Lung Immune Prognostic Index (LIPI): Prognostic predictor for patients with extensive-stage small-cell lung cancer

Abstract

Objective: Extensive-stage small-cell lung cancer (ES-SCLC) is an aggressive malignancy with a poor prognosis, for which prognostic factors are being investigated. In this study, we aimed to evaluate the prognostic significance of the Lung Immune Prognostic Index (LIPI) in ES-SCLC patients. Patients and Methods: Our retrospective study evaluated 60 ES-SCLC patients who were followed-up and treated between 2014 and 2022 and whose data could be accessed. Demographic characteristics, treatments and laboratory parameters (lactate dehydrogenase, white blood cell, neutrophil, lymphocyte) were collected from patients’ files and electronic system of our institution. Patients were divided into 3 groups (LIPI 0, LIPI 1 and LIPI 2). Results: The worst survival outcome was in LIPI 2. Median progression-free survival (PFS) was 7.7 months for LIPI 0; 5.6 months for LIPI 1 and 5.4 months for LIPI 2 (p = 0.001). Median overall survival (OS) was 19.7 months, 10.2 months and 7.7 months for LIPI 0, LIPI 1 and LIPI 2, respectively (p = 0.001). In both univariate and multivariate analyses, LIPI was found to be an independent negative prognostic factor (p = 0.001). Conclusion: Lung Immune Prognostic Index is a potentially valuable prognostic marker in ES-SCLC patients. It is thought to be helpful in individualized treatment decisions for ES-SCLC patients. However, further comprehensive multicenter studies are necessary to confirm our results.

Keywords

• Small-cell lung cancer
• Lung Immune Prognostic Index
• Progression-free survival
• Overall survival

References

1. Wang Y, Zou S, Zhao Z, et al. New insights into small‐cell lung cancer development and therapy. Cell Biol Int 2020; 44:1564- 76. doi: 10.1002/cbin.11359
2. Lee J, Saxena A, Giaccone G. Advancements in small cell lung cancer. Semin Cancer Biol 2023; 93:123-8. doi: 10.1016/j. semcancer.2023.05.008
3. Yu Y, Chen K, Fan Y. Extensive‐stage small‐cell lung cancer: Current management and future directions. Int J Cancer 2023; 152:2243-56. doi: 10.1002/ijc.34346
4. Petty WJ, Paz-Ares L. Emerging strategies for the treatment of small cell lung cancer. JAMA Oncol 2023; 9:419-29. doi: 10.1001/jamaoncol.2022.5631
5. Lalani AKA, Xie W, Martini DJ, et al. Change in neutrophilto- lymphocyte ratio (NLR) in response to immune checkpoint blockade for metastatic renal cell carcinoma. J Immunother Cancer 2018; 6:5. doi: 10.1186/s40425.018.0315-0
6. Liang Y, Yang R, Shang J, et al. Lung immune prognostic indexbased nomogram for recurrence of hepatocellular carcinoma after postoperative adjuvant TACE. J Cancer Res Clin Oncol 2023; 149:16461-71. doi: 10.1007/ s00432.023.05413-7
7. He X, Wang Y, Ye Q, et al. Lung Immune Prognostic Index could predict metastasis in patients with osteosarcoma. Front Surg 2022; 8;9. doi: 10.3389/fsurg.2022.923427
8. Gou M, Zhang Y, Qu T, Jia R, Wang Z, Dai G. Prognostic Value of the Lung Immune Prognostic Index for HER-2-negative metastatic gastric cancer. Biomark Med 2023; 17:711-21. doi: 10.2217/bmm-2023-0052

9. Zhou Q, Deng G, Wang Z, Dai G. Preoperative lung immune prognostic index predicts survival in patients with pancreatic cancer undergoing radical resection. Front Surg 2023;9:1002075. doi: 10.3389/fsurg.2022.100.2075
10. Huang L, Han H, Zhou L, et al. Evaluation of the Lung Immune Prognostic Index in non-small cell lung cancer patients treated with systemic therapy: A retrospective study and meta-analysis. Front Oncol 2021;11:670230. doi: 10.3389/ fonc.2021.670230
11. Mezquita L, Auclin E, Ferrara R, et al. Association of the Lung Immune Prognostic Index with ımmune checkpoint ınhibitor outcomes in patients with advanced non–small cell lung cancer. JAMA Oncol 2018; 4:351-7. doi: 10.1001/ jamaoncol.2017.4771
12. Azam F, Latif MF, Farooq A, et al. Performance status assessment by using ECOG (Eastern Cooperative Oncology Group) score for cancer patients by oncology healthcare professionals. Case Rep Oncol 2019; 12:728-36. doi: 10.1159/000503095
13. Kazandjian D, Gong Y, Keegan P, Pazdur R, Blumenthal GM. Prognostic Value of the Lung Immune Prognostic Index for patients treated for metastatic non-small cell lung cancer. JAMA Oncol 2019; 12:1481-5. doi: 10.1001/ jamaoncol.2019.1747
14. Qi WX, Xiang Y, Zhao S, Chen J. Assessment of systematic inflammatory and nutritional indexes in extensive-stage small-cell lung cancer treated with first-line chemotherapy and atezolizumab. Cancer Immunol Immunother 2021; 70:3199-206. doi: 10.1007/s00262.021.02926-3
15. Ye C, Yuan L, Wu K, Shen B, Zhu C. Association between systemic immune-inflammation index and chronic obstructive pulmonary disease: a population-based study, BMC Pulm Med 2023; 23:295. doi: 10.1186/s12890.023.02583-5
16. Zhu L, Li X, Shen Y, et al. A new prognostic score based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Onco Targets Ther 2016; 9:4879- 86. doi: 10.2147/OTT.S107279
17. Mezquita L, Park W, Arbour K, et al. P1.01-68 Correlation of the Lung Immune Prognostic Index (LIPI) and PDL1 status with outcomes for ımmune checkpoint ınhibitors in advanced NSCLC patients. Journal of Thoracic Oncology 2018; 13:488 Supplement. doi: 10.1016/j.jtho.2018.08.624