Systemic Inflammation/Nutritional Status Scores Are Prognostic but Not Predictive in Metastatic Non-Small-Cell Lung Cancer Treated with First-Line Immune Checkpoint Inhibitors

• Published in: International journal of molecular sciences Vol. 24; no. 4; p. 3618
• Main Authors: Mahiat, Cédric, Bihin, Benoît, Duplaquet, Fabrice, Stanciu Pop, Claudia, Dupont, Michael, Vander Borght, Thierry, Rondelet, Benoît, Vanderick, Jean, André, Bénédicte, Pirard, Lionel, Ocak, Sebahat
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-02-2023; MDPI
• Subjects: Biomarkers; Cancer; Cancer immunotherapy; Care and treatment; Chemotherapy; Clinical medicine; Growth factors; immune checkpoint inhibitor; Immune checkpoint inhibitors; immunotherapy; Inflammation; Inhibitors; Lung cancer; Lung cancer, Non-small cell; Medical prognosis; Metastases; Metastasis; Mutation; Non-small cell lung carcinoma; non-small-cell lung cancer; Nutritional status; Oncology; PD-(L)1 inhibitor; Survival; systemic inflammation; Tumors; Belgium; United Kingdom; systemic inflammation; immune checkpoint inhibitor; nutritional status; PD-(L)1 inhibitor; immunotherapy; non-small-cell lung cancer
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms24043618

Biomarkers of systemic inflammation/nutritional status have been associated with outcomes in advanced-stage non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). However, most of them were not tested in cohorts of patients treated with ICIs in combination with chemotherapy (CT) (ICI + CT) or with CT alone, making it impossible to discriminate a predictive from a prognostic effect. We conducted a single-center retrospective study to search for associations between various baseline biomarkers/scores that reflected the systemic inflammation/nutritional status (Lung Immune Prognostic Index, Modified Lung Immune Prognostic Index, Scottish Inflammatory Prognostic Score, Advanced Lung Cancer Inflammation Index, EPSILoN, Prognostic Nutritional Index, Systemic Immune-Inflammation Index, Gustave Roussy Immune Score, Royal Marsden Hospital Prognostic Score, Lung Immuno-oncology Prognostic Score 3, Lung Immuno-oncology Prognostic Score 4, score published by Holtzman et al., and Glasgow Prognostic Score) and outcomes in metastatic NSCLC treated in a first-line setting either with ICI in monotherapy (cohort 1;
= 75), ICI + CT (cohort 2;
= 56), or CT alone (cohort 3;
= 221). In the three cohorts, the biomarkers/scores were moderately associated with overall survival (OS) and progression-free survival (PFS). Their prognostic performance was relatively poor, with a maximum c-index of 0.66. None of them was specific to ICIs and could help to choose the best treatment modality. The systemic inflammation/nutritional status, associated with outcomes independently of the treatment, is therefore prognostic but not predictive in metastatic NSCLC.