Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region
BackgroundWhether the prognostic nutritional index (PNI), which is suggested to reflect systemic inflammation and nutritional status of patients, could be used as an effective prognostic factor for small-cell lung cancer (SCLC) has not yet been clarified. The purpose of this study was to verify the...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1041140/full |
| _version_ | 1827989948886679552 |
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| author | Yunjiao Wu Jing Yang Xinyi Qiao Yingjie Li Rui Zhao Tie Lin Xiaoli Li Meng Wang |
| author_facet | Yunjiao Wu Jing Yang Xinyi Qiao Yingjie Li Rui Zhao Tie Lin Xiaoli Li Meng Wang |
| author_sort | Yunjiao Wu |
| collection | DOAJ |
| description | BackgroundWhether the prognostic nutritional index (PNI), which is suggested to reflect systemic inflammation and nutritional status of patients, could be used as an effective prognostic factor for small-cell lung cancer (SCLC) has not yet been clarified. The purpose of this study was to verify the prognostic value of the PNI in SCLC patients treated with programmed cell death ligand-1/programmed cell death 1 (PD-L1/PD-1) inhibitors in the alpine region of China.MethodsSCLC patients treated with PD-L1/PD-1 inhibitors monotherapy or combined with chemotherapy between March 2017 and May 2020 were included. Based on the values of serum albumin and total lymphocyte count, the study population was divided into two groups: high and low PNI. The Kaplan-Meier method was used to compute the median survival time and the log-rank test was used to compare the two groups. To evaluate the prognostic value of the PNI, univariable and multivariable analyses of progression-free survival (PFS) and overall survival (OS) were performed. The correlations between PNI and DCR or ORR were calculated by Point biserial correlation analysis.ResultsOne hundred and forty patients were included in this study, of which, 60.0% were high PNI (PNI > 49.43) and 40.0% were low PNI (PNI ≤ 49.43). Results indicated that the high PNI group had better PFS and OS than the low PNI group in the patients who received PD-L1/PD-1 inhibitors monotherapy (median PFS: 11.0 vs. 4.8 months, p < 0.001 and median OS: 18.5 vs. 11.0 months, p = 0.004). Similarly, better PFS and OS were associated with an increase in PNI level in the patients who accepted PD-L1/PD-1 inhibitors combined with chemotherapy (median PFS: 11.0 vs. 5.3 months, p < 0.001 and median OS: 17.9 vs. 12.6 months, p = 0.005). Multivariate Cox-regression model showed that high PNI was significantly related to better PFS and OS in patients who accepted PD-L1/PD-1 inhibitors monotherapy or combined with chemotherapy (PD-L1/PD-1 inhibitors monotherapy: PFS: HR = 0.23, 95% CI: 0.10–0.52, p < 0.001 and OS: HR = 0.13, 95% CI: 0.03–0.55, p = 0.006; PD-L1/PD-1 inhibitors combined with chemotherapy: PFS: HR = 0.34, 95% CI: 0.19–0.61, p < 0.001 and OS: HR = 0.53, 95% CI: 0.29–0.97, p = 0.040, respectively). Additionally, Point biserial correlation analysis between PNI and disease control rate (DCR) showed that PNI status was positively correlated with DCR in SCLC patients receiving PD-L1/PD-1 inhibitors or combined with chemotherapy (r = 0.351, p < 0.001; r = 0.285, p < 0.001, respectively).ConcussionsPNI may be a promising biomarker of treatment efficacy and prognosis in SCLC patients treated with PD-L1/PD-1 inhibitors in the alpine region of China. |
| first_indexed | 2024-04-10T00:28:20Z |
| format | Article |
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| language | English |
| last_indexed | 2024-04-10T00:28:20Z |
| publishDate | 2023-03-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-07a175d9b25f4d62b3025dda562177db2023-03-15T04:37:54ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-03-011310.3389/fonc.2023.10411401041140Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine regionYunjiao Wu0Jing Yang1Xinyi Qiao2Yingjie Li3Rui Zhao4Tie Lin5Xiaoli Li6Meng Wang7Department of Respiratory Medical Oncology, Harbin Medical University Cancer Hospital, Heilongjiang, Harbin, ChinaChongqing Engineering Research Center for Processing and Storage of Distinct Agricultural Products, Chongqing Technology and Business University, Chongqing, ChinaDepartment of Respiratory Medical Oncology, Harbin Medical University Cancer Hospital, Heilongjiang, Harbin, ChinaDepartment of Respiratory Medical Oncology, Harbin Medical University Cancer Hospital, Heilongjiang, Harbin, ChinaDepartment of Respiratory Medical Oncology, Harbin