Systemic Inflammatory Score Predicts Response and Prognosis in Patients With Lung Cancer Treated With Immunotherapy

Anticancer Res. 2021 Jul;41(7):3673-3682. doi: 10.21873/anticanres.15158.

Abstract

Aim: This study aimed to investigate useful prognostic factors of immunotherapy in patients with lung cancer.

Patients and methods: We retrospectively observed 73 patients who underwent immunotherapy (nivolumab, pembrolizumab, and atezolizumab) for lung cancer. The systemic inflammatory score (SIS) was calculated as the sum of the following factors scored one point each: Hemoglobin <12.5 g/dl and serum albumin <3.6 g/dl, resulting in scores of 0-2. We examined the correlation between the SIS and initial tumor response and progression-free and overall survival with other existing markers, namely tumor programmed death-ligand 1 (PD-L1) expression level; neutrophil-to-lymphocyte ratio (NLR); modified Glasgow prognostic score; and prognostic nutritional index, etc. Results: SIS ≤1 was significantly associated with better initial tumor response. In multivariate analysis, PD-L1 expression ≥50% (p=0.010), SIS ≤1 (p=0.028) and NLR <5.6 (p=0.047) were significantly associated with longer progression-free survival, and SIS ≤1 (p=0.030) and NLR <5.6 (p=0.037) were associated with longer overall survival.

Conclusion: SIS is a useful marker of the efficacy of immunotherapy that can be obtained via routine blood tests.

Keywords: Albumin; hemoglobin; immunotherapy; primary lung cancer; systemic inflammatory score.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • B7-H1 Antigen / metabolism
  • Biomarkers, Tumor / metabolism
  • Female
  • Humans
  • Immunotherapy / methods
  • Inflammation / pathology*
  • Lung Neoplasms / immunology
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / therapy
  • Lymphocytes / metabolism
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Neutrophils / metabolism
  • Neutrophils / pathology
  • Nivolumab / therapeutic use
  • Prognosis
  • Progression-Free Survival
  • Retrospective Studies

Substances

  • Antibodies, Monoclonal, Humanized
  • B7-H1 Antigen
  • Biomarkers, Tumor
  • Nivolumab
  • atezolizumab
  • pembrolizumab