Hebei General Hospital, North China University of Science and Technology, Shijiazhuang, China.
The Fifth Department of Oncology, Hebei General Hospital, Shijiazhuang, China.
Oncol Res Treat. 2021;44(4):164-175. doi: 10.1159/000514443. Epub 2021 Mar 3.
Our purpose was to evaluate the predictive value of the lung immune prognostic index (LIPI) in patients with advanced non-small cell lung cancer (NSCLC) receiving different treatments.
A systemic literature search of major databases of medicine was performed to explore the association of LIPI with different therapeutic effects in patients with advanced NSCLC, with overall survival (OS) as the surrogate marker. As such, HR and 95% CI were simultaneously selected to evaluate such an association.
A total of 4 studies involving 7,373 patients reported an association of the LIPI score with OS in advanced NSCLC patients. Further sorted by therapeutic regimen, the numbers of patients receiving immune checkpoint inhibitors (ICI), targeted therapy (TT), and chemotherapy (CT) were 3,651, 1,241, and 2,481, respectively. Overall, the good and intermediate LIPI groups (HR = 1.61; 95% CI 1.48-1.75; p < 0.01) showed no heterogeneity (I2 = 0%; p = 0.521), whereas the good and poor LIPI groups (HR = 2.74; 95% CI 2.26-3.33; p < 0.01) had a high heterogeneity (I2 = 67.9%; p = 0.019). For ICI, CT, and TT, the good and intermediate LIPI groups exhibited an HR of 1.70 (95% CI 1.49-1.93; p < 0.01) with I2 = 0% (p = 0.521), an HR 1.49 (95% CI 1.32-1.67; p < 0.01) with I2 = 0% (p = 0.437), and an HR of 1.85 (95% CI 1.45-2.36; p < 0.01) with I2 = 0% (p = 0.382), respectively. The good and poor LIPI groups had an HR of 3.46 (95% CI 2.72-4.39; p < 0.01) with I2 = 51.7% (p = 0.126), an HR of 2.22 (95% CI 1.85-2.66; p < 0.01) with I2 = 20.3% (p = 0.286), and an HR of 3.32 (95% CI 2.53-4.36; p < 0.01) with I2 = 0% (p = 0.703), for ICI, CT, and TT, respectively.
In addition to being a possible prognostic indicator for advanced NSCLC patients receiving ICI, CT or TT, the LIPI may be used to stratify patients in randomized studies. These findings are of great help in deciding on the therapeutic strategy, and more well-designed studies are warranted to further verify them.
本研究旨在评估肺免疫预后指数（LIPI）在接受不同治疗的晚期非小细胞肺癌（NSCLC）患者中的预测价值。
系统检索医学主要数据库，探讨 LIPI 与晚期 NSCLC 患者不同治疗效果的相关性，以总生存期（OS）为替代标志物。因此，同时选择 HR 和 95%CI 来评估这种相关性。
共有 4 项研究纳入了 7373 例患者，报告了 LIPI 评分与晚期 NSCLC 患者 OS 的相关性。进一步按治疗方案分类，接受免疫检查点抑制剂（ICI）、靶向治疗（TT）和化疗（CT）的患者数量分别为 3651、1241 和 2481 例。总体而言，LIPI 评分良好和中等组（HR=1.61；95%CI 1.48-1.75；p<0.01）无异质性（I2=0%；p=0.521），而 LIPI 评分良好和差组（HR=2.74；95%CI 2.26-3.33；p<0.01）异质性较高（I2=67.9%；p=0.019）。对于 ICI、CT 和 TT，LIPI 评分良好和中等组的 HR 为 1.70（95%CI 1.49-1.93；p<0.01），I2=0%（p=0.521），HR 为 1.49（95%CI 1.32-1.67；p<0.01），I2=0%（p=0.437），HR 为 1.85（95%CI 1.45-2.36；p<0.01），I2=0%（p=0.382）。LIPI 评分良好和差组的 HR 分别为 3.46（95%CI 2.72-4.39；p<0.01），I2=51.7%（p=0.126），HR 为 2.22（95%CI 1.85-2.66；p<0.01），I2=20.3%（p=0.286），HR 为 3.32（95%CI 2.53-4.36；p<0.01），I2=0%（p=0.703），用于 ICI、CT 和 TT。
除了作为接受 ICI、CT 或 TT 治疗的晚期 NSCLC 患者的可能预后指标外，LIPI 还可用于随机研究中的患者分层。这些发现对决定治疗策略有很大帮助，需要更多精心设计的研究进一步验证。
