Wang Wenxian, Huang Zhangzhou, Yu Zongyang, Zhuang Wu, Zheng Weijun, Cai Zhijian, Shi Lei, Yu Xinmin, Lou Guangyuan, Hong Wei, Zhang Yiping, Chen Ming, Song Zhengbo
Department of Medical Oncology, Cancer Hospital of the University of Chinese Academy of Sciences & Zhejiang Cancer Hospital, Hangzhou, China.
Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou, China.
Front Oncol. 2020 Oct 9;10:572853. doi: 10.3389/fonc.2020.572853. eCollection 2020.
Lung immune prognostic index (LIPI) status was recently developed to predict responses to immune checkpoint inhibitor (ICI) treatments. However, it is unclear whether LIPI is a prognostic index for both patients treated with ICI monotherapy and patients treated with ICIs combined with chemotherapy (ICIs CC).
This retrospective study established the patterns of LIPI in Chinese patients with advanced non-small cell lung cancer. Lung immune prognostic index based on the derived neutrophil-to-lymphocyte ratio greater than 3 and lactate dehydrogenase greater than the upper limit of normal was developed to characterize good, intermediate, or poor LIPI status. Associations between LIPI status and progression-free survival (PFS) and overall survival (OS) were analyzed. Kaplan-Meier curves and Cox proportional hazards models were used to determine survival differences.
Three hundred thirty patients were included in this study. Of these patients, 216 received ICI monotherapy and 114 received ICIs CC. A good LIPI status was associated with better PFS (6.1 months vs. 2.3 months vs. 2.1 months, = 0.023) and OS (24.2 months vs. 14.5 months vs. 9.3 months, < 0.001) in ICI monotherapy compared to intermediate or poor LIPI status. No differences in PFS (17.9 vs. 9.9 months vs. 7.6 months, = 0.355, respectively) and OS ( = 0.346) were observed in patients who received ICIs CC. Moreover, we found that patients who had an improved LIPI status compared with the baseline value had a longer PFS with ICI monotherapy and LIPI intermediate status (8.4 months vs. 2.1 months vs. 1.4 months, < 0.001). However, in patients treated with ICIs CC, these dynamic changes were not observed ( = 0.444).
Lung immune prognostic index status and dynamic changes in LIPI could be prognostic markers of treatment response to ICI monotherapy, but not to ICIs CC. In particular, good LIPI status was associated with a better clinical outcome compared with intermediate and poor LIPI status in ICI monotherapy treatment.
肺免疫预后指数（LIPI）状态最近被开发用于预测免疫检查点抑制剂（ICI）治疗的反应。然而，尚不清楚LIPI对于接受ICI单药治疗的患者和接受ICI联合化疗（ICIs CC）的患者是否均为预后指标。
这项回顾性研究确立了中国晚期非小细胞肺癌患者的LIPI模式。基于衍生的中性粒细胞与淋巴细胞比率大于3且乳酸脱氢酶大于正常上限制定肺免疫预后指数，以表征LIPI状态良好、中等或较差。分析LIPI状态与无进展生存期（PFS）和总生存期（OS）之间的关联。使用Kaplan-Meier曲线和Cox比例风险模型确定生存差异。
本研究纳入330例患者。其中，216例接受ICI单药治疗，114例接受ICIs CC。与LIPI状态中等或较差相比，在ICI单药治疗中，良好的LIPI状态与更好的PFS（6.1个月对2.3个月对2.1个月，P = 0.023）和OS（24.2个月对14.5个月对9.3个月，P < 0.001）相关。在接受ICIs CC的患者中，未观察到PFS（分别为17.9对9.9个月对7.6个月，P = 0.355）和OS（P = 0.346）的差异。此外，我们发现与基线值相比LIPI状态改善的患者在接受ICI单药治疗且LIPI为中等状态时具有更长的PFS（8.4个月对2.1个月对1.4个月，P < 0.001）。然而，在接受ICIs CC治疗的患者中，未观察到这些动态变化（P = 0.444）。
肺免疫预后指数状态和LIPI的动态变化可能是ICI单药治疗反应的预后标志物，但不是ICIs CC治疗反应的预后标志物。特别是，在ICI单药治疗中，与LIPI状态中等和较差相比，良好的LIPI状态与更好的临床结局相关。
