Systemic Inflammation/Nutritional Status Scores Are Prognostic but Not Predictive in Metastatic Non-Small-Cell Lung...

Area of Science:

• Oncology
• Immunotherapy
• Cancer Biomarkers

Background:

• Systemic inflammation and nutritional status influence outcomes in advanced non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs).
• Previous studies often lacked data from combined immunotherapy and chemotherapy (ICI + CT) or chemotherapy alone (CT) cohorts, hindering the distinction between predictive and prognostic effects.
• The predictive value of these biomarkers for specific treatment modalities remains unclear.

Purpose of the Study:

• To investigate the association between baseline systemic inflammation/nutritional status biomarkers and outcomes in metastatic NSCLC patients.
• To evaluate if these biomarkers can differentiate between prognostic and predictive effects across different first-line treatment settings (ICI monotherapy, ICI + CT, CT alone).

Main Methods:

• A retrospective single-center study analyzed data from 352 metastatic NSCLC patients in a first-line setting.
• Patients were grouped into three cohorts: ICI monotherapy (n=75), ICI + CT (n=56), and CT alone (n=221).
• Various inflammation/nutrition scores (e.g., LIPI, SPI, SISI, GPS) were assessed for association with overall survival (OS) and progression-free survival (PFS).

Main Results:

• Biomarkers showed moderate associations with OS and PFS across all three treatment cohorts.
• The prognostic performance of these scores was limited, with a maximum c-index of 0.66.
• No biomarker demonstrated specificity for ICIs or aided in selecting the optimal treatment modality.

Conclusions:

• Systemic inflammation and nutritional status are prognostic factors for outcomes in metastatic NSCLC, independent of treatment type.
• These biomarkers do not appear to be predictive for ICI-based therapies or chemotherapy alone.
• Further research is needed to identify truly predictive biomarkers for guiding treatment decisions in NSCLC.