Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec;8(6):1078-1085.
doi: 10.21037/tlcr.2019.11.07.

Evaluation of the lung immune prognostic index in advanced non-small cell lung cancer patients under nivolumab monotherapy

Juan Ruiz-Bañobre  1   2 , María C Areses-Manrique  3 , Joaquín Mosquera-Martínez  4 , Alexandra Cortegoso  2   5 , Francisco J Afonso-Afonso  1 , Noemí de Dios-Álvarez  6 , Natalia Fernández-Núñez  7 , Cristina Azpitarte-Raposeiras  8 , Margarita Amenedo  9 , Lucía Santomé  10 , José Luis Fírvida-Pérez  3 , Rosario García-Campelo  4 , Jorge García-González  2   5 , Joaquín Casal-Rubio  6 , Sergio Vázquez  7
Affiliations

Evaluation of the lung immune prognostic index in advanced non-small cell lung cancer patients under nivolumab monotherapy

Juan Ruiz-Bañobre et al. Transl Lung Cancer Res. 2019 Dec.

Abstract

The lung immune prognostic index (LIPI) has been proposed as a new categorical blood-based biomarker to select advanced non-small cell lung cancer (NSCLC) patients for anti-programmed cell death-1 (PD-1) or programmed death ligand 1 (PD-L1) therapy. In this study, we investigate for the first time to the best of our knowledge the prognostic and predictive utility of the LIPI in a multicenter nivolumab monotherapy-based cohort. We retrospectively analyzed the influence of the baseline LIPI on overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and overall response rate (ORR) among 153 patients of a cohort of 188 advanced NSCLC patients treated with nivolumab in the second line of therapy or beyond. Worse LIPI was significantly associated with shorter OS in univariate [hazard ratio (HR) =3.12, 95% confidence interval (CI), 2.12-4.60; P<0.0001] and multivariate (HR =3.67, 95% CI, 1.96-6.86; P<0.0001) analyses. Worse LIPI was associated with shorter PFS (HR =1.45, 95% CI, 1.05-2.03; P=0.03), but this correlation did not reach statistical significance in multivariate analysis (HR =1.49, 95% CI, 0.94-2.38; P=0.09). Worse LIPI was associated with lower DCR in univariate [odds ratio (OR) =0.41, 95% CI, 0.24-0.70; P=0.001] and multivariate (OR =0.44, 95% CI, 0.25-0.78; P=0.005) analyses. This study confirms the utility of the LIPI in prognostication and disease control prediction in advanced NSCLC patients treated with nivolumab in the second line of therapy or beyond.

Keywords: Lung immune prognostic index (LIPI); biomarkers; immunotherapy; lung cancer; nivolumab.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Juan Ruiz-Bañobre - Travel, Accommodations, Expenses: Bristol-Myers Squibb, Merck Sharp & Dohme, Ipsen, PharmaMar. Speakers’ Bureau: Roche. María C. Areses-Manrique - Consulting or Advisory Role: Roche/Genentech, AstraZeneca, Boehringer Ingelheim, Merck Sharp & Dohme, Takeda, Lilly, Bristol-Myers Squibb. Francisco J. Afonso-Afonso - Consulting or Advisory Role: Merck Sharp & Dohme, AstraZeneca, Bristol-Myers Squibb, Pfizer, Novartis, Takeda, Boehringer Ingelheim. Travel, Accommodations, Expenses: Bristol-Myers Squibb, Merck Sharp & Dohme, Pfizer. Margarita Amenedo - Consulting or Advisory Role: Boehringer Ingelheim, Clovis Oncology. Speakers' Bureau: AstraZeneca; PharmaMar, Roche, Pierre Fabre, Lilly. Travel, Accommodations, Expenses: Roche, Lilly. José Luis Fírvida-Pérez - Consulting or Advisory Role: Roche/Genentech, AstraZeneca, Boehringer Ingelheim, MSD Oncology, Takeda, Lilly, Bristol-Myers Squibb. Rosario García-Campelo - Consulting or Advisory Role: Roche/Genentech, MSD Oncology, AstraZeneca, Bristol-Myers Squibb, Pfizer, Novartis, Takeda, Boehringer Ingelheim. Speakers’ Bureau: Roche, AstraZeneca, Bristol-Myers Squibb, Pfizer, Novartis, Takeda, Boehringer Ingelheim, MSD Oncology. Jorge García-González - Consulting or Advisory Role: Bristol-Myers Squibb, MSD Oncology, Roche/Genentech, Lilly, Boehringer Ingelheim, AstraZeneca, Pierre Fabre. Travel, Accommodations, Expenses: Bristol-Myers Squibb, Merck Sharp & Dohme, Roche/Genentech. Sergio Vázquez - Consulting or Advisory Role: Pfizer, Astellas, Janssen, MSD Oncology, Bayer, Roche, Bristol-Myers Squibb, Boehringer Ingelheim, AstraZeneca, Ipsen, Novartis, Eusa Pharma, Eisai and Sanofi. Speakers’ Bureau: Lilly, Astellas, Bayer, Roche, Boehringer Ingelheim, Ipsen, Novartis, AstraZeneca and Sanofi. Travel, Accommodations, Expenses: Pfizer, Roche and AstraZeneca. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier overall survival and progression-free survival curves according to lung immune prognostic index (LIPI).
Figure 2
Figure 2
Nivolumab response distribution by lung immune prognostic index (LIPI) groups. NE, not evaluable; PD, progressive disease; SD, stable disease; PR, partial response; CR, complete response.
Figure S1
Figure S1
Flow diagram of the patient selection process. aNSCLC, advanced non-small cell lung cancer; LDH, lactate dehydrogenase; LIPI, lung immune prognostic index; dNLR, derived neutrophil to lymphocyte ratio. CHUO, Complejo Hospitalario Universitario de Ourense; CHUAC, Complejo Hospitalario Universitario de A Coruña; CHUS, Complejo Hospitalario Universitario de Santiago de Compostela; CHUF, Complejo Hospitalario Universitario de Ferrol; CHUVI, Complejo Hospitalario Universitario de Vigo; HULA, Hospital Universitario Lucus Augusti; CHOP, Complejo Hospitalario de Pontevedra; COG, Centro Oncológico de Galicia; POVISA, Hospital Povisa.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019;69:7-34. 10.3322/caac.21551 - DOI - PubMed
    1. Borghaei H, Paz-Ares L, Horn L, et al. Nivolumab versus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer. N Engl J Med 2015;373:1627-39. 10.1056/NEJMoa1507643 - DOI - PMC - PubMed
    1. Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer. N Engl J Med 2015;373:123-35. 10.1056/NEJMoa1504627 - DOI - PMC - PubMed
    1. Rittmeyer A, Barlesi F, Waterkamp D, et al. Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial. Lancet 2017;389:255-65. 10.1016/S0140-6736(16)32517-X - DOI - PMC - PubMed
    1. Reck M, Rodríguez-Abreu D, Robinson AG, et al. Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. N Engl J Med 2016;375:1823-33. 10.1056/NEJMoa1606774 - DOI - PubMed