First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Respiratory Medicine, Nagano Red Cross Hospital, Nagano, Japan.
Thorac Cancer. 2023 Feb;14(6):636-642. doi: 10.1111/1759-7714.14798. Epub 2023 Jan 12.
Combination immunotherapy (immune checkpoint inhibitors and cytotoxic anticancer agents) is widely used as first-line treatment for advanced non-small cell lung cancer (NSCLC). However, the therapeutic effect of combination immunotherapy has not been fully investigated. C-reactive protein, performance status, lactate dehydrogenase, albumin, and derived neutrophil-to-lymphocyte ratio (C-PLAN) are useful biomarkers for predicting the prognosis of NSCLC; however, there are no reports examining the C-PLAN index, which combines these five factors in a single prognostic factor.
We retrospectively collected data from 178 patients with previously untreated advanced NSCLC who received combination immunotherapy at multicenter institutions in Nagano Prefecture between December 2018 and April 2022. We investigated the utility of the C-PLAN index as a prognostic factor using Cox regression analysis and correlated it with survival.
The good and poor C-PLAN index groups included 85 and 93 patients, respectively. The good C-PLAN index group had a longer median progression-free survival (PFS) (10.7 vs. 6.0 months; p = 0.022) and overall survival (OS) (25.3 vs. 16.5 months; p = 0.003) than the poor C-PLAN index group. The C-PLAN index was an independent favorable prognostic factor that correlated with PFS and OS in multivariate analysis. The good C-PLAN index group had a higher proportion of never-smokers (16.5 vs. 4.3%; p = 0.007) and stage III disease/postoperative recurrence (32.9 vs. 15.1%; p = 0.005) than the poor C-PLAN index group.
The C-PLAN index is a useful prognostic factor for patients with previously untreated advanced NSCLC undergoing combination immunotherapy.
联合免疫疗法（免疫检查点抑制剂和细胞毒性抗癌药物）被广泛用作晚期非小细胞肺癌（NSCLC）的一线治疗方法。然而，联合免疫疗法的治疗效果尚未得到充分研究。C 反应蛋白、体能状态、乳酸脱氢酶、白蛋白和衍生的中性粒细胞与淋巴细胞比值（C-PLAN）是预测 NSCLC 预后的有用生物标志物；然而，目前尚无报告研究结合这五个因素的单一预后因素的 C-PLAN 指数。
我们回顾性收集了 2018 年 12 月至 2022 年 4 月在长野县多中心机构接受联合免疫治疗的 178 例未经治疗的晚期 NSCLC 患者的数据。我们使用 Cox 回归分析研究了 C-PLAN 指数作为预后因素的效用，并将其与生存相关联。
良好和不良 C-PLAN 指数组分别包括 85 例和 93 例患者。良好 C-PLAN 指数组的中位无进展生存期（PFS）（10.7 与 6.0 个月；p=0.022）和总生存期（OS）（25.3 与 16.5 个月；p=0.003）均长于不良 C-PLAN 指数组。在多变量分析中，C-PLAN 指数是与 PFS 和 OS 相关的独立有利预后因素。良好 C-PLAN 指数组从不吸烟者（16.5%与 4.3%；p=0.007）和 III 期疾病/术后复发（32.9%与 15.1%；p=0.005）的比例高于不良 C-PLAN 指数组。
C-PLAN 指数是接受联合免疫治疗的未经治疗的晚期 NSCLC 患者的有用预后因素。
