Response to the Letter to the Editor: Lung Immune Prognostic Index for Outcome Prediction to Immunotherapy in Patients With NSCLC

Abstract

Phase II trial of atezolizumab as first-line or subsequent therapy for patients with programmed death-ligand 1-selected advanced non-small-cell lung cancer (BIRCH).

Value of the Lung Immune Prognostic Index in Patients with Non-Small Cell Lung Cancer Initiating First-Line Atezolizumab Combination Therapy: Subgroup Analysis of the IMPOWER150 Trial

“…For example, the estimated absolute benefit in median PFS for ABCP (compared to BCP) was 3 months in the good LIPI group with no observed benefit in the poor LIPI group. The estimated decrease in OS and PFS benefit in the poor LIPI group did not constitute a statistically significant interaction, which is consistent with prior studies demonstrating that LIPI is also a prognostic marker for traditional chemotherapy options [8,14,15,21,22]. Nonetheless, it is recognized that clinical trials are not typically powered to detected treatment-by-covariate interactions.…”

“…Studies have also demonstrated that LIPI may differentiate prognosis in patients treated with ICIs in other cancer types, including breast cancer, hepatocellular carcinoma, melanoma, renal cell carcinoma, small cell lung cancer, and urothelial carcinoma [12,[17][18][19][20]. In addition to behaving as a prognostic biomarker, LIPI has been proposed as a method to classify patients subgroups with disparities in ICI treatment efficacy (i.e., a predictive biomarker) [13], albeit findings have been conflicting [8,14,15,21,22]. To date, there is minimal information of the prognostic performance of LIPI in patients with NSCLC initiating first-line, combination ICI approaches [11,12], and there is no information on treatment efficacy across LIPI defined subgroups in this cohort.…”