The Prediction Potential of the Pretreatment Lung Immune Prognostic Index for the Therapeutic Outcomes of Immune Checkpoint Inhibitors in Patients With Solid Cancer: A Systematic Review and Meta-Analysis

Liu, Hui; Yang, Xiaoli; Yang, Xiaoyun; Dong, Zhao‐Ru; Chen, Zhiqiang; Hong, Jian‐Guo; Li, Tao

doi:10.3389/fonc.2021.691002

Cited by 11 publications

(14 citation statements)

References 37 publications

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“…LIPI was first proposed to predict the effectiveness of ICIs in patients with mNSCLC ( 14 ) and was subsequently validated in patients with other tumors treated with ICIs ( 16 , 18 , 19 ). Researchers later found that LIPI also had the potential to predict the prognosis of patients with different cancers reeving non-ICI therapies ( 15 , 17 , 20 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…LIPI was subsequently found to be an important prognostic biomarker irrespective of the treatment modality for patients with mNSCLC (15). To date, the prognostic value of LIPI has been demonstrated in several solid tumors, including gastric cancer, urothelial bladder cancer, and squamous esophageal cancer (16)(17)(18)(19)(20). However, there are currently no studies investigating the predictive value of LIPI for patients with PCa.…”

Section: Introductionmentioning

confidence: 99%

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The prognostic value of the pretreatment lung immune prognostic index in patients with metastatic hormone-sensitive and castration-resistant prostate cancer

Wang¹,

Liu²,

Zhao³

et al. 2023

Ann Transl Med

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Background The lung immune prognostic index (LIPI) was first reported to predict the effectiveness of immune checkpoint inhibitors in patients with metastatic non-small cell lung cancer and there are no studies investigating the predictive value of LIPI for patients with PCa. This study explores the prognostic value of the LIPI in patients with metastatic hormone-sensitive prostate cancer (mHSPC) and metastatic castration-resistant prostate cancer (mCRPC). Methods Data from 502 patients with mHSPC primarily treated with maximal androgen blockade (MAB; 89% of patients received MAB) and 158 patients with mCRPC who received abiraterone were retrospectively analyzed. All cases were classified into LIPI-good, LIPI-intermediate, and LIPI-poor groups based on their LIPI score as calculated with the derived neutrophil-to-lymphocyte ratio and lactate dehydrogenase level. The potential for LIPI to be used in predicting mCRPC-free survival (CFS), prostate-specific antigen (PSA) response, PSA-progression-free survival (PSA-PFS), and overall survival (OS) was analyzed. A propensity score matching (PSM) methodology was performed to balance the baseline factors of the different groups. Results In the mHSPC cohort, patients of the LIPI-good (mCFS: 25.7 months; mOS: 93.3 months), LIPI-intermediate (mCFS: 14.8 months; mOS: 51.9 months), and LIPI-poor group (mCFS: 6.8 months; mOS: 18.5 months) had sequentially worse clinical outcomes (P<0.001 for all pairwise comparisons). The results remained consistent after PSM. Multivariate Cox regression further confirmed that LIPI was an independent predictor of survival outcomes. Subgroup analysis verified that LIPI was associated with an unfavorable prognosis in all subgroups except for cases with visceral metastases or those receiving abiraterone or docetaxel. As for patients with mCRPC receiving abiraterone, LIPI was also an indicator of poor prognosis. Specifically, cases in the LIPI-good, LIPI-intermediate, and LIPI-poor groups had a ladder-shaped worse PSA response [71.4% (50/70) vs. 56.5% (39/69) vs. 36.8% (7/19); P=0.015], PSA-PFS (14.9 vs. 9.3 vs. 3.1 months; P<0.001), and OS (14.6 vs. 32.3 vs. 53.4 months; P<0.001). The results were robust even after PSM. Multivariate Cox regression confirmed that LIPI was an independent prognosticator of PSA-PFS and OS in patients with mCRPC treated with abiraterone. Conclusions This study demonstrated that the baseline LIPI was a significant prognostic biomarker for patients with both mHSPC and mCRPC and could potentially facilitate risk classification and clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The prognostic value of the pretreatment lung immune prognostic index in patients with metastatic hormone-sensitive and castration-resistant prostate cancer

Wang¹,

Liu²,

Zhao³

et al. 2023

Ann Transl Med

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“…Other studies suggest that patients with ≥ 2 irAEs had a better survival benefit than those with one [ 23 ]. Since then, several research groups have studied irAEs, with France and Japan having the highest number of publications on this subject [ 3 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pre-treatment LIPI has been correlated with poorer outcomes for ICIs but not for chemotherapy, suggesting that it may be a potentially useful tool in selecting the best treatment for patients with NSCLC [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Immunotherapy Efficacy in Metastatic Non-Small Cell Lung Cancer: Lung Immune Prognostic Index and Immune-Related Toxicity

