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Published on: February 25, 2020
Prognostic Value of the Systemic Immune-Inflammation Index in Advanced Endometrial Cancer Treated with
Eleonora Palluzzi1, Amedeo Cefaliello1, Olga Martelli1
1Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy.
Background:
The prognostic role of the Systemic Immune-Inflammation Index (SII) in patients with endometrial cancer (EC) treated with pembrolizumab plus lenvatinib (Len-Pem) is unknown. In this study, the association between baseline SII and progression-free survival (PFS) was evaluated.
Methods:
This is a monocentric, observational, retrospective/ambispective study including patients with advanced, recurrent, or metastatic mismatch repair proficient (pMMR) EC treated with Len-Pem.
Results:
Fifty-three patients were enrolled, with a median age of 64 years. Median PFS in the overall population was 7.1 months; median OS was 15 months. Patients with baseline SII ≤ 540 had significantly longer PFS (12.5 months) compared to those with SII > 540 (5.5 months; HR 2.94, p = 0.004). Higher SII was also significantly associated with increased risk of specific toxicities, including nausea, anorexia, and vomiting. The Overall Response Rate (ORR) was 42%, and Disease Control Rate (DCR) was 71%.
Conclusion:
Our real-world study supports the hypothesis-generation of a prognostic role for SII in predicting outcomes and toxicity in EC patients treated with Len-Pem. SII may serve as a cost-effective, accessible biomarker to stratify patients and hypothetically guide clinical decision-making. Further prospective studies are warranted to validate its clinical utility and to optimize dosing strategies that balance efficacy and tolerability.