Krpina Kristina, Mavrinac Martina, Samarzija Miroslav, Tolic Ena, Darapi Dora, Baticic Lara
Clinic for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.
Department of Medical Informatics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
J Clin Med. 2022 Nov 11;11(22):6695. doi: 10.3390/jcm11226695.
Lung cancer is one of the most diagnosed malignancies with increasing incidence worldwide. Immunotherapy is the main oncological treatment for advanced non-small cell lung cancer (NSCLC), for which the discovery of new efficient biomarkers is crucial. Scientific evidence points to the importance of the Lung Immune Prognostic Index (LIPI), but its predictive significance is unclear. The aim of this study was to investigate the clinical significance and predictive role of LIPI in patients with advanced NSCLC and PD-L1 mutation who are eligible for immunotherapy in combination with chemotherapy. In addition, to our knowledge, this is the first time that the association between COVID-19 infection and the course and outcome of oncologic treatment of NSCLC has been investigated. Patients were divided into four study groups according to strictly defined clinical parameters, therapeutic approach, and COVID-19 infection. LIPI was determined and its predictive power was evaluated in all studied groups, as well as overall survival (OS), progression-free survival (PFS), and disease control rate (DCR). This study confirmed the understudied and uncertain predictive power and clinical relevance of LIPI as a biomarker in patients with advanced NSCLC. Patients infected with COVID-19 had a higher survival rate than uninfected patients despite the therapeutic approach, which may be attributed to their hospitalization and intensive medical management during the pandemic. Findings obtained in this study may help to determine treatment options according to the clinical condition of the patient by using LIPI values as a non-invasive, readily available and economically acceptable predictive biomarker in lung oncology.
肺癌是全球诊断率最高的恶性肿瘤之一,其发病率呈上升趋势。免疫疗法是晚期非小细胞肺癌(NSCLC)的主要肿瘤治疗方法,因此发现新的有效生物标志物至关重要。科学证据表明肺免疫预后指数(LIPI)很重要,但其预测意义尚不清楚。本研究的目的是探讨LIPI在符合免疫疗法联合化疗条件的晚期NSCLC和PD-L1突变患者中的临床意义和预测作用。此外,据我们所知,这是首次研究新型冠状病毒肺炎(COVID-19)感染与NSCLC肿瘤治疗过程及结果之间的关联。根据严格定义的临床参数、治疗方法和COVID-19感染情况,将患者分为四个研究组。在所有研究组中测定LIPI并评估其预测能力,以及总生存期(OS)、无进展生存期(PFS)和疾病控制率(DCR)。本研究证实了LIPI作为晚期NSCLC患者生物标志物的预测能力和临床相关性尚未得到充分研究且存在不确定性。尽管治疗方法不同,但感染COVID-19的患者比未感染患者的生存率更高,这可能归因于他们在疫情期间住院并接受了强化医疗管理。本研究获得的结果可能有助于通过将LIPI值作为肺癌肿瘤学中一种非侵入性、易于获得且经济上可接受的预测生物标志物,根据患者的临床状况确定治疗方案。
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