Pretreatment Lung Immune Prognostic Index as a Biomarker in Advanced Non-Small-Cell Lung Cancer Patients Receiving First Line Pembrolizumab

Veccia, Antonello; Sforza, Vincenzo; Vattemi, Emanuela; Inno, Alessandro; Kinspergher, Stefania; Dipasquale, Mariachiara; Gori, Stefania; Morabito, Alessandro; Baldi, Ileana; Caffo, Orazio

doi:10.2217/imt-2021-0002

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Moreover, retrospective database studies can be marred by errors in recording data and failure to collect some information. For example, biological data were missing for nearly half of the patients, explaining why LIPI (Lung Immune Prognostic Index) score was not mentioned in our analysis [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Real-world multicentre cohort of first-line pembrolizumab alone or in combination with platinum-based chemotherapy in non-small cell lung cancer PD-L1 ≥ 50%

Pons‐Tostivint

Hulo

Guardiolle

et al. 2023

Cancer Immunol Immunother

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Introduction Pembrolizumab alone (IO-mono) or in combination with platinum-based chemotherapy (CT-IO) is first-line standard of care for advanced non-small cell lung cancer (NSCLC) patients with PD-L1 ≥ 50%. This retrospective multicentre study assessed real-world use and efficacy of both strategies. Methods Patients with advanced NSCLC PD-L1 ≥ 50% from eight hospitals who had received at least one cycle of IO-mono or CT-IO were included. Overall survival (OS) and real-word progression-free-survival were estimated using Kaplan–Meier methodology. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs, and a Cox model with inverse propensity treatment weighting was carried out. Results Among the 243 patients included, 141 (58%) received IO-mono and 102 (42%) CT-IO. Younger patients, those with symptomatic disease and brain metastases were more likely to be proposed CT-IO. With a median follow-up of 11.5 months (95% CI 10.4–13.3), median OS was not reached, but no difference was observed between groups (p = 0.51). Early deaths at 12 weeks were 11% (95% CI 4.6–16.9) and 15.2% (95% CI 9.0–20.9) in CT-IO and IO groups (p = 0.32). After adjustment for age, gender, performance status, histology, brain metastases, liver metastases and tobacco status, no statistically significant difference was found for OS between groups, neither in the multivariate adjusted model [HR 1.07 (95% CI 0.61–1.86), p = 0.8] nor in propensity adjusted analysis [HR 0.99 (95% CI 0.60–1.65), p = 0.99]. Male gender (HR 2.01, p = 0.01) and PS ≥ 2 (HR 3.28, p < 0.001) were found to be negative independent predictive factors for OS. Conclusion Younger patients, those with symptomatic disease and brain metastases were more likely to be proposed CT-IO. However, sparing the chemotherapy in first-line does not appear to impact survival outcomes, even regarding early deaths.

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Section: Discussionmentioning

confidence: 99%

Real-world multicentre cohort of first-line pembrolizumab alone or in combination with platinum-based chemotherapy in non-small cell lung cancer PD-L1 ≥ 50%

Pons‐Tostivint

Hulo

Guardiolle

et al. 2023

Cancer Immunol Immunother

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“…LIPI is a comprehensive inflammatory factor composed of dNLR and LDH (24). LIPI was relevant with inflammatory status and has recently been widely reported as a novel prognostic factor in lung cancer and extra-pulmonary cancer ( Mezquita et al, 2018 ; Kazandjian et al, 2019 ; Sonehara et al, 2020 ; Auclin et al, 2021 ; Feng et al, 2021 ; Veccia et al, 2021 ; Xie et al, 2021 ; Obayashi et al, 2022 ). More inspiring, studies have shown that LIPI can not only predict the survival but also excellently predict the response to immunotherapy ( Mezquita et al, 2018 ; Auclin et al, 2021 ; Feng et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of modified lung immune prognostic index in osteosarcoma patients

Tang

Zou

et al. 2022

Front. Genet.

