Evaluation of the lung immune prognostic index in advanced non-small cell lung cancer patients under nivolumab monotherapy

Juan Ruiz-Bañobre, María C. Areses-Manrique, Joaquín Mosquera-Martínez, Alexandra Cortegoso, Francisco J. Afonso-Afonso, Noemí de Dios-Álvarez, Natalia Fernández-Núñez, Cristina Azpitarte-Raposeiras, Margarita Amenedo, Lucía Santomé, José Luis Fírvida-Pérez, Rosario García-Campelo, Jorge García-González, Joaquín Casal-Rubio, Sergio Vázquez

Abstract

The lung immune prognostic index (LIPI) has been proposed as a new categorical blood-based biomarker to select advanced non-small cell lung cancer (NSCLC) patients for anti-programmed cell death-1 (PD-1) or programmed death ligand 1 (PD-L1) therapy. In this study, we investigate for the first time to the best of our knowledge the prognostic and predictive utility of the LIPI in a multicenter nivolumab monotherapy-based cohort. We retrospectively analyzed the influence of the baseline LIPI on overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and overall response rate (ORR) among 153 patients of a cohort of 188 advanced NSCLC patients treated with nivolumab in the second line of therapy or beyond. Worse LIPI was significantly associated with shorter OS in univariate [hazard ratio (HR) =3.12, 95% confidence interval (CI), 2.12–4.60; P<0.0001] and multivariate (HR =3.67, 95% CI, 1.96–6.86; P<0.0001) analyses. Worse LIPI was associated with shorter PFS (HR =1.45, 95% CI, 1.05–2.03; P=0.03), but this correlation did not reach statistical significance in multivariate analysis (HR =1.49, 95% CI, 0.94– 2.38; P=0.09). Worse LIPI was associated with lower DCR in univariate [odds ratio (OR) =0.41, 95% CI, 0.24–0.70; P=0.001] and multivariate (OR =0.44, 95% CI, 0.25–0.78; P=0.005) analyses. This study confirms the utility of the LIPI in prognostication and disease control prediction in advanced NSCLC patients treated with nivolumab in the second line of therapy or beyond.