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The Correlation between the Efficacy and Survival of Chemotherapy Combined with PD-1 and Granulocyte Colony-Stimulating Factor in Patients with Advanced NSCLC

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Open Access
Article Type Comparative Studies
Subject Medicine Group
OCLC JBRES Record
Liu X*, Lai C, Liu H and Ding Y
Issue: Volume6-Issue10
Pages: 1505-1513
Received: 2025-10-09
Accepted: 2025-10-19
Published: 2025-10-21

Abstract

Objective: This study investigates the relationship between the prophylactic use of granulocyte colony-stimulating factors and clinical efficacy, as well as survival outcomes, in patients with advanced non-small cell lung cancer who develop neutropenia following platinum-based dual-drug chemotherapy combined with immunotherapy.

Methods: A retrospective analysis was conducted on patients diagnosed with advanced non-small cell lung cancer and neutropenia in our department from 2021 to 2023. All patients received chemotherapy combined with immunotherapy. The prevention group was given long-acting granulocyte-stimulating factor for preventive treatment, while the control group did not receive preventive treatment.

Consequence: The results of univariate and multivariate analyses in this study indicate that pathological type, distant metastasis, and prophylactic use of granulocyte-stimulating factor are important influencing factors for Progression-Free Survival (PFS). After receiving chemotherapy combined with immunotherapy, the median PFS in the prevention group was 15.500 months, while that in the control group was 8.000 months (p = 0.010). This reduced the risk of disease progression by 80.3% (p = 0.039), which was statistically significant. Additionally, the median PFS for patients with adenocarcinoma components was 15.000 months, while that for patients with squamous cell carcinoma was 7.500 months (p = 0.020), which was also statistically significant. The median PFS for patients with distant metastasis was 5.000 months, while that for patients without distant metastasis was 14.500 months (p = 0.014), and the risk of disease progression increased by 6.396 times (p = 0.047).

Conclusion: Patients with adenocarcinoma components, those with distant metastasis, and those who benefit from chemotherapy combined with immunotherapy by receiving preventive use of granulocyte-stimulating factor can experience a reduced risk of disease progression. This suggests the necessity of closely monitoring neutrophil levels and taking timely intervention measures during the post-treatment monitoring period.

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© 2025 Liu X, et al. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

Liu X, Lai C, Liu H, Ding Y. The Correlation between the Effi cacy and Survival of Chemotherapy Combined with PD-1 and Granulocyte Colony-Stimulating Factor in Patients with Advanced NSCLC. J Biomed Res Environ Sci. 2025 Oct 21; 6(10): 1505-1513. doi: 10.37871/jbres2206, Article ID: JBRES2206, Available at: https:// www.jelsciences.com/articles/jbres2206.pdf

Subject area(s)

