Prognostic Nutritional Index Predicts Efficacy and Immune-Related Adverse Events of First-Line Chemoimmunotherapy in...

Area of Science:

• Oncology
• Immunotherapy
• Biomarkers

Background:

• Predictive markers for chemoimmunotherapy efficacy in small-cell lung cancer (SCLC) are lacking.
• Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), advanced lung cancer inflammation index (ALI), and prognostic nutritional index (PNI) are potential prognostic factors in various cancers but their role in SCLC is unclear.

Purpose of the Study:

• To investigate the predictive role of peripheral blood biomarkers, including NLR, PLR, ALI, and PNI, in patients with extensive-stage SCLC (ES-SCLC) treated with first-line chemoimmunotherapy.
• To assess the correlation between these biomarkers and prognosis, as well as immune-related adverse events (IRAEs).

Main Methods:

• Retrospective study of 114 ES-SCLC patients receiving first-line chemoimmunotherapy.
• Extraction and analysis of peripheral blood biomarkers from medical records.
• Correlation analysis with progression-free survival (PFS), overall survival (OS), and IRAEs.

Main Results:

• Low PLR, high ALI, and high PNI were associated with prolonged PFS.
• Low NLR, low PLR, high ALI, and high PNI were associated with prolonged OS.
• PNI was an independent predictor for PFS and OS, outperforming NLR, PLR, and ALI.
• A PNI-based nomogram showed strong predictive capability.
• PNI correlated significantly with IRAEs.

Conclusions:

• A high baseline PNI may indicate improved prognosis in ES-SCLC patients undergoing chemoimmunotherapy.
• PNI may also be associated with the occurrence of IRAEs in this patient population.
• PNI shows potential as a predictive biomarker for treatment outcomes and toxicity in SCLC.