Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
Eur J Med Res. 2023 Jul 5;28(1):225. doi: 10.1186/s40001-023-01198-0.
To evaluate whether the pretreatment Lung Immune Prognostic Index (LIPI) is associated with outcomes in advanced hepatocellular carcinoma (HCC) patients under ICI.
A two-center retrospective study of patients with HCC treated with immune checkpoint inhibitors (ICIs) between January 2018 and January 2021 was performed. Based on pretreatment derived neutrophils/ (leukocytes minus neutrophils) ratio (dNLR) greater than 3 and a lactate dehydrogenase (LDH) level greater than the normal value, patients were stratified into three groups (good LIPI:0 risk factor, intermediate LIPI: 1 risk factor, and poor LIPI: 2 risk factors). The primary endpoints were overall survival (OS) and progression-free survival (PFS). The second endpoints were disease control rate (DCR) and objective response rate (ORR).
In the pooled cohort (n = 224), 80 (35.7%) had a good LIPI (zero factor), 91 (40.6%) had intermediate LIPI (one factor), and 53 (23.7%) had poor LIPI (two factors). The median follow-up was 25.1 months. Median OS was 16.8 months, 12.5 months, and 9.5 months for the good, intermediate, and poor LIPI groups, respectively (P < 0.0001). Median PFS was 11.8 months, 7.8 months, and 4.0 months for the good, intermediate, and poor LIPI groups, respectively (P < 0.0001). Multivariate analysis indicated that the intermediate LIPI and poor LIPI both were independently associated with OS, PFS, and ORR, DCR (P < 0.05), as risk factors.
Pretreatment LIPI was correlated with worse outcomes for ICIs suggesting that LIPI could be promising biomarker for advanced HCC patients under ICIs.
评估预先治疗的肺免疫预后指数（LIPI）是否与接受免疫检查点抑制剂（ICI）治疗的晚期肝细胞癌（HCC）患者的结局相关。
对 2018 年 1 月至 2021 年 1 月期间接受免疫检查点抑制剂（ICI）治疗的 HCC 患者进行了一项来自两个中心的回顾性研究。根据预先治疗得出的中性粒细胞/（白细胞减去中性粒细胞）比值（dNLR）大于 3 和乳酸脱氢酶（LDH）水平大于正常值，将患者分为三组（良好 LIPI：无风险因素；中等 LIPI：有 1 个风险因素；不良 LIPI：有 2 个风险因素）。主要终点为总生存期（OS）和无进展生存期（PFS）。次要终点为疾病控制率（DCR）和客观缓解率（ORR）。
在汇总队列（n=224）中，80 例（35.7%）具有良好的 LIPI（无风险因素），91 例（40.6%）具有中等 LIPI（1 个风险因素），53 例（23.7%）具有不良 LIPI（2 个风险因素）。中位随访时间为 25.1 个月。良好、中等和不良 LIPI 组的中位 OS 分别为 16.8、12.5 和 9.5 个月（P<0.0001）。中位 PFS 分别为 11.8、7.8 和 4.0 个月（P<0.0001）。多变量分析表明，中等 LIPI 和不良 LIPI 均与 OS、PFS 和 ORR、DCR 相关（P<0.05），是独立的危险因素。
预先治疗的 LIPI 与 ICI 的较差结果相关，表明 LIPI 可能是接受 ICI 治疗的晚期 HCC 患者有前途的生物标志物。
