Portal de Periódicos da CAPES

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

2021; Elsevier BV; Volume: 6; Issue: 2 Linguagem: Inglês

10.1016/j.esmoop.2021.100078

2059-7029

Giuseppe Luigi Banna, Alessio Cortellini, Diego Cortinovis, Marcello Tiseo, Joachim G.J.V. Aerts, Fausto Barbieri, Raffaele Giusti, Emilio Bria, Francesco Grossi, Pamela Pizzutilo, Rossana Berardi, Alessandro Morabito, Carlo Genova, Francesca Mazzoni, Vincenzo Di Noia, Diego Signorelli, Alain Gelibter, Marianna Macerelli, Francesca Rastelli, Rita Chiari, Danilo Rocco, Stefania Gori, Michele De Tursi, Pietro Di Marino, Giovanni Mansueto, Federica Zoratto, Marco Filetti, Michele Montrone, Fabrizio Citarella, Rosanna De Marco, Luca Cantini, Olga Nigro, Ettore D’Argento, Sebastiano Buti, Gabriele Minuti, Lorenza Landi, Giorgia Guaitoli, Giuseppe Lo Russo, Alessandro De Toma, Clelia Donisi, Alex Friedlaender, Andrea De Giglio, Giulio Metro, Giampiero Porzio, Corrado Ficorella, Alfredo Addeo,

Pancreatic and Hepatic Oncology Research

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.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.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.We advocate the use of LIPS-3 as an easy-to-assess and inexpensive adjuvant prognostic tool for patients with PD-L1 ≥ 50% aNSCLC.