Evaluation and modification of lung immune prognostic index in patients with metastatic NSCLC treated by immunotherapy

Aim of the study: to evaluate prognostic value of baseline lung immune prognostic index (LIPI) and its modification (mLIPI) for metastatic non-small cell lung cancer (mNSCLC) patients treated with immune checkpoint inhibitors (ICI). Material and methods. Baseline neutrophil-to-lymphocyte ratio, lactate dehydrogenase, hemoglobin, platelets, and fibrinogen level were collected from 133 patients treated with ICI in monotherapy or combination between July 2015 and July 2022 in N.N. Blokhin NMRCO. According to evaluating factors patients were divided into three groups of “good” (LIPI 0/mLIPI 0-1), “intermediate” (LIPI 1/mLIPI 2-3) and “poor” prognosis (LIPI 2/mLIPI 4-5). The primary endpoint was progression free survival (PFS). Results. The median PFS for the LIPI groups were 9.7 months (1.4-17.9; 95 % CI), 7.9 months (5.9-9.9; CI 95 %) and 6.0 months (4.07-7.93; 95 % CI) in the “good”, “intermediate” and “poor” prognosis groups, respectively; the hazard ratio (HR) for patients in the “poor” prognosis group (17 patients) was 2.02 (1.06-3.84; 95 % CI) compared with the “good” LIPI group (p=0.03). The median PFS for mLIPI groups were9.0 months (4.53-13.47; 95 % CI), 8.0 months (5.4-10.6; CI 95 %) and 2.0 months. (1.33-2.67; 95 % CI) in the“good”, “intermediate” and “poor” prognosis groups, respectively. The HR for patients in the “poor” prognosis group (n=12) was 3.12 (1.51-6.46; 95 % CI) compared with the “good” mLIPI group (p=0.002). Conclusion. Baseline LIPI and mLIPI predicts potential resistance to ICI treatment in mNSCLC patients.