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Purpose: Osteosarcoma is the most common primary malignancy of bone with a dismal prognosis for patients with pulmonary metastases. Evaluation of osteosarcoma prognosis would facilitate the prognosis consultation as well as the development of personalized treatment decisions. However, there is limited effective prognostic predictor at present. Lung Immune Prognostic Index (LIPI) is a novel prognostic factor in pulmonary cancers, whereas, the prognostic significance of LIPI in osteosarcoma has not yet been well clarified. In this study, we firstly explore the prognostic role of LIPI and further modify this predictive model in osteosarcoma.Patients and methods: A retrospectively study was conducted at Musculoskeletal Tumor Center of West China Hospital between January 2016 and January 2021. Hematological factors and clinical features of osteosarcoma patients were collected and analyzed. The area under curve (AUC) and optimal cuff-off of each single hematological factor was calculated.Results: In this study, lactate dehydrogenase (LDH), derived neurtrophil to lymphocyte ratio (dNLR), and Hydroxybutyrate dehydrogenase (HBDH) have higher AUC values. LIPI was composed of LDH and dNLR and was further modified by combing the HBDH, forming the osteosarcoma immune prognostic index (OIPI). OIPI divided 223 osteosarcoma patients divided into four groups, none, light, moderate, and severe (p < 0.0001). OIPI has a higher AUC value than LIPI and other hematological indexes in t-ROC curve. According to the univariate and multivariate analysis, pathological fracture, metastasis, NLR, platelet–lymphocyte ratio (PLR), and OIPI were associated with the prognosis; and metastasis and OIPI were independent prognostic factors of osteosarcoma patients. An OIPI-based nomogram was also established and could predict the 3-year and 5-year overall survival. In addition, OIPI was also revealed correlated with metastasis and pathological fracture in osteosarcoma.Conclusion: This study first explore the prognostic significance of LIPI in osteosarcoma patients. In addition, we developed a modified LIPI, the OIPI, for osteosarcoma patients. Both the LIPI and OIPI could predict the overall survival of osteosarcoma patients well, while OIPI may be more suitable for osteosarcoma patients. In particular, OIPI may have the ability to identify some high-risk patients from clinically low-risk patients.

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Prognosis stratification of cancer patients treated with immune checkpoint inhibitors through lung immune prognostic index: a meta-analysis and systematic review

Guo,

Pan,

Wan

et al. 2024

BMC Cancer

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Background Although numerous studies have reported the prognostic value of the lung immune prognostic index (LIPI) in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs), the prognostic value of the LIPI in a pancancer setting remains unclear. Methods A comprehensive search was conducted until July 2023 across the PubMed, Embase, Web of Science, and Cochrane Library databases to identify relevant studies evaluating the prognostic value of the LIPI in cancer patients treated with ICIs. The outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). We described and compared the pooled outcomes by stratifying the patients based on different groupings of LIPI (good vs. intermediate [0 vs. 1], good vs. poor [0 vs. 2], and good vs. intermediate / poor [0 vs. 1 + 2]). Results A total of 9959 patients in 35 studies were included. A higher score of LIPI was associated with impaired OS. The pooled HRs were 1.69 (95% CI: 1.55–1.85, p < 0.001; 0 vs. 1), 3.03 (95% CI: 2.53–3.63, p < 0.001; 0 vs. 2), and 2.38 (95% CI: 1.97–2.88, p < 0.001; 0 vs. 1 + 2). A higher LIPI score was associated with shorter PFS. The pooled HRs were 1.41 (95% CI: 1.31–1.52, p < 0.001; 0 vs. 1), 2.23 (95% CI: 1.87–2.66, p < 0.001; 0 vs. 2), and 1.65 (95% CI: 1.46–1.86, p < 0.001; 0 vs. 1 + 2). Similarly, a higher LIPI score was associated with a lower ORR. The pooled ORs were 0.63 (95% CI: 0.54–0.75, p < 0.001; 0 vs. 1) and 0.38 (95% CI: 0.29–0.50, p < 0.001; 0 vs. 2). A higher LIPI score was associated with a lower DCR. The pooled ORs were 0.47 (95% CI: 0.35–0.61, p < 0.001; 0 vs. 1) and 0.19 (95% CI: 0.12–0.30, p < 0.001; 0 vs. 2). Conclusion In patients with NSCLC or other solid tumours, the lung immune prognostic index could robustly stratify the clinical outcomes into three groups among the patients who receive ICIs. LIPI is a low-cost, simple, accessible, and accurate prognostic tool in a pancancer setting and it may contribute to the evaluation of risk stratification in patients treated with ICIs.

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Pretreatment Lung Immune Prognostic Index as a Biomarker in Advanced Non-Small-Cell Lung Cancer Patients Receiving First Line Pembrolizumab

Cited by 3 publications

References 25 publications

Real-world multicentre cohort of first-line pembrolizumab alone or in combination with platinum-based chemotherapy in non-small cell lung cancer PD-L1 ≥ 50%

Real-world multicentre cohort of first-line pembrolizumab alone or in combination with platinum-based chemotherapy in non-small cell lung cancer PD-L1 ≥ 50%

Prognostic significance of modified lung immune prognostic index in osteosarcoma patients

Prognosis stratification of cancer patients treated with immune checkpoint inhibitors through lung immune prognostic index: a meta-analysis and systematic review

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