Association between pretreatment emotional distress and immune checkpoint inhibitor response in non-small-cell lung cancer.

Emotional distress (ED), commonly characterized by symptoms of depression and/or anxiety, is prevalent in patients with cancer. Preclinical studies suggest that ED can impair antitumor immune responses, but few clinical studies have explored its relationship with response to immune checkpoint inhibitors (ICIs). Here we report results from cohort 1 of the prospective observational STRESS-LUNG study, which investigated the association between ED and clinical efficacy of first-line treatment of ICIs in patients with advanced non-small-cell lung cancer. ED was assessed by Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale. The study included 227 patients with 111 (48.9%) exhibiting ED who presented depression (Patient Health Questionnaire-9 score ≥5) and/or anxiety (Generalized Anxiety Disorder 7-item score ≥5) symptoms at baseline. On the primary endpoint analysis, patients with baseline ED exhibited a significantly shorter median progression-free survival compared with those without ED (7.9 months versus 15.5 months, hazard ratio 1.73, 95% confidence interval 1.23 to 2.43, P = 0.002). On the secondary endpoint analysis, ED was associated with lower objective response rate (46.8% versus 62.1%, odds ratio 0.54, P = 0.022), reduced 2-year overall survival rate of 46.5% versus 64.9% (hazard ratio for death 1.82, 95% confidence interval 1.12 to 2.97, P = 0.016) and detriments in quality of life. The exploratory analysis indicated that the ED group showed elevated blood cortisol levels, which was associated with adverse survival outcomes. This study suggests that there is an association between ED and worse clinical outcomes in patients with advanced non-small-cell lung cancer treated with ICIs, highlighting the potential significance of addressing ED in cancer management. ClinicalTrials.gov registration: NCT05477979 .

Relationship between net primary productivity and stand age in typical plantation forests in China.

Plantation forests play an important role in carbon sink in terrestrial ecosystems. Based on tree rings of five main plantation tree species (Robinia pseudoacacia, Quercus variabilis, Cunninghamia lanceolata, Pinus sylvestris var. mongolica, and Pinus tabuliformis) at 25 sites in China, we calculated the average annual NPP of standard trees in each study area by the biomass equations and extended to the stand scale. The relationships between NPP and stand age were fitted by the InTEC and Law models. The results showed that NPP of R. pseu-doacacia, C. lanceolata, and P. tabuliformis plantations increased to a peak and then leveling off with stand age, while that of Q. variabilis and P. sylvestris var. mongolica plantations reached a peak and then showed a decreasing trend. The inflection points of NPP-stand age curve for different planatations was 11 years for P. sylvestris var. mongolica, 14 years for C. lanceolata, 16 years for P. tabuliformis, and 20 years for R. pseudoacacia. The NPP peak was 6.65, 7.58, 4.70 and 2.59 t·hm-2·a-1, respectively. Both the InTEC and Law NPP-stand age models had high fitting accuracy at a large scale, with the lowest R2 of 0.95 and RMSE of 0.55 t·hm-2·a-1 for the P. sylvestris var. mongolica InTEC model and the highest R2 of 0.99 and RMSE of 0.26 t·hm-2·a-1 for the C. lanceolata InTEC model. The construction of NPP-stand age relationship for major plantations in China provided mechanistic support for the estimation of carbon sinks in plantations at long time scales and provided a reference for the diversification of afforestation tree species selection.