Pretreatment “prognostic nutritional index” as an indicator of outcome in lung cancer patients receiving ICI-based treatment: Systematic review and meta-analysis

Shao, Yifeng; Cao, Wei; Gao, Xinliang; Tang, Mingbo; Zhu, Dongshan; Liu, Wei

doi:10.1097/md.0000000000031113

Cited by 8 publications

(7 citation statements)

References 64 publications

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“…PNI, particularly the lowest Post-PNI (Post-PNI-L), was significantly associated with OS in multivariate analysis. PNI has shown prognostic value regardless of the tumor origin [ 56 , 57 , 58 , 59 , 60 , 61 , 62 ], especially in gastrointestinal malignancies [ 58 , 63 , 64 , 65 , 66 ]. Nutritional impairment is associated with diminished performance, shorter survival, and increased mortality in cancer patients [ 67 , 68 , 69 ], and this is particularly concerning in patients with liver cancer given the presence of associated underlying diseases and the possibility of nutritional impairment due to cirrhosis [ 64 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Posttreatment Serum Platelet-to-Lymphocyte Ratio and Distant Metastases in Patients with Hepatocellular Carcinoma Receiving Curative Radiation Therapy

Lee

Kim

et al. 2023

Cancers

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Background: We sought to investigate whether serum immune and inflammatory parameters can help to predict distant metastasis (DM) in patients with unresectable hepatocellular carcinoma (HCC) undergoing curative radiation therapy (RT). Methods: A total of 76 RT courses were analyzed. The following variables were included in the analysis: systemic inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), absolute lymphocyte count, lymphocyte-to-monocyte ratio, albumin, albumin-to-alkaline phosphatase ratio, RT-related parameters, and levels of total protein, hemoglobin, α-fetoprotein, and PIVKA-II. Distant control (DC) and overall survival (OS) rates were calculated and compared. Results: The mean age was 61.4 years, and most patients were men (n = 62, 81.6%). The median RT fraction number and fractional doses were 12 (range, 4–30) and 5 (range, 2–12) Gy, respectively. With a median follow-up of 12 (range, 3.1–56.7) months, the 1-year DC and OS rates were 64.4% and 55.2%, respectively. The development of DM significantly deteriorated OS (p = 0.013). In the multivariate analysis, significant independent prognostic indicators for DC and OS rates were the highest posttreatment PLR (≤235.7 vs. >235.7, p = 0.006) and the lowest posttreatment PNI (≤25.4 vs. >25.4, p < 0.001), respectively. Conclusions: Posttreatment serum PLR might be helpfully used as a predictive biomarker of DM in unresectable HCC patients undergoing RT. Future research is necessary to confirm our findings.

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Section: Discussionmentioning

confidence: 99%

Association between Posttreatment Serum Platelet-to-Lymphocyte Ratio and Distant Metastases in Patients with Hepatocellular Carcinoma Receiving Curative Radiation Therapy

Lee

Kim

et al. 2023

Cancers

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“…On the other hand, the PNI, a major prognostic indicator in many carcinomas calculated from serum albumin levels and lymphocyte count, is a particularly useful biomarker which indicates the nutritional and immunological status of cancer patients. 14 As poor nutritional status, such as cachexia, causes low serum albumin level, hypoalbuminemia indicates increased nutritional risk and is inversely correlated with nutritional status. Cachexia is associated with a poor prognosis and indicates cancer progression and poor tolerance to surgery and chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…The PNI is a key indicator of nutritional and immune status and has utility in predicting the prognosis of cancer patients. 14 In the present study, we combined fibrinogen and the PNI to develop a novel score that may more accurately reflect the inflammatory tumor microenvironment and cachexia status of patients with pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Fibrinogen to Prognostic Nutritional Index Rate on Prognosis of Pancreatic Ductal Adenocarcinoma

Igarashi,

Shirai,

Tanji

et al. 2023

The American Surgeon™

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Introduction The aim of the present study was to evaluate the prognostic value of the ratio of serum fibrinogen to prognostic nutritional index (PNI; Fbg/PNI) in patients undergoing resection for pancreatic ductal adenocarcinoma. Methods A total of 140 patients who had undergone resection for pancreatic cancer were included. Patients were divided into two groups according to a Fbg/PNI ≥8.8 or <8.8. Survival data were analyzed using the log-rank test for univariate analysis and Cox proportional hazards for multivariate analysis. Results Fbg/PNI was a significant prognostic indicator in univariate analysis for overall survival (OS) and disease-free survival (DFS). Fbg/PNI retained significance in multivariate analysis for OS (hazard ratio, 1.81; 95% confidence interval, 1.19-2.77; P < .01) in addition to tumor differentiation and nodal involvement. Fbg/PNI was a significant independent prognostic indicator of poor DFS on multivariate analysis (hazard ratio, 1.54; 95% confidence interval, 1.05-2.26; P = .03). Conclusion Preoperative Fbg/PNI is a novel significant independent prognostic indicator for OS and DFS following resection of pancreatic cancer with curative intent.

