On-treatment lung immune prognostic index is predictive for first-line PD-1 inhibitor combined with chemotherapy in patients with non-small cell lung cancer.
On-treatment lung immune prognostic index is predictive for first-line PD-1 inhibitor combined with chemotherapy in patients with non-small cell lung cancer.
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DOI：
10.3389/fimmu.2023.1173025
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发表时间：
2023
影响因子：
7.3
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中科院分区：
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炎症是促进肿瘤进展和免疫抑制的一个因素。肺免疫预后指数(LIPI)是一种无创、易计算的炎症指标。本研究旨在探讨持续监测LIPI对接受一线程序性细胞死亡1(PD-1)抑制剂加化疗的非小细胞肺癌(NSCLC)患者化疗免疫治疗的预测价值。此外，还探讨了LIPI在PD-L1表达阴性或低表达患者中的预测价值。共146例接受一线PD-1抑制剂联合化疗的IIIB~IV期或复发NSCLC患者进入本研究。在基线(LIPI前)和联合用药两个周期(LIPI后)计算LIPI评分。本研究采用Logistic和COX回归模型分析LIPI治疗前(后)好/中/差与客观有效率(ORR)和无进展生存率(PFS)的关系。此外，还探讨了LIPI在PD-L1表达阴性或低表达患者中的预测价值。为了进一步评估持续评估LIPI的潜在预测价值，对146例患者进行了SUM(LIPI)[SUM(LIPI)=LIPI前+LIPI后]与PFS的相关性分析。与LIPI后良好组相比，LIPI后中度组(P=0.005)和不良组(P=0.018)的ORR显著降低。此外，LIPI后中度(P=0.003)和LIPI后差(P<；0.001)与LIPI后良好的PFS相比显著相关。此外，在PD-L1表达阴性或低水平的患者中，LIPI后评分较高仍与较差的治疗效果显著相关。此外，总分越高，PFS越短(P=0.001)。连续监测LIPI可能是预测PD-1抑制剂联合化疗疗效的有效方法。此外，在PD-L1表达阴性或低表达的患者中，在治疗过程中持续评估LIPI也可能对疗效具有潜在的预测价值。
Inflammation is a factor that promotes tumor progression and immunosuppression. Lung immune prognostic index (LIPI) is a non-invasive and easily calculated indicator of inflammation. This study aimed to investigate whether continuous assessment of LIPI has predictive value for chemoimmunotherapy in non-small cell lung cancer (NSCLC) patients receiving first-line programmed cell death 1 (PD-1) inhibitor plus chemotherapy. In addition, the predictive value of LIPI in patients with the negative or low programmed death-ligand (PD-L1) expression level was also explored. Totally, 146 stage IIIB to IV or recurrent NSCLC patients who received first-line PD-1 inhibitor combined with chemotherapy were enrolled in this study. The LIPI scores were calculated at baseline (PRE-LIPI) and after two cycles of the combined administration (POST-LIPI). This study analyzed the relationship between good/intermediate/poor PRE (POST)-LIPI and objective response rate (ORR), as well as progression-free survival (PFS) using logistic and Cox regression models. In addition, the predictive value of LIPI in patients with the negative or low PD-L1 expression level was explored. To further assess the potential predictive value of continuous assessment of LIPI, the association of sum (LIPI) [sum(LIPI) = PRE-LIPI + POST-LIPI] and PFS was analyzed in the 146 patients. Compared with good POST-LIPI group, significantly lower ORRs were found in intermediate POST-LIPI (P = 0.005) and poor POST-LIPI (P = 0.018) groups. Moreover, intermediate POST-LIPI (P =0.003) and poor POST-LIPI (P < 0.001) were significantly associated with a shorter PFS than good POST-LIPI. Additionally, a higher POST-LIPI score was still significantly associated with poorer treatment efficacy in patients with the negative or low PD-L1 expression level. Moreover, a higher sum (LIPI) score was significantly correlated with a shorter PFS (P = 0.001). Continuous assessment of LIPI might be an effective method for predicting the efficacy of PD-1 inhibitor plus chemotherapy in NSCLC patients. In addition, in patients with the negative or low PD-L1 expression level, it might also have a potential predictive value for therapeutic efficacy to continuously assess LIPI during the treatment.