32%、83.02%和90.01%。在放射组学特征参数基础上,增加剂量学特征,支持向量机和随机森林模型的预测准确性得到有效提高。结论:针对支持向量机和随机森林模型,使用放射组学和放...     

Prognostic factors and effect on survival of immune-related adverse events in patients with non-small-cell lung cancer treated with immune checkpoint blockage

Our aim was to describe the incidence and characteristics of immune-related adverse events (irAEs) in patients with non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI) and to evaluate their impact on outcome. All cases of NSCLC patients treated with ICIs in the second-line setting between December 2015 and May 2018 were evaluated. Seventy patients were included. Mean age was 65.9?years, and the majority of male (n?=?53, 75.7%), with PS of 0-1 (n?=?62, 88.6%) treated with nivolumab (n?=?51; 72.9%). Thirty-one patients (44.3%) experienced an AE, 5 (7.1%) were grades 3–4. Median OS in patients with AE was 30.1?months (95% CI, 16.7–43.5) compared with 5.1?months (95% CI, 1.2–9.0) in cases without AE (log-rank test: p?=?0.010). The adjusted HR for OS was 0.46 (95% CI, 0.25–0.86) for the irAE occurrence and 3.60 (95% CI, 1.56–8.32) for PS 2-3 group. The development of irAEs was associated with improved patient outcome.