Moratiel Pellitero,

Zapata Garcia,

Gascon Ruiz

et al. 2024

World J Oncol

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Background Immune checkpoint inhibitors (ICIs) have been proposed as the standard first-line and subsequent treatment for metastatic non-small cell lung cancer (NSCLC). This study analyzed whether patients with good lung immune prognostic index (LIPI) have a better response to ICIs and the relationship between immune-related adverse events (irAEs) and response in clinical practice. Methods This was an observational, retrospective, single-center study. Patients with stage IV NSCLC between 2016 and 2021 were included in the study. Toxicity was assessed according to The Common Terminology Criteria for Adverse Events. Response assessment was performed according to RECIST 2.0 and immuno-related criteria. Descriptive and survival analyses were conducted. Degree of toxicity and response to treatment (based on treatment and histology) were assessed. LIPI and response were assessed. LIPI included dNLR (absolute neutrophil count/(white blood cell count - absolute neutrophil count)) ≥ 3 and lactate dehydrogenase (LDH) greater than the upper limit of normal. Patients were stratified into good (G), intermediate (I), and poor (P) prognostic groups. Results A total of 168 patients were included (130 men and 38 women, mean age 64.3 years). ICI use in the first- or second-line treatment was 65% and 35%, respectively. Fifteen (9%) patients showed complete response (CR), 50 (30%) showed partial response (PR), 39 (22%) had stable disease (SD), 45 (28%) had progressive disease (PD), and 19 (11%) were not evaluated (NE). Patients with good prognostic LIPI (dNLR < 3 and normal LDH levels) showed a better response. Progression-free survival (PFS) was 19 months in G, 6 months in I, and 2 months in P. Overall survival (OS) was 27 months in G, 8 months in I, and 3 months in P. One hundred fourteen patients died (56% G, 76% I, 93% P). Patients with adenocarcinoma were 116 (77 with irAEs G1-4 (13 CR, 31 PR, 21 SD, eight PD, and four NE)), and without were 39 (three PR, six SD, 21 PD, and nine NE). Fifty-two patients had squamous carcinoma (27 with irAEs G1-4 (two CR, 12 PR, nine SD, and four PD)), and 25 did not (four PR, three SD, 12 PD, and six NE)). IrAEs appearance was observed in longer PFS (19 vs. 2 months) and OS (27 vs. 4 months; P < 0.0001). Conclusions LIPI was a positive predictor of response to ICI. The presence of irAEs is associated with a better immune response. In contrast, the absence of toxicity predicted a worse prognosis.

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“…LIPI score is derived from serum lactate dehydrogenase level and lymphocyte-neutrophil ratio, which can be used to predict the prognosis of patients with non-small cell lung cancer receiving immunotherapy, chemotherapy, and targeted therapy [21,39] . Studies have shown that LIPI score can also predict the prognosis of immunotherapy and chemotherapy in patients with other solid tumors [40][41][42] . In this study, the LIPI score could predict the prognosis of patients with advanced tumor receiving anti-PD-1 therapy, but the result was not statistically signi cant, which may be due to the small sample size.…”

Section: Discussionmentioning

confidence: 99%

Thyroid dysfunction induced by anti-PD-1 therapy is associated with a better progression-free survival in patients with advanced carcinoma

et al. 2023

Preprint

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Purpose Immune checkpoint inhibitors are associated with immune-related adverse events. Thyroid dysfunction during anti-programmed cell death 1(anti-PD-1) therapy remains to be fully characterized and mechanism underlying this complication and effects on patient prognosis remain unclear. Methods Patients with advanced carcinoma treated with anti-PD-1 therapy were evaluated for thyroid function at baseline and after treatment initiation from August 2020 to March 2022. Seventy-three patients were finally included in the study. Results Among these patients, 19 (26.03%) developed thyroid dysfunction after receiving anti-PD-1 therapy. Primary hypothyroidism and thyrotoxicosis were the most common clinical manifestation. Anti-PD-1 induced thyroid dysfunction occurred 63 (26-131) days after administration, thyrotoxicosis appeared earlier than primary hypothyroidism. In Kaplan–Meier survival analysis, the progression-free survival (PFS) of the thyroid dysfunction group was better than that of the non-thyroid dysfunction group (227 (95% confidence interval (CI): 50.85-403.15) days vs 164 (95% CI: 77.76-250.24) days, p=0.026). Male patients had better PFS than female patients (213 (95% CI: 157.74-268.26) days vs 74 (95% CI: 41.23-106.77) days, p=0.031). In cox proportional hazards regression model, anti-PD-1 induced thyroid dysfunction remained an independent predictor of better PFS (Hazard ratio (HR)=0.339(0.136-0.848), p=0.021). Conclusion Thyroid dysfunction is a common immune-related adverse events in advanced cancer patients treated with anti-PD-1 therapy and predicts a better prognosis. This study was retrospectively registered with Trial ClinicalTrials.gov (NCT05593744) on October 25, 2022.

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The Prediction Potential of the Pretreatment Lung Immune Prognostic Index for the Therapeutic Outcomes of Immune Checkpoint Inhibitors in Patients With Solid Cancer: A Systematic Review and Meta-Analysis

Cited by 11 publications

References 37 publications

The prognostic value of the pretreatment lung immune prognostic index in patients with metastatic hormone-sensitive and castration-resistant prostate cancer

The prognostic value of the pretreatment lung immune prognostic index in patients with metastatic hormone-sensitive and castration-resistant prostate cancer

Predictors of Immunotherapy Efficacy in Metastatic Non-Small Cell Lung Cancer: Lung Immune Prognostic Index and Immune-Related Toxicity

Thyroid dysfunction induced by anti-PD-1 therapy is associated with a better progression-free survival in patients with advanced carcinoma

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