First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Thorac Cancer. 2021 May;12(9):1366-1372. doi: 10.1111/1759-7714.13909. Epub 2021 Mar 12.
The geriatric nutritional risk index (GNRI) is a simple and useful marker for predicting prognosis and treatment efficacy among patients with various cancers. However, to the best of our knowledge, there are no previous reports regarding the prognostic value of GNRI among patients with non-small cell lung cancer (NSCLC) who were treated with immune checkpoint inhibitors (ICIs).
We retrospectively evaluated 85 patients with previously treated advanced NSCLC who were administered ICIs at Shinshu University Hospital between February 2016 and October 2020. Progression-free survival (PFS) and overall survival (OS) were compared between groups with high (≥89.5) and low (<89.5) GNRI values. We used univariate and multivariate Cox regression analyses to identify prognostic factors that were associated with PFS and OS.
The high and low GNRI groups included 61 and 24 patients, respectively. Relative to the low GNRI group, the high GNRI group had significantly longer median PFS (3.7 vs. 2.4 months, p = 0.041) and significantly longer median OS (14.2 vs. 6.1 months, p = 0.008). Multivariate analyses revealed that independent predictors of favorable OS were high GNRI, performance status of 0-1, and age of ≥70 years. The high GNRI group was significantly more likely to undergo subsequent therapy after immunotherapy (68.6 vs. 33.3%, p = 0.008).
The present study revealed that high GNRI was associated with good outcomes among patients with previously treated NSCLC who were treated with ICIs.
老年营养风险指数(GNRI)是一种预测各种癌症患者预后和治疗效果的简单而有用的标志物。然而,据我们所知,目前尚无关于接受免疫检查点抑制剂(ICI)治疗的非小细胞肺癌(NSCLC)患者中 GNRI 预后价值的报道。
我们回顾性评估了 2016 年 2 月至 2020 年 10 月在信州大学医院接受 ICI 治疗的 85 例既往治疗过的晚期 NSCLC 患者。比较 GNRI 值较高(≥89.5)和较低(<89.5)组之间的无进展生存期(PFS)和总生存期(OS)。我们使用单变量和多变量 Cox 回归分析来确定与 PFS 和 OS 相关的预后因素。
高 GNRI 组和低 GNRI 组分别包括 61 例和 24 例患者。与低 GNRI 组相比,高 GNRI 组的中位 PFS 显著延长(3.7 个月 vs. 2.4 个月,p = 0.041),中位 OS 显著延长(14.2 个月 vs. 6.1 个月,p = 0.008)。多变量分析显示,OS 良好的独立预测因素为高 GNRI、0-1 表现状态和年龄≥70 岁。高 GNRI 组在免疫治疗后更有可能接受后续治疗(68.6% vs. 33.3%,p = 0.008)。
本研究表明,在接受 ICI 治疗的既往治疗过的 NSCLC 患者中,高 GNRI 与良好的结局相关。