Cancer Biomark. 2021;31(2):177-185. doi: 10.3233/CBM-201502.
To investigate the prognostic role of lung immune prognostic index (LIPI) in extensive-stage small-cell lung cancer (ES-SCLC) patients treated with platinum plus etoposide chemotherapy.
Data were obtained from two randomized controlled trials (NCT00119613 and NCT00363415). Overall survival (OS) and progression-free survival (PFS) was assessed according to LIPI score through Kaplan-Meier analysis. Univariate and multivariate Cox-regression analysis were performed to investigate predictors for OS and PFS.
A total of 911 patients with ES-SCLC treated with platinum plus etoposide chemotherapy (CT) were included for analysis. The median age at diagnosis was 62 years, and 760 (83.4%) had performance status of 1 or less. 1-year OS for ES-SCLC with poor, intermediate, and good LIPI was 20%, 30% and 31%, respectively, and 1-year PFS was 7%, 15% and 21%, respectively. Cox-regression analysis showed that the PFS and OS of ES-SCLC with a poor LIPI score was significantly worse than those with good LIPI scores (HR 1.81, 95% CI: 1.38-2.36; p< 0.001 and HR 1.35, 95% CI: 1.07-1.72, p= 0.012), while no significant difference was observed between intermediate and poor LIPI groups in terms of OS (HR 1.01, 95% CI: 0.82-1.23, p= 0.82), but not for PFS (HR 1.27, 95% CI: 1.00-1.61, p= 0.048). In addition, LIPI score was significantly associated with disease control rate and objective response rate (both p< 0.0001).
Prognosis of patients with pretreatment LIPI score of 2 is poorer than those with LIPI score of 0-1 among ES-SCLC who received first-line platinum plus etoposide chemotherapy; Further studies are still recommended to confirm our findings in prospective studies.
研究肺免疫预后指数（LIPI）在接受铂类加依托泊苷化疗的广泛期小细胞肺癌（ES-SCLC）患者中的预后作用。
数据来自两项随机对照试验（NCT00119613 和 NCT00363415）。通过 Kaplan-Meier 分析评估 LIPI 评分与总生存期（OS）和无进展生存期（PFS）的关系。采用单因素和多因素 Cox 回归分析探讨影响 OS 和 PFS 的因素。
共纳入 911 例接受铂类加依托泊苷化疗（CT）的 ES-SCLC 患者进行分析。中位诊断年龄为 62 岁，760 例（83.4%）患者的体能状态为 1 或以下。ES-SCLC 中 LIPI 差、中、好的 1 年 OS 分别为 20%、30%和 31%，1 年 PFS 分别为 7%、15%和 21%。Cox 回归分析显示，LIPI 评分差的 ES-SCLC 患者的 PFS 和 OS 明显差于 LIPI 评分好的患者（HR 1.81，95%CI：1.38-2.36；p<0.001 和 HR 1.35，95%CI：1.07-1.72，p=0.012），而中间和差的 LIPI 组在 OS 方面无显著差异（HR 1.01，95%CI：0.82-1.23，p=0.82），但在 PFS 方面无显著差异（HR 1.27，95%CI：1.00-1.61，p=0.048）。此外，LIPI 评分与疾病控制率和客观缓解率显著相关（均 p<0.0001）。
接受一线铂类加依托泊苷化疗的 ES-SCLC 患者，治疗前 LIPI 评分 2 分的患者预后较 LIPI 评分 0-1 分的患者差；仍推荐进一步的前瞻性研究来证实我们的研究结果。
