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)

Yıl 2024, Cilt: 7 Sayı: 5, 494 - 499, 27.09.2024

Asım Armağan Aydın , Mehmet Acun

https://doi.org/10.32322/jhsm.1489971

Öz

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.

Anahtar Kelimeler

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

Kaynakça

• Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi:10.3322/caac.21834
• Petty WJ, Paz-Ares L. Emerging strategies for the treatment of small cell lung cancer: a review. JAMA Oncol. 2023;9(3):419-429.
• Rudin CM, Brambilla E, Faivre-Finn C, Sage J. Small-cell lung cancer. Nat Rev Dis Primers. 2021;7(1):3.
• Wen Y, Zhu Y, Zhang C, et al. Chronic inflammation, cancer development and immunotherapy. Front Pharmacol. 2022;13: 1040163. doi:10.3389/fphar.2022.1040163
• Liu J, Li S, Zhang S, et al. Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio can predict clinical outcomes in patients with metastatic non-small-cell lung cancer treated with nivolumab. J Clin Lab Anal. 2019;33(8):e22964. doi:10.1002/jcla.22964
• Mandaliya H, Jones M, Oldmeadow C, Nordman IIC. Prognostic biomarkers in stage IV non-small cell lung cancer (NSCLC): neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI). Transl Lung Cancer Res. 2019;8(6):886-894. doi:10.21037/tlcr.2019.11.16
• Platini H, Ferdinand E, Kohar K, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognostic markers for advanced non-small-cell lung cancer treated with immunotherapy: a systematic review and meta-analysis. Medicina (B Aires). 2022;58(8):1069.
• Smith D, Raices M, Cayol F, Corvatta F, Caram L, Dietrich A. Is the neutrophil-to-lymphocyte ratio a prognostic factor in non-small cell lung cancer patients who receive adjuvant chemotherapy? Semin Oncol. 2022;49(6):482-489.
• Yang XC, Liu H, Liu DC, Tong C, Liang XW, Chen RH. Prognostic value of pan-immune-inflammation value in colorectal cancer patients: a systematic review and meta-analysis. Front Oncol. 2022;12:1036890. doi:10.3389/fonc.2022.1036890
• Baba Y, Nakagawa S, Toihata T, et al. Pan-immune-inflammation value and prognosis in patients with oesophageal cancer. Ann Surg Open. 2021;3(1):e113. doi:10.1097/AS9.0000000000000113
• Susok L, Said S, Reinert D, et al. The pan-immune-inflammation value and systemic immune-inflammation index in advanced melanoma patients under immunotherapy. J Cancer Res Clin Oncol. 2022;148(11):3103-3108. doi:10.1007/s00432-021-03878-y
• Yekedüz E, Tural D, Ertürk İ, et al. The relationship between pan-immune-inflammation value and survival outcomes in patients with metastatic renal cell carcinoma treated with nivolumab in the second line and beyond: a Turkish oncology group kidney cancer consortium (TKCC) study. J Cancer Res Clin Oncol. 2022; 148(12):3537-3546. doi:10.1007/s00432-022-04055-5
• Lin F, Zhang LP, Xie SY, et al. Pan-immune-inflammation value: a new prognostic index in operative breast cancer. Front Oncol. 2022;12:830138. doi:10.3389/fonc.2022.830138
• Gambichler T, Said S, Abu Rached N, et al. Pan-immune-inflammation value independently predicts disease recurrence in patients with Merkel cell carcinoma. J Cancer Res Clin Oncol. 2022;148(11):3183-3189. doi:10.1007/s00432-022-03929-y
• Zhu M, Zhou Y, Liu Z, et al. Diagnostic Efficiency of Pan-Immune-Inflammation Value to Predict Prostate Cancer in Patients with Prostate-Specific Antigen between 4 and 20 ng/ml. J Clin Med. 2023;12(3):820. doi:10.3390/jcm12030820
