Lower prognostic nutritional index is associated with poorer survival in patients receiving immune checkpoint inhibitors

Biomark Med. 2021 Sep;15(13):1123-1130. doi: 10.2217/bmm-2020-0674. Epub 2021 Aug 16.

Abstract

Aim: Blood-based biomarkers like prognostic nutritional index (PNI) are readily available biomarkers for immunotherapy efficacy, although the data are limited. So, we aimed to evaluate the association between PNI and overall survival (OS) in immunotherapy-treated patients. Materials & methods: For this retrospective cohort study, data of 150 immunotherapy-treated advanced cancer patients were evaluated. The association between clinical factors and OS was evaluated with multivariate Cox-regression analyses. Results: After a median follow-up of 8.5 months, 94 patients died. The median OS was 11.07 months. The low PNI (hazard ratio [HR]: 2.065; p = 0.001), high lactate dehydrogenase (HR: 2.515; p = 0.001) and poor Eastern Cooperative Oncology Group (ECOG) status (HR: 2.164; p = 0.009) was associated with poorer OS in multivariate analyses. Conclusion: In our experience, survival with immunotherapy was impaired in patients with lower PNI and higher lactate dehydrogenase levels and poorer ECOG status.

Keywords: ECOG; LDH; biomarkers; immunotherapy; prognostic nutritional index.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / metabolism*
  • Female
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Immunotherapy / methods*
  • Kaplan-Meier Estimate
  • L-Lactate Dehydrogenase / metabolism
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / immunology
  • Neoplasms / pathology
  • Neoplasms / therapy*
  • Nutrition Assessment*
  • Prognosis
  • Retrospective Studies
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Immune Checkpoint Inhibitors
  • L-Lactate Dehydrogenase