Medical University Cancer Hospital, Heilongjiang, Harbin, ChinaDepartment of Surgery, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, Harbin, ChinaDepartment of Respiratory Medical Oncology, Harbin Medical University Cancer Hospital, Heilongjiang, Harbin, ChinaDepartment of Respiratory Medical Oncology, Harbin Medical University Cancer Hospital, Heilongjiang, Harbin, ChinaBackgroundWhether the prognostic nutritional index (PNI), which is suggested to reflect systemic inflammation and nutritional status of patients, could be used as an effective prognostic factor for small-cell lung cancer (SCLC) has not yet been clarified. The purpose of this study was to verify the prognostic value of the PNI in SCLC patients treated with programmed cell death ligand-1/programmed cell death 1 (PD-L1/PD-1) inhibitors in the alpine region of China.MethodsSCLC patients treated with PD-L1/PD-1 inhibitors monotherapy or combined with chemotherapy between March 2017 and May 2020 were included. Based on the values of serum albumin and total lymphocyte count, the study population was divided into two groups: high and low PNI. The Kaplan-Meier method was used to compute the median survival time and the log-rank test was used to compare the two groups. To evaluate the prognostic value of the PNI, univariable and multivariable analyses of progression-free survival (PFS) and overall survival (OS) were performed. The correlations between PNI and DCR or ORR were calculated by Point biserial correlation analysis.ResultsOne hundred and forty patients were included in this study, of which, 60.0% were high PNI (PNI > 49.43) and 40.0% were low PNI (PNI ≤ 49.43). Results indicated that the high PNI group had better PFS and OS than the low PNI group in the patients who received PD-L1/PD-1 inhibitors monotherapy (median PFS: 11.0 vs. 4.8 months, p < 0.001 and median OS: 18.5 vs. 11.0 months, p = 0.004). Similarly, better PFS and OS were associated with an increase in PNI level in the patients who accepted PD-L1/PD-1 inhibitors combined with chemotherapy (median PFS: 11.0 vs. 5.3 months, p < 0.001 and median OS: 17.9 vs. 12.6 months, p = 0.005). Multivariate Cox-regression model showed that high PNI was significantly related to better PFS and OS in patients who accepted PD-L1/PD-1 inhibitors monotherapy or combined with chemotherapy (PD-L1/PD-1 inhibitors monotherapy: PFS: HR = 0.23, 95% CI: 0.10–0.52, p < 0.001 and OS: HR = 0.13, 95% CI: 0.03–0.55, p = 0.006; PD-L1/PD-1 inhibitors combined with chemotherapy: PFS: HR = 0.34, 95% CI: 0.19–0.61, p < 0.001 and OS: HR = 0.53, 95% CI: 0.29–0.97, p = 0.040, respectively). Additionally, Point biserial correlation analysis between PNI and disease control rate (DCR) showed that PNI status was positively correlated with DCR in SCLC patients receiving PD-L1/PD-1 inhibitors or combined with chemotherapy (r = 0.351, p < 0.001; r = 0.285, p < 0.001, respectively).ConcussionsPNI may be a promising biomarker of treatment efficacy and prognosis in SCLC patients treated with PD-L1/PD-1 inhibitors in the alpine region of China.https://www.frontiersin.org/articles/10.3389/fonc.2023.1041140/fullprognostic nutritional index (PNI)small cell lung cancer (SCLC)PD-L1/PD-1 inhibitorsimmune-related adverse events (irAEs)prognostic factor |
| spellingShingle | Yunjiao Wu Jing Yang Xinyi Qiao Yingjie Li Rui Zhao Tie Lin Xiaoli Li Meng Wang Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region Frontiers in Oncology prognostic nutritional index (PNI) small cell lung cancer (SCLC) PD-L1/PD-1 inhibitors immune-related adverse events (irAEs) prognostic factor |
| title | Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region |
| title_full | Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region |
| title_fullStr | Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region |
| title_full_unstemmed | Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region |
| title_short | Use of the prognostic nutrition index as a predictive biomarker in small-cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the Chinese alpine region |
| title_sort | use of the prognostic nutrition index as a predictive biomarker in small cell lung cancer patients undergoing immune checkpoint inhibitor treatment in the chinese alpine region |
| topic | prognostic nutritional index (PNI) small cell lung cancer (SCLC) PD-L1/PD-1 inhibitors immune-related adverse events (irAEs) prognostic factor |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1041140/full |
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