Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, China.
Department of Pharmacy, Affiliated Hospital of Nantong University, Pharmacy School of Nantong University, Nantong, 226001, China.
BMC Cancer. 2023 Oct 6;23(1):944. doi: 10.1186/s12885-023-11366-4.
Pan-immune-inflammation value (PIV) is defined by the neutrophil, platelet, monocyte, and lymphocyte counts and is associated with immune-checkpoint inhibitor (ICI) therapy outcomes in advanced non-small cell lung cancer (aNSCLC). However, PIV is dynamic under therapy and its longitudinal assessment may help predict efficacy. This study investigated the impact of baseline PIV and its dynamics on ICI efficacy and its immune-related adverse events (irAEs). The study additionally attempted to understand the biological significance of PIV.
This retrospective study analyzed the clinical data of 269 consecutive patients with aNSCLC. PIV was calculated at baseline and at weeks 3-4 to determine its association with overall survival (OS), progression-free survival (PFS), and irAEs.
Results revealed that low baseline PIV was positively correlated with the incidence of irAEs. Moreover, a low PIV at baseline was significantly associated with a prolonged PFS (median PFS: 10 vs. 7 months, p = 0.0005) and OS (median OS: 29 vs. 21 months, p < 0.0001). When the PIV at baseline and weeks 3-4 was considered together, its low dynamics correlated with a higher incidence of irAEs (p = 0.001), a longer PFS (median PFS, 9 vs. 6 months, p = 0.012), and a longer OS (median OS; 28 vs. 21 months, p = 0.002).
Thus, PIV at baseline and its dynamics are novel and potent predictors of irAEs, PFS, and OS in patients with aNSCLC receiving immunotherapy. Moreover, the PIV dynamics may be an effective, novel surrogate marker to dynamically observe the efficacy of immunotherapy.
免疫炎症综合值（PIV）由中性粒细胞、血小板、单核细胞和淋巴细胞计数定义，与晚期非小细胞肺癌（aNSCLC）患者接受免疫检查点抑制剂（ICI）治疗的疗效相关。然而，PIV 在治疗过程中是动态变化的，对其进行纵向评估可能有助于预测疗效。本研究探讨了基线 PIV 及其动态变化对 ICI 疗效及其免疫相关不良事件（irAEs）的影响。本研究还试图了解 PIV 的生物学意义。
本回顾性研究分析了 269 例连续的 aNSCLC 患者的临床数据。在基线和第 3-4 周计算 PIV，以确定其与总生存期（OS）、无进展生存期（PFS）和 irAEs 的关系。
结果显示，基线时低 PIV 与 irAEs 的发生率呈正相关。此外，基线时低 PIV 与较长的 PFS（中位 PFS：10 个月 vs. 7 个月，p=0.0005）和 OS（中位 OS：29 个月 vs. 21 个月，p<0.0001）显著相关。当同时考虑基线和第 3-4 周的 PIV 时，其低动态变化与较高的 irAEs 发生率（p=0.001）、较长的 PFS（中位 PFS，9 个月 vs. 6 个月，p=0.012）和较长的 OS（中位 OS；28 个月 vs. 21 个月，p=0.002）相关。
因此，基线 PIV 及其动态变化是预测接受免疫治疗的 aNSCLC 患者 irAEs、PFS 和 OS 的新型且有效的预测因子。此外，PIV 动态变化可能是一种有效的新型替代标志物，可动态观察免疫治疗的疗效。
