Abstract
ObjectiveThis study was designed to demonstrate the prognostic value of prognostic nutritional index (PNI), a reflection systemic immunonutritional status, on the long-term survival of patients taking epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs).MethodsIn this retrospective study, eligible advanced NSCLC patients with sensitive EGFR mutations (exon 19 deletion or L858R in exon 21) were included to investigate the correlation between the PNI and overall survival (OS). The PNI was calculated as 10 x serum albumin value (g/dl) + 0.005 x peripheral lymphocyte count (per mm3). The prognostic significance of PNI and other clinicopathologic factors was identified by univariate and multivariate analysis.ResultsFinally, 144 patients met the inclusion criteria. The optimal cut-off value of PNI for survival stratification was 48.78. Compared with high PNI group (n = 81), low PNI (n = 63) was significantly associated with elevated C-reactive protein (CRP) level and non-response to TKIs. Overall survival was superior in the high PNI group (HR, 0.44, p = 0.004), especially for patient with L858R (HR, 0.37, p = 0.009) rather than 19 deletion (HR, 0.69, p = 0.401). The independent prognostic value of PNI was validated by multivariate analysis.ConclusionThis pilot investigation demonstrated that low prognostic nutritional index correlates with worse survival for patients with advanced NSCLC and taking EGFR-TKIs. The assessment of a convenient index, known as PNI, worth attention in routine clinical practice for patients following EGFR-TKIs treatment.
Highlights
Lung cancer remains the leading cause of cancer-related mortality [1]
Overall survival was superior in the high prognostic nutritional index (PNI) group (HR, 0.44, p = 0.004), especially for patient with L858R (HR, 0.37, p = 0.009) rather than 19 deletion (HR, 0.69, p = 0.401)
This pilot investigation demonstrated that low prognostic nutritional index correlates with worse survival for patients with advanced Non-small-cell lung cancer (NSCLC) and taking epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs)
Summary
Lung cancer remains the leading cause of cancer-related mortality [1]. Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of lung cancers [2]. There is increasing evidence that the nutritional and immunological status is closely related to the long-term outcome of patients with malignancies [9, 10]. The prognostic nutritional index (PNI), which is calculated on the basis of serum albumin level and total lymphocyte count in peripheral blood, is originally employed as a reflection of pre-treatment immunonutritional status [11]. The prognostic value of PNI in patients treated with EGFR-TKIs is not yet fully evaluated. Whether the systemic inflammation interaction varies between two EGFR mutation types is undefined. In this retrospective study, we evaluated the association between pre-treatment PNI and clinicopathological factors as well as survival data for patients with EGFR sensitive mutations and treated with EGFR-TKIs
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
