Immune checkpoint inhibitors (ICI) have changed advanced cancer treatment over the last few years. Evidence suggests that tumor-associated inflammation influence the host immune response and its response to immunotherapy. Lung Immune Prognostic Index (LIPI) is a score that is correlated with patients' outcomes treated with ICI in certain malignancies.
Retrospective analysis of 114 patients with solid tumors who received ICI since January 2016 til June 2020. LIPI score was classified in 3 groups: good (G), intermediate (I) and poor (P) and was tested for association with overall survival (OS) and progression free survival (PFS).
From 114 patients treated with ICI, 84 (73.7%) were male, with a mean age of 61 years. Fourteen (12.3%) were treatment-naive. Nivolumab was used in 59 patients (51.8%), pembrolizumab in 50 (43.9%), durvalumab in 4 (3.5%) and atezolizumab in 1 (0.9%). Regarding tumor sites: 80.7% NSCLC, 7.9% bladder, 5.3% renal, 2.6% colorectal, 0.9% breast, 0.9% thymus, 0.9% mesothelioma and 0.9% nasopharynx. According to LIPI classification, 11 patients (9.6%) were in P group, 37 (32.5%) in I group and 66 (57.9%) in G group. Median OS was 2.3m (95% CI 0.0 – 4.6) in P group, 12.2m (95% CI 2.4 – 22.0) in I group and 16.3m (95% CI 12.2 – 20.4) in G group (p<0.001). Median PFS was 1.8m (95% CI 0.5 – 3.2m) in P group, 7.1m (95% CI 2.4 – 11.8) in I group and 8.9m (95% CI 5.0 – 12.7) in G group (p<0.001). Cox regression analysis showed a better OS and PFS in G group comparing with I group (HR 7.1 (95% CI 3.2 – 15.9) and HR 5.0 (95% CI 2.4 – 10.5), respectively). No stastically significant difference for P group.
Poor LIPI score was associated with worse outcomes for ICI treated patients with solid tumors. LIPI score may be a useful tool to select patients for ICI treatment.
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