Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, China.
Hubei Key Laboratory of Molecular Imaging, 430022, Wuhan, China.
BMC Cancer. 2024 Apr 25;24(1):523. doi: 10.1186/s12885-024-12271-0.
BACKGROUND: Although numerous studies have reported the prognostic value of the lung immune prognostic index (LIPI) in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs), the prognostic value of the LIPI in a pancancer setting remains unclear. METHODS: A comprehensive search was conducted until July 2023 across the PubMed, Embase, Web of Science, and Cochrane Library databases to identify relevant studies evaluating the prognostic value of the LIPI in cancer patients treated with ICIs. The outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). We described and compared the pooled outcomes by stratifying the patients based on different groupings of LIPI (good vs. intermediate [0 vs. 1], good vs. poor [0 vs. 2], and good vs. intermediate / poor [0 vs. 1 + 2]). RESULTS: A total of 9959 patients in 35 studies were included. A higher score of LIPI was associated with impaired OS. The pooled HRs were 1.69 (95% CI: 1.55-1.85, p < 0.001; 0 vs. 1), 3.03 (95% CI: 2.53-3.63, p < 0.001; 0 vs. 2), and 2.38 (95% CI: 1.97-2.88, p < 0.001; 0 vs. 1 + 2). A higher LIPI score was associated with shorter PFS. The pooled HRs were 1.41 (95% CI: 1.31-1.52, p < 0.001; 0 vs. 1), 2.23 (95% CI: 1.87-2.66, p < 0.001; 0 vs. 2), and 1.65 (95% CI: 1.46-1.86, p < 0.001; 0 vs. 1 + 2). Similarly, a higher LIPI score was associated with a lower ORR. The pooled ORs were 0.63 (95% CI: 0.54-0.75, p < 0.001; 0 vs. 1) and 0.38 (95% CI: 0.29-0.50, p < 0.001; 0 vs. 2). A higher LIPI score was associated with a lower DCR. The pooled ORs were 0.47 (95% CI: 0.35-0.61, p < 0.001; 0 vs. 1) and 0.19 (95% CI: 0.12-0.30, p < 0.001; 0 vs. 2). CONCLUSION: In patients with NSCLC or other solid tumours, the lung immune prognostic index could robustly stratify the clinical outcomes into three groups among the patients who receive ICIs. LIPI is a low-cost, simple, accessible, and accurate prognostic tool in a pancancer setting and it may contribute to the evaluation of risk stratification in patients treated with ICIs.
背景：尽管许多研究报告了肺免疫预后指数（LIPI）在接受免疫检查点抑制剂（ICI）治疗的非小细胞肺癌（NSCLC）患者中的预后价值，但 LIPI 在泛癌种环境中的预后价值尚不清楚。
方法：我们对 PubMed、Embase、Web of Science 和 Cochrane Library 数据库进行了全面检索，检索时间截至 2023 年 7 月，以确定评估 LIPI 在接受 ICI 治疗的癌症患者中的预后价值的相关研究。主要结局为总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）和疾病控制率（DCR）。我们根据 LIPI （0 与 1、0 与 2、0 与 1+2）的不同分组描述和比较了汇总结局。
结果：共有 35 项研究的 9959 名患者纳入本研究。较高的 LIPI 评分与 OS 降低相关。汇总的 HR 分别为 1.69（95%CI：1.55-1.85，p<0.001；0 与 1）、3.03（95%CI：2.53-3.63，p<0.001；0 与 2）和 2.38（95%CI：1.97-2.88，p<0.001；0 与 1+2）。较高的 LIPI 评分与 PFS 缩短相关。汇总的 HR 分别为 1.41（95%CI：1.31-1.52，p<0.001；0 与 1）、2.23（95%CI：1.87-2.66，p<0.001；0 与 2）和 1.65（95%CI：1.46-1.86，p<0.001；0 与 1+2）。同样，较高的 LIPI 评分与较低的 ORR 相关。汇总的 OR 分别为 0.63（95%CI：0.54-0.75，p<0.001；0 与 1）和 0.38（95%CI：0.29-0.50，p<0.001；0 与 2）。较高的 LIPI 评分与较低的 DCR 相关。汇总的 OR 分别为 0.47（95%CI：0.35-0.61，p<0.001；0 与 1）和 0.19（95%CI：0.12-0.30，p<0.001；0 与 2）。
结论：在 NSCLC 或其他实体瘤患者中，肺免疫预后指数可以在接受 ICI 治疗的患者中稳健地将临床结局分为三组。LIPI 是一种成本低、简单、易于获得且准确的泛癌种预后工具，它可能有助于评估接受 ICI 治疗的患者的风险分层。
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