Department of Urology, Tokiwakai Jyoban Hospital, 57 Kaminodai, Jyoban Kamiyunagayamachi, Iwaki, Fukushima, 972-8322, Japan.
Department of Urology, Tokyo Women's Medical University Adachi Medical Center, 4-33-1 Kouhoku, Adachi-Ku, Tokyo, 123-8558, Japan.
Int J Clin Oncol. 2023 Jul;28(7):913-921. doi: 10.1007/s10147-023-02341-x. Epub 2023 Apr 27.
Lung immune prognostic index score (LIPI), calculated using the derived neutrophil-lymphocyte ratio and lactate dehydrogenase level, is reported for use in numerous malignancies, while its role on metastatic urothelial carcinoma (mUC) treated with pembrolizumab remains limited. We aimed to investigate association between LIPI and outcomes in this setting.
We retrospectively evaluated 90 patients with mUC treated with pembrolizumab at four institutions. The associations between three LIPI groups and progression-free survival (PFS), overall survival (OS), objective response rates (ORRs) or disease control rates (DCRs) were assessed.
Based on the LIPI, good, intermediate, and poor groups were observed in 41 (45.6%), 33 (36.7%), and 16 (17.8%) patients, respectively. The PFS and OS were significantly correlated with the LIPI (median PFS: 21.2 vs. 7.0 vs. 4.0 months, p = 0.001; OS: 44.3 vs. 15.0 vs. 4.2 months, p < 0.001 in the LIPI good vs. intermediate vs. poor groups). Multivariable analysis further revealed that LIPI good (vs. intermediate or poor, hazard ratio: 0.44, p = 0.004) and performance status = 0 (p = 0.015) were independent predictors of a longer PFS. In addition, LIPI good (hazard ratio: 0.29, p < 0.001) were shown to be associated with a longer OS together with performance status = 0 (p < 0.001). The ORRs tended to be different among patients with Good LIPI compared with Poor, and DCRs were significantly different among the three groups.
LIPI, a simple and convenient score, could be a significant prognostic biomarker of OS, PFS, and DCRs for mUC treated with pembrolizumab.
肺免疫预后指数评分（LIPI），通过计算中性粒细胞-淋巴细胞比值和乳酸脱氢酶水平得出，已在多种恶性肿瘤中得到应用，但其在接受派姆单抗治疗的转移性尿路上皮癌（mUC）中的作用仍有限。我们旨在研究 LIPI 与该环境下的结果之间的关系。
我们回顾性评估了在四个机构接受派姆单抗治疗的 90 例 mUC 患者。评估了 LIPI 的三个组与无进展生存期（PFS）、总生存期（OS）、客观缓解率（ORR）或疾病控制率（DCR）之间的关系。
根据 LIPI，观察到 41 例（45.6%）、33 例（36.7%）和 16 例（17.8%）患者分别为良好、中等和差组。PFS 和 OS 与 LIPI 显著相关（中位 PFS：21.2 与 7.0 与 4.0 个月，p=0.001；OS：44.3 与 15.0 与 4.2 个月，p<0.001，LIPI 良好组与中等组与差组）。多变量分析进一步表明，LIPI 良好（与中等或差，风险比：0.44，p=0.004）和表现状态=0（p=0.015）是 PFS 延长的独立预测因素。此外，LIPI 良好（风险比：0.29，p<0.001）与 OS 延长相关，与表现状态=0（p<0.001）相关。与 LIPI 良好的患者相比，ORR 倾向于在患者中有所不同，而 DCR 在三组之间存在显著差异。
LIPI 是一种简单方便的评分，可以作为接受派姆单抗治疗的 mUC 的 OS、PFS 和 DCR 的重要预后生物标志物。
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