Abstract
Combination therapy with immune checkpoint inhibitors and cytotoxic chemotherapies (chemoimmunotherapy) is associated with significantly better survival outcomes than cytotoxic chemotherapies alone in patients with advanced non-small cell lung cancer (NSCLC). However, there are no prognostic markers for chemoimmunotherapy. The prognostic nutritional index (PNI) and lung immune prognostic index (LIPI) are prognostic biomarkers for immune checkpoint inhibitor (ICI) monotherapy or cytotoxic chemotherapies. Thus, we aimed to examine whether these factors could also be prognostic markers for chemoimmunotherapy. We retrospectively examined 237 patients with advanced NSCLC treated with chemoimmunotherapy. In the total group, the median overall survival (OS) was not reached, and the median progression-free survival (PFS) was 8.6 months. Multivariate analysis of OS and PFS revealed significant differences based on PNI and LIPI. Programmed cell death ligand 1 (PD-L1) was also significantly associated with OS and PFS. PNI and a PD-L1 tumor proportion score (TPS) of <50% and poor LIPI (regardless of PD-L1 TPS) were associated with poor prognosis. PNI and LIPI predicted survival outcomes in patients with advanced NSCLC treated with chemoimmunotherapy, especially in patients with PD-L1 TPS <50%. For patients in this poor category, chemoimmunotherapy may result in a worse prognosis than expected.
Highlights
Combination therapy with immune checkpoint inhibitors (ICIs) and chemotherapy is currently approved and used as the first-line treatment for advanced non-small cell lung cancer (NSCLC)
An additional report from the KEYNOTE-189 trial has stated that the median overall survival (OS) in the chemoimmunotherapy group was 22.0 months, which was more than twice the median OS of 10.7 months in the chemotherapy alone group [5]
Unknown Histology Adenocarcinoma Squamous NSCLC—others Molecular alteration other than epidermal growth factor receptor (EGFR) or ALK programmed cell death ligand 1 (PD-L1) status * Negative (
Summary
Combination therapy with immune checkpoint inhibitors (ICIs) and chemotherapy (hereafter chemoimmunotherapy) is currently approved and used as the first-line treatment for advanced non-small cell lung cancer (NSCLC). Chemoimmunotherapy regimens that can be used for advanced NSCLC include pembrolizumab (Pemb) plus a platinumbased drug plus pemetrexed (PEM) (as per the KEYNOTE-189 trial) [1], Pemb plus carboplatin (CBDCA) plus paclitaxel (PTX) or nab-PTX (as per the KEYNOTE-407 trial) [2], atezolizumab (Atezo) plus CBDCA plus PTX plus bevacizumab [3], and Atezo plus a platinum-based drug plus PEM [4]. All these regimens have shown significant improvements in progression-free survival (PFS) and safety when compared to regimens of chemotherapy alone. The establishment of a prognostic marker is required to create a more appropriate treatment selection
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
