TY - JOUR AU - Hofer, Thomas P AU - Nieto, Alexander E AU - Käsmann, Lukas AU - Pelikan, Carolyn J AU - Taugner, Julian AU - Mathur, Saloni AU - Eze, Chukwuka AU - Belka, Claus AU - Manapov, Farkhad AU - Noessner, Elfriede TI - Early recovery of leukocyte subsets is associated with favorable progression-free survival in patients with inoperable stage II/III NSCLC after multimodal treatment: a prospective explorative study. JO - Radiation oncology VL - 20 IS - 1 SN - 1748-717X CY - London PB - BioMed Central M1 - DKFZ-2025-00597 SP - 43 PY - 2025 AB - We explored the dynamic changes of major leukocyte subsets during definitive treatment of patients with inoperable stage II/III NSCLC lung cancer and correlated it to survival to identify subpopulations associated with maximal patient benefit.We analyzed peripheral blood of 20 patients, either treated with thoracic radiotherapy (RT), concurrent chemo-radiotherapy (cCRT), or cCRT with additional immune-checkpoint inhibition therapy. Peripheral blood of 20 patients was collected at 9 timepoints before, during, and up to 1 year post treatment and analyzed by multi-color flow cytometry. Statistical analysis was conducted for leukocyte subpopulations, IL-6, progression-free survival (PFS) and overall survival (OS).Increase of absolute lymphocyte counts (ALC) after the end of RT until 6 months thereafter was a predictor of PFS. Baseline lymphocyte counts showed no significant correlation to PFS or OS. Early recovery of absolute counts (AC) at 3 weeks after RT, total CD3 + T-cells, and CD8 + cytotoxic T-cells distinguished those patients with favorable PFS (≥ 12 months) from all other patients. Discriminant analysis identified B-cells, neutrophil-lymphocyte-ratio (NLR), CD4 + T-helper-cells, and NK-cells as predictors of favorable PFS. High variability in IL-6 plasma concentration of consecutive measurements within 6 months after the end of RT correlated negatively with PFS.Our results suggest that two parameters commonly assessed in clinical routine can be used to predict patient outcome. These are: early increase in CD8 + T-cell lymphocyte count and variability in IL-6 plasma concentration, that are correlated to patients with favorable, respectively, poor outcome after definitive therapy independent of treatment regimen. KW - Humans KW - Male KW - Carcinoma, Non-Small-Cell Lung: pathology KW - Carcinoma, Non-Small-Cell Lung: mortality KW - Carcinoma, Non-Small-Cell Lung: therapy KW - Carcinoma, Non-Small-Cell Lung: blood KW - Carcinoma, Non-Small-Cell Lung: radiotherapy KW - Female KW - Lung Neoplasms: pathology KW - Lung Neoplasms: mortality KW - Lung Neoplasms: therapy KW - Lung Neoplasms: blood KW - Lung Neoplasms: radiotherapy KW - Aged KW - Middle Aged KW - Prospective Studies KW - Combined Modality Therapy KW - Progression-Free Survival KW - Neoplasm Staging KW - Chemoradiotherapy: mortality KW - Prognosis KW - Survival Rate KW - Area under curve analysis (Other) KW - B-cells (Other) KW - CD4 + T-cells (Other) KW - CD8 + T-cells (Other) KW - Eosinophils (Other) KW - Immune checkpoint therapy (Other) KW - Linear discriminant analysis (Other) KW - NK-cells (Other) KW - Neutrophils (Other) KW - Non-small cell lung cancer (Other) KW - Overall survival (Other) KW - Peripheral blood markers (Other) KW - Progression-free survival (Other) LB - PUB:(DE-HGF)16 C6 - pmid:40114261 C2 - pmc:PMC11927295 DO - DOI:10.1186/s13014-025-02620-z UR - https://inrepo02.dkfz.de/record/300097 ER -