Development of a Simple and Objective Prognostication Model for Patients with Advanced Solid Malignant Tumors Treated with Immune Checkpoint Inhibitors: A Pan-Cancer Analysis

Abstract

Systemic therapy using immune checkpoint inhibitors (ICIs) has recently become prevalent in the treatment of patients with various types of advanced cancers; however, difficulties are still associated with predicting the outcomes of patients receiving ICIs due to heterogenous responses to these agents. To develop a prognostic model for advanced cancer patients treated with ICIs. This study retrospectively analyzed the impact of clinical parameters on overall survival (OS) in 329 patients with several advanced solid malignant tumors who received systemic therapy using ICIs. The primary tumors of 329 patients were as follows: lung (n = 89), kidney (n = 70), urinary tract (n = 52), skin (n = 50), stomach (n = 30), esophagus (n = 21), and head and neck (n = 17). Median OS after the introduction of ICIs was 17.3 months. Among the factors that correlated with OS in a univariate analysis, body mass index, C-reactive protein, hemoglobin, lymphocytes, and platelets were identified as independent predictors of OS in a multivariate analysis. Following the classification of patients into 3 groups based on positive numbers of these independent risk factors, median OS was not reached in the favorable risk group with 0 or 1 risk factor (n = 76), 19.5 months in the intermediate-risk group with 2 or 3 risk factors (n = 182), and 7.2 months in the poor risk group (n = 71) with 4 or 5 risk factors. Although this is a simple and objective model, it may be used as a reliable tool to predict the outcomes of advanced cancer patients receiving ICIs across multiple tumor types.