The prognostic impact of the pan-immune-inflammation value (PIV) on the efficacy of treatment and clinical outcomes in patients with extensive-stage small cell lung cancer (ES-SCLC)

Abstract

Aims: This study aimed to assess the prognostic and predictive implications of pre-treatment pan-immune-inflammation value (PIV) on treatment efficacy and clinical outcomes in patients with extensive-stage small-cell lung cancer (ES-SCLC), comparing it with established indices such as the systemic immune-inflammation index (SII) and neutrophil to lymphocyte ratio (NLR). Methods: A retrospective cohort study included 70 patients diagnosed with ES-SCLC treated with standard chemotherapy with or without immune checkpoint inhibitors. PIV was calculated as PIV=(neutrophils×platelets×monocytes)÷lymphocytes. Patients were categorized into low PIV (<825) and high PIV (≥825) groups. The primary endpoint was overall survival (OS). Results: Patients with low PIV exhibited significantly longer OS compared to those with high PIV (p=0.047). Although progression-free survival in the low-PIV group was longer than the high-PIV group, the difference was not statistically significant (p=0.081). The highest area under the receiver operating characteristic (ROC) curve AUC values were found for PIV at 0.83 (95% CI: 0.65-1.0), SII at 0.90 (95% CI: 0.81-0.99), and NLR at 0.81 (95% CI: 0.67-0.95). Univariate and multivariate analyses revealed that PIV’s impact on clinical outcomes in ES-SCLC was less pronounced compared to SII. Elevated values of the SII (≥829.5) and the NLR (≥5.5) demonstrated superior predictive performance for adverse PFS and OS outcomes, albeit the study’s limited sample size might have influenced these findings. Moreover, independent predictors of poorer prognosis included liver metastasis and elevated SII, underscoring the importance of systemic inflammation and disease burden in treatment decisions. Conclusion: This study provides valuable insights into the value of PIV as a prognostic biomarker for survival outcomes in ES-SCLC patients. It suggests potential for PIV to aid in personalized treatment strategies for this aggressive lung cancer subtype. Despite limitations, such as the study’s retrospective nature and relatively small sample size, future research with larger cohorts is essential to validate these findings and support the routine clinical integration of PIV in ES-SCLC management.

Keywords

• Extensive-stage small-cell lung cancer
• survival
• prognosis
• pan-immune-inflammation
• biomarker

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