Alternative MedicineHematologyCancerPublic Health

References

  1. Zheng RS, Chen R, Han BF, Wang SM, Li L, Sun KX, Zeng HM, Wei WW, He J. [Cancer incidence and mortality in China, 2022]. Zhonghua Zhong Liu Za Zhi. 2024 Mar 23;46(3):221-231. Chinese. doi: 10.3760/cma.j.cn112152-20240119-00035. PMID: 38468501.
  2. Ye X, Huang A, Zhou Y, Kuang Y, Wang W, Gu A, Xu L. Efficacy and safety analysis of anlotinib combined with PD-1 inhibitors in advanced non-small cell lung cancer: a retrospective cohort study. J Thorac Dis. 2023 Apr 28;15(4):2003-2011. doi: 10.21037/jtd-23-289. Epub 2023 Apr 23. PMID: 37197506; PMCID: PMC10183545.
  3. Di Maio M, Gridelli C, Gallo C, Shepherd F, Piantedosi FV, Cigolari S, Manzione L, Illiano A, Barbera S, Robbiati SF, Frontini L, Piazza E, Ianniello GP, Veltri E, Castiglione F, Rosetti F, Gebbia V, Seymour L, Chiodini P, Perrone F. Chemotherapy-induced neutropenia and treatment efficacy in advanced non-small-cell lung cancer: a pooled analysis of three randomised trials. Lancet Oncol. 2005 Sep;6(9):669-77. doi: 10.1016/S1470-2045(05)70255-2. PMID: 16129367.
  4. Holmes FA, Jones SE, O'Shaughnessy J, Vukelja S, George T, Savin M, Richards D, Glaspy J, Meza L, Cohen G, Dhami M, Budman DR, Hackett J, Brassard M, Yang BB, Liang BC. Comparable efficacy and safety profiles of once-per-cycle pegfilgrastim and daily injection filgrastim in chemotherapy-induced neutropenia: a multicenter dose-finding study in women with breast cancer. Ann Oncol. 2002 Jun;13(6):903-9. doi: 10.1093/annonc/mdf130. PMID: 12123336.
  5. Lawicki S, Czygier M, Omyła J, Szmitkowski M. Ocena stezeń czynnika stymulujacego kolonie granulocytarne (G-CSF) i makrofagowe (M-CSF) w osoczu pacjentek z rakiem piersi [The plasma levels of granulocyte-colony stimulating factor (G-CSF) and macrophage-colony stimulating factor (M-CSF) in breast cancer patients]. Pol Arch Med Wewn. 2006 Aug;116(2):749-55. Polish. PMID: 17424919.
  6. Waller EK. The role of sargramostim (rhGM-CSF) as immunotherapy. Oncologist. 2007;12 Suppl 2:22-6. doi: 10.1634/theoncologist.12-S2-22. PMID: 18039636.
  7. Zhang X, Shi X, Li J, Mo L, Hu Z, Gao J, Wu S, Long Z. PD-1 Blockade Overcomes Adaptive Immune Resistance in Treatment with Anchored-GM-CSF Bladder Cancer Cells Vaccine. J Cancer. 2018 Oct 22;9(23):4374-4381. doi: 10.7150/jca.25423. PMID: 30519342; PMCID: PMC6277664.
  8. Passaro A, Attili I, Morganti S, Del Signore E, Gianoncelli L, Spitaleri G, Stati V, Catania C, Curigliano G, de Marinis F. Clinical features affecting survival in metastatic NSCLC treated with immunotherapy: A critical review of published data. Cancer Treat Rev. 2020 Sep;89:102085. doi: 10.1016/j.ctrv.2020.102085. Epub 2020 Jul 22. PMID: 32771858.
  9. Yamanaka T, Matsumoto S, Teramukai S, Ishiwata R, Nagai Y, Fukushima M. Predictive value of chemotherapy-induced neutropenia for the efficacy of oral fluoropyrimidine S-1 in advanced gastric carcinoma. Br J Cancer. 2007 Jul 2;97(1):37-42. doi: 10.1038/sj.bjc.6603831. Epub 2007 Jun 5. PMID: 17551497; PMCID: PMC2359669.
  10. He Y, Tang X, Yang F, Jiang Q, Deng L, Lang W. Exploring resistance to initial chemotherapy in small cell lung cancer: The role of bone metastasis and other clinicopathologic characteristics. Medicine (Baltimore). 2025 Mar 21;104(12):e41953. doi: 10.1097/MD.0000000000041953. PMID: 40128052; PMCID: PMC11936556.
  11. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000 Feb 2;92(3):205-16. doi: 10.1093/jnci/92.3.205. PMID: 10655437.
  12. Nordvig J, Aagaard T, Daugaard G, Brown P, Sengeløv H, Lundgren J, Helleberg M. Febrile Neutropenia and Long-term Risk of Infection Among Patients Treated With Chemotherapy for Malignant Diseases. Open Forum Infect Dis. 2018 Oct 25;5(10):ofy255. doi: 10.1093/ofid/ofy255. PMID: 30377628; PMCID: PMC6201153.
  13. Blayney DW, Schwartzberg L. Chemotherapy-induced neutropenia and emerging agents for prevention and treatment: A review. Cancer Treatment Reviews. 2022;109:102427.
  14. Cornish AL, Campbell IK, McKenzie BS, Chatfield S, Wicks IP. G-CSF and GM-CSF as therapeutic targets in rheumatoid arthritis. Nat Rev Rheumatol. 2009 Oct;5(10):554-9. doi: 10.1038/nrrheum.2009.178. PMID: 19798030.
  15. Liew PX, Kubes P. The Neutrophil's Role During Health and Disease. Physiol Rev. 2019 Apr 1;99(2):1223-1248. doi: 10.1152/physrev.00012.2018. PMID: 30758246.
