Incidence and risk factors of serious infections occurred in lung cancer patients following immune checkpoint blockade therapy

Immune checkpoint inhibitors (ICIs) have revolutionized anti-cancer therapy and lung cancer exhibits sustained clinical responses to it. However, the understanding of the incidence and risk factors of serious infections in lung cancer patients following ICIs therapy is still lacking. Our study aimed to investigate the incidence and risk factors of serious infections in lung cancer patients following ICIs therapy. Medical records were retrospectively reviewed from 885 lung cancer patients who received ICIs therapy at Zhongshan Hospital Affiliated with Fudan University between 2021-1 and 2023-2. Serious infections were defined as infections requiring hospitalization or parenteral antimicrobials. Statistical analyses were performed to assess the incidence rate of serious infections and to explore the infection site and pathogen distribution. Risk factors of serious infections were assessed by logistic regression analysis afterward. Among the study population, 241 patients (27.23%) suffered from serious infections during an average follow-up of 432.62±377.09 days. The main site of infection was lung (20.90%), and bacteria (24.29%) were the main pathogens identified, followed by viruses (1.69%), Mycobacterium tuberculosis (1.69%), and fungi (1.02%). Risk factors included age over 60, hyperlipidemia, cardiac insufficiency, COPD, bronchiectasis, asthma, low lymphocyte count, hypoalbuminemia, low white blood cell count, low NK cell count, and glucocorticoid use (all P＜0.05). COPD, asthma, hypoalbuminemia, and glucocorticoid use were identified as independent risk factors (all P＜0.05), , which should be managed in a standardized manner as a prevention strategy.