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

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G.L. Banna¹  A. Cortellini²  D.L. Cortinovis⁴  M. Tiseo⁵  J.G.J.V. Aerts⁷  F. Barbieri⁸  R. Giusti⁹  E. Bria^1,10  F. Grossi^1,12  P. Pizzutilo^1,13  R. Berardi^1,14  A. Morabito^1,15  C. Genova^1,16  F. Mazzoni^1,17  V. Di Noia^1,18  D. Signorelli^1,19  A. Gelibter^2,20  M. Macerelli^2,21  F. Rastelli^2,22  R. Chiari^2,22  D. Rocco^2,23  S. Gori^2,24  M. De Tursi^2,25  P. Di Marino^2,26  G. Mansueto^2,27  F. Zoratto^2,28  M. Filetti⁹  M. Montrone^1,13  F. Citarella^2,29  R. Marco^2,29  L. Cantini⁷  O. Nigro^2,22  E. D^1,10  S. Buti⁵  G. Minuti^3,30  L. Landi^3,30  G. Guaitoli⁸  G. Lo Russo^2,20  A. De Toma^2,20  C. Donisi^3,31  A. Friedlaender^3,32  A. De Giglio^3,33  G. Metro^3,34  G. Porzio^3,35  C. Ficorella³  A. Addeo^3,32 

[1]Oncology Department, Portsmouth University Hospitals NHS Trust

[2]Department of Surgery and Cancer, Imperial College London

[3]Department of Biotechnology and Applied Clinical Sciences, University of L"Aquila

[4]Medical Oncology, Ospedale San Gerardo

[5]Medical Oncology Unit, University Hospital of Parma

[6]Department of Medicine and Surgery, University of Parma

[7]Department of Pulmonary Diseases, Erasmus Medical Center

[8]Department of Oncology and Hematology, Modena University Hospital

[9]Medical Oncology, St. Andrea Hospital

[10]Comprehensive Cancer Center, Fondazione Policlinico Universitario ‘A. Gemelli’ IRCCS

[11]Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore

[12]Medical Oncology Unit, Fondazione IRCCS Ca" Granda Ospedale Maggiore Policlinico

[13]Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Temorid ‘Giovanni Paolo II’

[14]Oncology Clinic, Università Politecnica Delle Marche

[15]Thoracic Medical Oncology, Istituto Nazionale Tumori ‘Fondazione G Pascale’

[16]Lung Cancer Unit, IRCCS Ospedale Policlinico San Martino

[17]Department of Oncology, Careggi University Hospital

[18]Medical Oncology, University Hospital of Foggia

[19]Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori

[20]Medical Oncology ,(B), Policlinico Umberto I, ‘Sapienza’ University of Rome

[21]Department of Oncology, University Hospital Santa Maria Della Misericordia

[22]Medical Oncology

[23]Pneumo-Oncology Unit, Monaldi Hospital

[24]Oncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria

[25]Department of Medical, Oral & Biotechnological Sciences University G. D"Annunzio

[26]Clinical Oncology Unit, S.S. Annunziata Hospital

[27]Medical Oncology, F. Spaziani Hospital

[28]Medical Oncology, Santa Maria Goretti Hospital

[29]Medical Oncology, Campus Bio-Medico University

[30]Department of Oncology and Hematology

[31]Medical Oncology Unit, University Hospital and University of Cagliari

[32]Oncology Department, University Hospital of Geneva

[33]Division of Medical Oncology, S.Orsola-Malpighi Hospital, University of Bologna

[34]Department of Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia

[35]Medical Oncology, St. Salvatore Hospital

关键词: non-small-cell lung cancer;    immunotherapy;    PD-L1;    LDH;    neutrophil-to-lymphocyte ratio;    steroids;    performance status;    immune-checkpoint inhibitor;    prognostic;   

DOI  :  10.1016/j.esmoop.2021.100078

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background 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.Methods 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.Results NLR < 4 was a significant prognostic factor in both cohorts (P 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 2 risk factors, 5%, 1-year OS 10.7%) prognosis.Conclusions We advocate the use of LIPS-3 as an easy-to-assess and inexpensive adjuvant prognostic tool for patients with PD-L1 ≥ 50% aNSCLC.

【 授权许可】

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