• Zhang N, Hou T, Zhang S, et al. Prognostic significance of pan-immune-inflammation value (PIV) in nasopharyngeal carcinoma patients. Heliyon. 2024;10(2):e24804.
• Murat B, Murat S, Ozgeyik M, Bilgin M. Comparison of pan‐immune‐inflammation value with other inflammation markers of long‐term survival after <scp>ST</scp> ‐segment elevation myocardial infarction. Eur J Clin Invest. 2023;53(1):e13872.
• Guven DC, Sahin TK, Erul E, Kilickap S, Gambichler T, Aksoy S. The Association between the Pan-Immune-Inflammation Value and Cancer Prognosis: A Systematic Review and Meta-Analysis. Cancers (Basel). 2022;14(11):2675. doi:10.3390/cancers14112675
• Fucà G, Guarini V, Antoniotti C, et al. The Pan-Immune-Inflammation Value is a new prognostic biomarker in metastatic colorectal cancer: results from a pooled-analysis of the Valentino and TRIBE first-line trials. Br J Cancer. 2020;123(3):403-409.
• Fu F, Deng C, Wen Z, et al. Systemic immune-inflammation index is a stage-dependent prognostic factor in patients with operable non-small cell lung cancer. Transl Lung Cancer Res. 2021;10(7):3144-3154. doi:10.21037/tlcr-21-267
• Kucuk A, Topkan E, Ozkan EE, Ozturk D, Pehlivan B, Selek U. A high pan-immune-inflammation value before chemoradiotherapy indicates poor outcomes in patients with small-cell lung cancer. Int J Immunopathol Pharmacol. 2023;37: 3946320231187759. doi:10.1177/03946320231187759
• Topkan E, Kucuk A, Ozkan EE, et al. High pre-chemoradiotherapy pan-immune-inflammation value levels predict worse outcomes in patients with stage IIIB/C non-small-cell lung cancer. Discov Oncol. 2023;14(1):230. doi:10.1007/s12672-023-00851-8
• Zhai WY, Duan FF, Lin YB, et al. Pan-Immune-Inflammatory Value in Patients with Non-Small-Cell Lung Cancer Undergoing Neoadjuvant Immunochemotherapy. J Inflamm Res. 2023;16: 3329-3339. doi:10.2147/JIR.S418276
• Chen Y, Gong L, Gu P, et al. Pan-immune-inflammation and its dynamics: predictors of survival and immune-related adverse events in patients with advanced NSCLC receiving immunotherapy. BMC Cancer. 2023;23(1):944.
• Chen X, Hong X, Chen G, et al. The Pan-immune-inflammation value predicts the survival of patients with anaplastic lymphoma kinase-positive non-small cell lung cancer treated with first-line ALK inhibitor. Transl Oncol. 2022;17:101338.
• Wang Y, Li Y, Chen P, Xu W, Wu Y, Che G. Prognostic value of the pretreatment systemic immune-inflammation index (SII) in patients with non-small cell lung cancer: a meta-analysis. Ann Transl Med. 2019;7(18):433-433. doi:10.21037/atm.2019.08.116
• Mazzella A, Maiolino E, Maisonneuve P, Loi M, Alifano M. Systemic inflammation and lung cancer: is it a real paradigm? prognostic value of inflammatory indexes in patients with resected non-small-cell lung cancer. Cancers (Basel). 2023;15(6):1854.
• Li C, Wu J, Jiang L, et al. The predictive value of inflammatory biomarkers for major pathological response in non-small cell lung cancer patients receiving neoadjuvant chemoimmunotherapy and its association with the immune-related tumor microenvironment: a multi-center study. Cancer Immunol Immunother. 2023;72(3):783-794.
• Huang T, Zhang H, Zhao Y, et al. Systemic immune-inflammation index changes predict outcome in stage III non-small-cell lung cancer patients treated with concurrent chemoradiotherapy. Future Oncology. 2021;17(17):2141-2149. doi:10.2217/fon-2020-1272