Huang Litang, Han Hedong, Zhou Li, Chen Xi, Xu Qiuli, Xie Jingyuan, Zhan Ping, Chen Si, Lv Tangfeng, Song Yong
Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, School of Medicine, Southeast University, Sch Med, Nanjing, China.
Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Front Oncol. 2021 Jun 24;11:670230. doi: 10.3389/fonc.2021.670230. eCollection 2021.
The lung immune prognostic index (LIPI) has been shown to be an important prognostic marker for various tumors. However, the prognostic value of LIPI among non-small cell lung cancer (NSCLC) patients treated with systemic therapy remains controversial. We aimed to evaluate survival status according to LIPI among NSCLC patients receiving different forms of systemic therapy at our institution. We also performed a meta-analysis of articles from PubMed and Embase to illustrate this question. For our cohort, we found that good LIPI was associated with better overall survival (OS) among 91 patients on immunotherapy, 329 patients on targeted therapy, and 570 patients on chemotherapy. For the meta-analysis, a total of eight studies with 8,721 patients were included. Pooled results showed that a higher LIPI (those with 1 or 2 factors) was associated with poor overall progression-free survival (PFS) (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.45-1.71) and OS (HR, 2.01; 95% CI, 1.75-2.31). Subgroup analyses showed that a higher LIPI was related to poor survival among patients prescribed different systemic therapies: immunotherapy (OS HR, 2.50; 95% CI, 1.99-3.13; PFS HR, 1.77; 95% CI, 1.56-2.01), chemotherapy (OS HR, 1.58; 95% CI, 1.34-1.86; PFS HR, 1.38; 95% CI, 1.23-1.55), and targeted therapy (OS HR; 2.15, 95% CI, 1.57-2.96; PFS HR, 1.60; 95% CI, 1.25-2.06). The study shows that the LIPI is a clinically significant prognostic factor for NSCLC patients receiving systemic therapy.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420209009.
肺免疫预后指数（LIPI）已被证明是多种肿瘤的重要预后标志物。然而，LIPI在接受全身治疗的非小细胞肺癌（NSCLC）患者中的预后价值仍存在争议。我们旨在评估我院接受不同形式全身治疗的NSCLC患者根据LIPI的生存状况。我们还对来自PubMed和Embase的文章进行了荟萃分析以阐明这个问题。对于我们的队列研究，我们发现，在接受免疫治疗的91例患者、接受靶向治疗的329例患者和接受化疗的570例患者中，良好的LIPI与更好的总生存期（OS）相关。对于荟萃分析，共纳入了八项研究，涉及8721例患者。汇总结果显示，较高的LIPI（具有1个或2个因素者）与较差的无进展生存期（PFS）（风险比[HR]，1.57；95%置信区间[CI]，1.45 - 1.71）和OS（HR，2.01；95% CI，1.75 - 2.31）相关。亚组分析显示，较高的LIPI与接受不同全身治疗的患者的不良生存相关：免疫治疗（OS HR，2.50；95% CI，1.99 - 3.13；PFS HR，1.77；95% CI，1.56 - 2.01）、化疗（OS HR，1.58；95% CI，1.34 - 1.86；PFS HR，1.38；95% CI，1.23 - 1.55）和靶向治疗（OS HR；2.15，95% CI，1.57 - 2.96；PFS HR，1.60；95% CI，1.25 - 2.06）。该研究表明，LIPI是接受全身治疗的NSCLC患者的一个具有临床意义的预后因素。
