Published 2021
| Version v1
Publication
The lung immuno-oncology prognostic score (LIPS-3): a prognostic classification of patients receiving first-line pembrolizumab for PD-L1 ≥ 50% advanced non-small-cell lung cancer
Creators
- Banna G. L.
- Cortellini A.
- Cortinovis D. L.
- Tiseo M.
- Aerts J. G. J. V.
- Barbieri F.
- Giusti R.
- Bria E.
- Grossi F.
- Pizzutilo P.
- Berardi R.
- Morabito A.
- Genova C.
- Mazzoni F.
- Di Noia V.
- Signorelli D.
- Gelibter A.
- Macerelli M.
- Rastelli F.
- Chiari R.
- Rocco D.
- Gori S.
- De Tursi M.
- Di Marino P.
- Mansueto G.
- Zoratto F.
- Filetti M.
- Montrone M.
- Citarella F.
- Marco R.
- Cantini L.
- Nigro O.
- D'Argento E.
- Buti S.
- Minuti G.
- Landi L.
- Guaitoli G.
- Lo Russo G.
- De Toma A.
- Donisi C.
- Friedlaender A.
- De Giglio A.
- Metro G.
- Porzio G.
- Ficorella C.
- Addeo A.
Contributors
Others:
- Banna, G. L.
- Cortellini, A.
- Cortinovis, D. L.
- Tiseo, M.
- Aerts, J. G. J. V.
- Barbieri, F.
- Giusti, R.
- Bria, E.
- Grossi, F.
- Pizzutilo, P.
- Berardi, R.
- Morabito, A.
- Genova, C.
- Mazzoni, F.
- Di Noia, V.
- Signorelli, D.
- Gelibter, A.
- Macerelli, M.
- Rastelli, F.
- Chiari, R.
- Rocco, D.
- Gori, S.
- De Tursi, M.
- Di Marino, P.
- Mansueto, G.
- Zoratto, F.
- Filetti, M.
- Montrone, M.
- Citarella, F.
- Marco, R.
- Cantini, L.
- Nigro, O.
- D'Argento, E.
- Buti, S.
- Minuti, G.
- Landi, L.
- Guaitoli, G.
- Lo Russo, G.
- De Toma, A.
- Donisi, C.
- Friedlaender, A.
- De Giglio, A.
- Metro, G.
- Porzio, G.
- Ficorella, C.
- Addeo, A.
Description
Background: To stratify the prognosis of patients with programmed cell death-ligand 1 (PD-L1) ≥ 50% advanced non-small-cell lung cancer (aNSCLC) treated with first-line immunotherapy. Methods: Baseline clinical prognostic factors, the neutrophil-to-lymphocyte ratio (NLR), PD-L1 tumour cell expression level, lactate dehydrogenase (LDH) and their combination were investigated by a retrospective analysis of 784 patients divided between statistically powered training (n = 201) and validation (n = 583) cohorts. Cut-offs were explored by receiver operating characteristic (ROC) curves and a risk model built with validated independent factors by multivariate analysis. Results: NLR < 4 was a significant prognostic factor in both cohorts (P < 0.001). It represented 53% of patients in the validation cohort, with 1-year overall survival (OS) of 76.6% versus 44.8% with NLR > 4, in the validation series. The addition of PD-L1 ≥ 80% (21% of patients) or LDH < 252 U/l (25%) to NLR < 4 did not result in better 1-year OS (of 72.6% and 74.1%, respectively, in the validation cohort). Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2 [P < 0.001, hazard ratio (HR) 2.04], pretreatment steroids (P < 0.001, HR 1.67) and NLR < 4 (P < 0.001, HR 2.29) resulted in independent prognostic factors. A risk model with these three factors, namely, the lung immuno-oncology prognostic score (LIPS)-3, accurately stratified three OS risk-validated categories of patients: favourable (0 risk factors, 40%, 1-year OS of 78.2% in the whole series), intermediate (1 or 2 risk factors, 54%, 1-year OS 53.8%) and poor (>2 risk factors, 5%, 1-year OS 10.7%) prognosis. Conclusions: We advocate the use of LIPS-3 as an easy-to-assess and inexpensive adjuvant prognostic tool for patients with PD-L1 ≥ 50% aNSCLC.
Additional details
Identifiers
- URL
- http://hdl.handle.net/11567/1073072
- URN
- urn:oai:iris.unige.it:11567/1073072
Origin repository
- Origin repository
- UNIGE