Comment on Hopkins et al. Value of the Lung Immune Prognostic Index in Patients with Non-Small Cell Lung Cancer Initiating First-Line Atezolizumab Combination Therapy: Subgroup Analysis of the IMPOWER150 Trial. Cancers 2021, 13, 1176

Abstract

We read, with great interest, the recently published article by Hopkins et al. [...]

Reply to Auclin et al. Comment on “Hopkins et al. Value of the Lung Immune Prognostic Index in Patients with Non-Small Cell Lung Cancer Initiating First-Line Atezolizumab Combination Therapy: Subgroup Analysis of the IMPOWER150 Trial. Cancers 2021, 13, 1176”

“…Thus, it is not surprising that in our analysis of IMpower150 the change in relative overall survival treatment effect of atezolizumab-bevacizumab-carboplatin-paclitaxel (ABCP) versus bevacizumabcarboplatin-paclitaxel (BCP) (and ACP vs. BCP) did not show any statistical difference across the LIPI subgroups (P-interaction = 0.66), despite no absolute benefit in median overall survival being observed in the poor LIPI group [2]. Reiterating, research needs: (1) to pool trials to increase the power to conclusively determine treatment effects within the poor LIPI group; (2) to evaluate LIPI performance for other immune checkpoint inhibitor combination approaches; and (3) to evaluate LIPI prognostic performance within a large real-world cohort. Auclin et al [1] also highlight EGFR/ALK and immunotherapy crossover populations are subgroups of interest for further investigation, which were beyond the scope of our analysis in a single trial.…”

“…We thank Auclin et al [1] for the comments on our manuscript in Cancers titled "Value of the Lung Immune Prognostic Index (LIPI) in Patients with Non-Small Cell Lung Cancer (NSCLC) Initiating First-Line Atezolizumab Combination Therapy: Subgroup Analysis of the IMpower150 Trial" [2]. We read with interest the elements of the approach proposed by Auclin et al's [1] to integrate LIPI into routine clinical practice and, specifically: (1) to validate LIPI retrospectively in previous clinical trials with immunotherapy; (2) to design prospective clinical trials including LIPI as a stratification factor; and (3) to design prospective clinical trials using LIPI as a marker for guiding treatment selection. However, caution is required to ensure the development of 'host-related inflammatory indices' for immunotherapies are well planned and target the key factors enabling precision immunotherapy use in oncology.…”

“…Auclin et al [1] provide valid comment that LIPI needs to continue to be investigated in post hoc analysis of clinical trials involving immunotherapies. It is well appreciated that single clinical trials are usually underpowered to statistically evaluate differences in treatment effect between arms across baseline subgroups [3].…”

“…Reiterating, research needs: (1) to pool trials to increase the power to conclusively determine treatment effects within the poor LIPI group; (2) to evaluate LIPI performance for other immune checkpoint inhibitor combination approaches; and (3) to evaluate LIPI prognostic performance within a large real-world cohort. Auclin et al [1] also highlight EGFR/ALK and immunotherapy crossover populations are subgroups of interest for further investigation, which were beyond the scope of our analysis in a single trial.…”

Effect of Ropivacaine Combined with Small Doses of Triamcinolone and Continuous Nerve Block of Unilateral Paravertebral Canal Guided by Ultrasound on Metastasis after Radical Treatment of Lung Cancer

“…Lung cancer incidence and mortality have been rising annually; the 6-year survival rate for phase-I and phase-II non-small cell lung cancer (NSCLC) was now 68–86 percent for phase-I and 46–70 percent for phase-II illness [ 2 ]. Local anaesthetics offer a wide range of pharmacological effects, including analgesia and antiarrhythmic.…”