Lung immune prognostic index (LIPI) as a prognostic factor in patients with extensive-stage small cell lung cancer treated with first-line chemoimmunotherapy

Elena Herranz-Bayo ¹, Luis Enrique Chara-Velarde ², Javier Cassinello-Espinosa ²

⁰Hospital Universitario Miguel Servet, P.º de Isabel La Católica, 1-3, 50009, Zaragoza, Spain. eherranz@salud.aragon.es.

Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico +

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September 6, 2024

View abstract on PubMed

Summary

The lung immune prognostic index (LIPI) can predict outcomes for extensive-stage small cell lung cancer (ES-SCLC) patients receiving chemoimmunotherapy. An intermediate or poor LIPI score indicates a worse prognosis for progression-free survival and overall survival.

Area Of Science

Oncology
Immunotherapy
Biomarkers

Background

The lung immune prognostic index (LIPI) combines lactate dehydrogenase (LDH) and neutrophil/lymphocyte ratio (dNLR).
LIPI's prognostic value is established in non-small cell lung cancer (NSCLC) with immunotherapy.
Its role in extensive-stage small cell lung cancer (ES-SCLC) with chemoimmunotherapy requires investigation.

Purpose Of The Study

To evaluate the prognostic significance of LIPI in patients with ES-SCLC.
To assess the association between LIPI scores and survival outcomes (PFS, OS) in ES-SCLC treated with chemoimmunotherapy.

Main Methods

Retrospective, multicenter study of 101 ES-SCLC patients receiving first-line atezolizumab plus chemotherapy.
Patients categorized into LIPI good, intermediate, and poor groups.
Kaplan-Meier analysis for PFS and OS; Cox models for prognostic factor assessment.

Main Results

Good LIPI group showed significantly longer median PFS (9.6 months) and OS (23.4 months) compared to intermediate and poor groups.
Multivariate analysis identified liver metastases and intermediate/poor LIPI as independent predictors of worse PFS.
Intermediate (HR: 2.18) and poor (HR: 5.40) LIPI scores were significantly associated with worse OS.

Conclusions

Pretreatment LIPI score is a significant prognostic factor in ES-SCLC patients receiving chemoimmunotherapy.
Intermediate and poor LIPI scores are linked to inferior progression-free survival and overall survival.
LIPI can aid in risk stratification and treatment decision-making for ES-SCLC.

Keywords:

Immunotherapy Lung immune prognostic index Prognostic factor Small cell lung cancer