  16. Sionov RV, Fridlender ZG, Granot Z. The Multifaceted Roles Neutrophils Play in the Tumor Microenvironment. Cancer Microenviron. 2015 Dec;8(3):125-58. doi: 10.1007/s12307-014-0147-5. Epub 2014 Jun 4. PMID: 24895166; PMCID: PMC4714999.
  17. Yvan-Charvet L, Ng LG. Granulopoiesis and Neutrophil Homeostasis: A Metabolic, Daily Balancing Act. Trends Immunol. 2019 Jul;40(7):598-612. doi: 10.1016/j.it.2019.05.004. PMID: 31256783.
  18. Huang X, Nepovimova E, Adam V, Sivak L, Heger Z, Valko M, Wu Q, Kuca K. Neutrophils in Cancer immunotherapy: friends or foes? Mol Cancer. 2024 May 18;23(1):107. doi: 10.1186/s12943-024-02004-z. PMID: 38760815; PMCID: PMC11102125.
  19. Huang X, Nepovimova E, Adam V, Sivak L, Heger Z, Valko M, Wu Q, Kuca K. Neutrophils in Cancer immunotherapy: friends or foes? Mol Cancer. 2024 May 18;23(1):107. doi: 10.1186/s12943-024-02004-z. PMID: 38760815; PMCID: PMC11102125.
  20. Singhal S, Bhojnagarwala PS, O'Brien S, Moon EK, Garfall AL, Rao AS, Quatromoni JG, Stephen TL, Litzky L, Deshpande C, Feldman MD, Hancock WW, Conejo-Garcia JR, Albelda SM, Eruslanov EB. Origin and Role of a Subset of Tumor-Associated Neutrophils with Antigen-Presenting Cell Features in Early-Stage Human Lung Cancer. Cancer Cell. 2016 Jul 11;30(1):120-135. doi: 10.1016/j.ccell.2016.06.001. Epub 2016 Jun 30. PMID: 27374224; PMCID: PMC4945447.
  21. Pylaeva E, Korschunow G, Spyra I, Bordbari S, Siakaeva E, Ozel I, Domnich M, Squire A, Hasenberg A, Thangavelu K, Hussain T, Goetz M, Lang KS, Gunzer M, Hansen W, Buer J, Bankfalvi A, Lang S, Jablonska J. During early stages of cancer, neutrophils initiate anti-tumor immune responses in tumor-draining lymph nodes. Cell Rep. 2022 Aug 16;40(7):111171. doi: 10.1016/j.celrep.2022.111171. PMID: 35977505.
  22. Cheng Y, Li H, Deng Y, Tai Y, Zeng K, Zhang Y, Liu W, Zhang Q, Yang Y. Cancer-associated fibroblasts induce PDL1+ neutrophils through the IL6-STAT3 pathway that foster immune suppression in hepatocellular carcinoma. Cell Death Dis. 2018 Apr 1;9(4):422. doi: 10.1038/s41419-018-0458-4. PMID: 29556041; PMCID: PMC5859264.
  23. Zhou Y, Medik YB, Patel B, Zamler DB, Chen S, Chapman T, Schneider S, Park EM, Babcock RL, Chrisikos TT, Kahn LM, Dyevoich AM, Pineda JE, Wong MC, Mishra AK, Cass SH, Cogdill AP, Johnson DH, Johnson SB, Wani K, Ledesma DA, Hudgens CW, Wang J, Wadud Khan MA, Peterson CB, Joon AY, Peng W, Li HS, Arora R, Tang X, Raso MG, Zhang X, Foo WC, Tetzlaff MT, Diehl GE, Clise-Dwyer K, Whitley EM, Gubin MM, Allison JP, Hwu P, Ajami NJ, Diab A, Wargo JA, Watowich SS. Intestinal toxicity to CTLA-4 blockade driven by IL-6 and myeloid infiltration. J Exp Med. 2023 Feb 6;220(2):e20221333. doi: 10.1084/jem.20221333. Epub 2022 Nov 11. PMID: 36367776; PMCID: PMC9664499.
  24. Cheung IY, Hsu K, Cheung NK. Activation of peripheral-blood granulocytes is strongly correlated with patient outcome after immunotherapy with anti-GD2 monoclonal antibody and granulocyte-macrophage colony-stimulating factor. J Clin Oncol. 2012 Feb 1;30(4):426-32. doi: 10.1200/JCO.2011.37.6236. Epub 2011 Dec 27. PMID: 22203761; PMCID: PMC3269968.
  25. Eksioglu EA, Kielbasa J, Eisen S, Reddy V. Granulocyte-macrophage colony-stimulating factor increases the proportion of circulating dendritic cells after autologous but not after allogeneic hematopoietic stem cell transplantation. Cytotherapy. 2011 Aug;13(7):888-96. doi: 10.3109/14653249.2011.579956. Epub 2011 May 24. PMID: 21609205.
  26. Jackson ER, Jared JR, Piccolo JK, Woo KM, Mably MS, Reed MP, Callander NS. Granulocyte colony-stimulating factor utilization postautologous hematopoietic stem cell transplant in multiple myeloma patients: Does one size fit all? J Oncol Pharm Pract. 2019 Jul;25(5):1135-1141. doi: 10.1177/1078155218781888. Epub 2018 Jun 11. PMID: 29890920.
  27. Skaznik-Wikiel ME, McGuire MM, Sukhwani M, Donohue J, Chu T, Krivak TC, Rajkovic A, Orwig KE. Granulocyte colony-stimulating factor with or without stem cell factor extends time to premature ovarian insufficiency in female mice treated with alkylating chemotherapy. Fertil Steril. 2013 Jun;99(7):2045-54.e3. doi: 10.1016/j.fertnstert.2013.01.135. Epub 2013 Feb 26. PMID: 23453120; PMCID: PMC3672312.
  28. Singh V, Keisham A, Bhalla A, Sharma N, Agarwal R, Sharma R, Singh A. Efficacy of Granulocyte Colony-Stimulating Factor and N-Acetylcysteine Therapies in Patients With Severe Alcoholic Hepatitis. Clin Gastroenterol Hepatol. 2018 Oct;16(10):1650-1656.e2. doi: 10.1016/j.cgh.2018.01.040. Epub 2018 Jan 31. PMID: 29391265.
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