<p>Association of the Pretreatment Lung Immune Prognostic Index with Survival Outcomes in Advanced Hepatocellular Carcinoma Patients Treated with PD-1 Inhibitors</p>

Abstract

Purpose At present, there are no validated biomarkers that can predict whether patients with advanced hepatocellular carcinoma (aHCC) are likely to benefit from anti-PD-1 therapy. We aimed to determine whether lung immune prognostic index (LIPI) is associated with outcomes in patients with aHCC treated with PD-1 inhibitors. Patients and Methods Patients undergoing initial treatment with PD-1 inhibitors for aHCC at a single center from January 1, 2015 to August 31, 2019 were included. The patients were stratified according to pretreatment LIPI based on a derived neutrophils/(leukocytes minus neutrophils) ratio (dNLR) ≥ 3 and a lactate dehydrogenase (LDH) level ≥ the upper limit of normal (ULN). Kaplan–Meier analysis and the Log rank test were used to calculate and compare survival between good LIPI and intermediate/poor LIPI scores. The prognostic values of LIPI for survival and disease control rate were evaluated using Cox proportional hazard and logistic regression models, respectively. Results Of the 108 study patients, 53 (49%) had a good LIPI (dNLR < 3 and LDH normal) and 55 (51%) had intermediate/poor LIPI (dNLR ≥ 3 or/and LDH ≥ ULN). With a median follow-up of 12.4 months, intermediate/poor LIPI was independently associated with shorter overall survival (OS) (hazard ratio [HR] 4.00; 95% CI, 2.00–8.03) and progression-free survival (PFS) (HR 2.65; 95% CI, 1.61–4.37). The median OS for good and intermediate/poor LIPI was not reached and was 13.7 (95% CI, 8.2–19.1) months, respectively, and the median PFS was 10.9 (95% CI, 8.9–12.9) and 4.0 (95% CI, 2.2–5.8) months (both P < 0.001), respectively. Conclusion Pretreatment LIPI combined with a dNLR ≥ 3 and/or LDH ≥ ULN is associated with poor outcomes in patients with aHCC treated with PD-1 inhibitors. Further validation in large, prospective studies are warranted.

Prognostic Value of the Pretreatment Lung Immune Prognostic Index in Advanced Small Cell Lung Cancer Patients Treated With First-Line PD-1/PD-L1 Inhibitors Plus Chemotherapy

“…Therefore, it might be more appropriate if the cohort was separated into two groups (LIPI good and LIPI intermediate/poor). In a previous study on the association of pretreatment LIPI with survival time in advanced hepatocellular carcinoma patients, the population was also divided into two groups (LIPI good and LIPI intermediate/poor) (40). Our findings showed that pretreatment LIPI was associated with PFS and OS in SCLC patients with first-line ICI treatment in univariate analysis.…”

The Prediction Potential of the Pretreatment Lung Immune Prognostic Index for the Therapeutic Outcomes of Immune Checkpoint Inhibitors in Patients With Solid Cancer: A Systematic Review and Meta-Analysis

“…After reviewing the remaining 39 articles via the full-text view, 27 full-text articles were excluded due to lack of intended outcomes (OS, PFS), HR with 95% CI or repeatedly published studies. Finally, 12 studies published between 2018 and 2020 were included in this analysis (11)(12)(13)(14)(19)(20)(21)(22)(23)(24)(25)(26).…”

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

“…It has been demonstrated as a prediction tool that differentiates likely prognosis of patients with NSCLC initiating ICI treatment [ 8 , 11 , 12 , 13 , 14 , 15 , 16 ]. Studies have also demonstrated that LIPI may differentiate prognosis in patients treated with ICIs in other cancer types, including breast cancer, hepatocellular carcinoma, melanoma, renal cell carcinoma, small cell lung cancer, and urothelial carcinoma [ 12 , 17 , 18 , 19 , 20 ]. In addition to behaving as a prognostic biomarker, LIPI has been proposed as a method to classify patients subgroups with disparities in ICI treatment efficacy (i.e., a predictive biomarker) [ 13 ], albeit findings have been conflicting [ 8 , 14 , 15 , 21 , 22 ].…”