Correlation of lung immune prognostic index with the efficacy of immune checkpoint inhibitors in Chinese patients with advanced non-small cell lung cancer

Treatment with immune checkpoint inhibitors (ICIs) improves the prognoses of patients with non-small cell lung cancer (NSCLC) but is ineffective in some patients. The lung immune prognostic index (LIPI) can predict response to ICIs treatment in European patients with NSCLC. This study assessed the correlation of LIPI score with outcomes in Chinese patients with advanced NSCLC receiving ICIs.

A total of 305 Chinese patients with advanced NSCLC who received ICIs were ultimately included. LIPI score was determined by a high derived neutrophil-to-lymphocyte ratio (dNLR > 3) and elevated lactate dehydrogenase (LDH) and classified as “good” (0), “intermediate” (1), or “poor” (2). The effects of baseline LIPI on overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and overall response rate (ORR) were analyzed.

The good LIPI group had better OS (26.0 months, P < 0.0001) and PFS (10.5 months, P < 0.0001) than the other two groups, but the three groups had similar ORR (P = 0.222). DCR was 79%, 65%, and 47% in the good, intermediate, and poor LIPI groups, respectively (P = 0.002). Multivariate analysis indicated that an intermediate LIPI score (HR = 1.56, P = 0.005) and a poor LIPI score (HR = 2.68, P < 0.001) were independent predictors of poor OS. The findings were similar for PFS. DCR had a significant negative correlation with the LIPI score (P = 0.045).

Our results confirmed that a good LIPI score was related to prolonged survival and better response to ICIs in Chinese patients with advanced NSCLC. The LIPI score might be useful for selecting patients most likely to benefit from ICIs treatment.