Lung Immune Prognosis Index (LIPI), based on pretreatment dNLR (neutrophils/(leucocytes-neutrophils)) and LDH, correlated with outcome after immune checkpoint inhibitors (ICI) in advanced NSCLC pts. We tested if LIPI, could have the same role in R/M SCCHN pts.
We conducted a retrospective study of 86 R/M HNSCC pts treated with ICI in our institution between Sep 2014 and Dec 2017. Complete blood cell counts and LDH were collected before ICI treatment. LIPI characterized 3 groups: good risk if dNLR < 3 and normal LDH, intermediate if dNLR > 3 or LDH > upper limit of normal (ULN), and poor if dNLR >3 and LDH >ULN. ICI benefit was analyzed according to overall survival (OS) and progression free survival (PFS).
In our cohort, 65 pts (76%) were males, 61 (71%) current/former smokers, 81 (94%) had PS ≤ 1, with median age 59 years. According to the location: 19 (22%) had oral cavity carcinoma, 43 (50%) oropharynx, 11 (13%) hypopharynx and 13 (15%) larynx. HPV by immunohistochemistry was positive in 11/52 pts (10 oropharynx, 1 oral cavity). Twenty-eight (33%) pts received PD1, PDL1, or CTLA-4 inhibitors in monotherapy, and 58 (67%) in combination. The median of prior lines was 1 (0-6). The median follow-up was 8 months (m) [95% CI:7-12], median PFS 3 m [95% CI:2-4] and median OS 12 m [95% CI 8-NA]. The dNLR >3 (36%) and LDH >ULN (10%) were associated with poor OS (P = 0.005). Based on them, LIPI considered: 44 pts (51%) as good, 38 (44%) intermediate and 4 (5%) poor prognosis group. LIPI was an independent factor for OS (hazard ratio [HR 2.49, 95% CI 1.2-5.2] for intermediate LIPI and [HR 7.97, 95%CI 1.9-32.6] for poor LIPI, P = 0.005) and PFS (P = 0.004). Median OS for poor, intermediate, and good LIPI was 3.5 m [95% CI, 2- not reached (NR)], 7 m (95% CI, 5-NR), and 12 m (95% CI, 8-NR), respectively (P = 0.003).
High LIPI was correlated with worse ICI outcomes in R/M SCCHN pts. Further studies are warranted to confirm the prognostic impact of this score and the potential predictive role for ICI.
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All authors have declared no conflicts of interest.