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“…The median BMI of the Low-GNRI group was 18.9 kg/m 2 , and since many patients were underweight, BMI was low, which would have affected GNRI. Low BMI and malnutrition are a common problem for patients with cancer, and cancer-related malnutrition is associated with increased morbidity and mortality (16,17). Furthermore, in patients with cancer, malnutrition and cachexia are reflected in hypoalbuminemia, and hypoalbuminemia correlates with a decreased immune response (18).…”

Section: Discussionmentioning

confidence: 99%

Association of Geriatric Nutritional Risk Index With Immune Checkpoint Inhibitor Treatment Duration and Adverse Events in Lung Cancer

SHIMIZU,

FUKASAWA,

MITANI

et al. 2023

In Vivo

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Background/Aim: Compared to conventional cytotoxic anticancer agent-based therapy, treatment with immune checkpoint inhibitors (ICI) significantly prolongs overall survival. The Geriatric Nutritional Risk Index (GNRI) has been used as a new prognostic indicator in cancer. As nutritional status is associated with prognosis and indicates treatment response, we investigated the effect of the pretreatment GNRI on the (1) occurrence of ICI-induced immune-related adverse events (ir-AE) and ( 2) association with time to treatment failure (TTF) in ICI monotherapy for lung cancer. Patients and Methods: In this study, 127 patients with lung cancer who were treated with ICI monotherapy were retrospectively enrolled. Based on a cutoff value of 92 for the GNRI, we investigated intergroup differences in the occurrence of adverse events and their association with TTF in the High-GNRI (≥92) and Low-GNRI (<92) groups. For intergroup comparisons, we used the Student's t-test, Welch's t-test, Fisher's direct probability test, and Mann-Whitney's Utest, and factors with p<0.05 in the intergroup comparison were extracted as explanatory variables. Results: Based on the pretreatment GNRI, the median TTF was 5.1 months (95%CI=2.4-7.9 months) in the High-GNRI group and 2.3 months (95%CI=1.6-3.1 months) in the Low-GNRI group, with the High-GNRI group having a significantly longer TTF (p<0.01). The incidence of skin rash (p=0.0129) and pruritus (p<0.01) was significantly higher in the High-GNRI group. Conclusion: Pretreatment GNRI influences the continuation of ICI monotherapy. The High-GNRI group demonstrated a significantly higher frequency of skin lesions, which may have influenced the prolongation of TTF.In Japan, 126,548 new cases of lung cancer were reported in 2019 and 75,585 deaths in 2020; thus, lung cancer has the second highest incidence rate by cancer site and the highest cancer mortality rate (1). Lung cancer may be treated surgically if detected early; however, in case of metastasis or recurrence, drug therapy is the mainstay of treatment, wherein cytotoxic anticancer agents, molecular-targeted drugs, and immune-checkpoint inhibitors (ICI) are used. Thus, in the treatment of non-small cell lung cancer, molecular-targeted agents and ICI are the mainstay of treatment. In small cell lung cancer, although cytotoxic anticancer agents have been the mainstay of treatment for a long time, ICI can also be used (2). Nivolumab, pembrolizumab, atezolizumab, and durvalumab are used in the treatment of lung cancer. Treatment with ICI significantly prolongs overall survival compared to conventional treatment with cytotoxic anticancer agents (3-6). However, ICI treatment discontinuation or withdrawal occurs when the disease progresses or serious adverse events occur, which results in the difference in treatment duration. In addition, many cancers are more prevalent in the 60-70 age group and in older adults (1), who may, regardless of disease status, have reduced nutritional status. According to the "Summary of the Results of the National Hea...

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Pretreatment “prognostic nutritional index” as an indicator of outcome in lung cancer patients receiving ICI-based treatment: Systematic review and meta-analysis

Cited by 8 publications

References 64 publications

Association between Posttreatment Serum Platelet-to-Lymphocyte Ratio and Distant Metastases in Patients with Hepatocellular Carcinoma Receiving Curative Radiation Therapy

Association between Posttreatment Serum Platelet-to-Lymphocyte Ratio and Distant Metastases in Patients with Hepatocellular Carcinoma Receiving Curative Radiation Therapy

The Impact of Fibrinogen to Prognostic Nutritional Index Rate on Prognosis of Pancreatic Ductal Adenocarcinoma

Association of Geriatric Nutritional Risk Index With Immune Checkpoint Inhibitor Treatment Duration and Adverse Events in Lung Cancer

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