Abstract 69P
Background
We aimed to reveal the predictive and prognostic value and biomarker of the novel scoring system, the inflammatory-nutritional prognostic score (INPS), on nutritional and immune status in patients with NSCLC who received second-line nivolumab therapy.
Methods
In this study, patients who were treated in Dokuz Eylul University, Department of Medical Oncology between October 2018 and September 2022, and who were diagnosed with metastatic NSCLC and received nivolumab as a second-line therapy were evaluated retrospectively. Demographic characteristics, blood tests, clinicopathological features of the tumor and information about the treatments they received were recorded. We selected the most valuable biomarkers to develop INPS by the least absolute shrinkage and selection operator (LASSO) Cox regression model. A prognostic nomogram incorporating INPS and other independent clinicopathological factors was developed based on the stepwise multivariate Cox regression method. Then, we evaluate the prognostic performance and predictive accuracy of the predictive nomogram.
Results
Using the LASSO Cox regression model, determining overall survival as primary endpoint, six inflammatory-nutritional biomarkers, namely, SII, NLR, PLR, MLR, PNI, and LAR, out of 8 (eliminated two inflamatory variables AAPR and CAR) have been selected and used to construct the INPS for 67 metastatic NSCLC cancer patients treated with nivolumab. Six of the eight inflammatory markers were shown to have a statistically significant prognostic value on overall survival and were included in the INPS nomogram. Using the cut-off points of these six inflammatory-nutritional biomarkers, the INPS scores (from 0 to 6) have been obtained. As a final step, the INPS scores are used to construct the risk groups (from low to high).
Conclusions
The search for prognostic markers other than PD-L1 and TMB is still ongoing in patients receiving immunotherapy. With this study, for the first time in the literature, the new screening system, INPS, created with various nutritional and inflammatory markers, has shown that it can be used as a prognostic tool in metastatic NSCLC patients receiving immunotherapy.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.