Giuseppe Luigi Banna1, Alex Friedlaender2,3, Marco Tagliamento4, Veronica Mollica5, Alessio Cortellini6, Sara Elena Rebuzzi4,7, Arsela Prelaj8,9, Abdul Rafeh Naqash10, Edouard Auclin11, Lucia Garetto12, Laura Mezquita13,14,15, Alfredo Addeo3. 1. Portsmouth Hospitals University NHS Trust, Portsmouth, UK. giuseppe.banna@nhs.net. 2. Department of Oncology, Clinique Générale Beaulieu, Geneva, Switzerland. 3. Department of Oncology, University Hospital of Geneva, Geneva, Switzerland. 4. Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genoa, Genoa, Italy. 5. Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy. 6. Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK. 7. Medical Oncology Unit, Ospedale San Paolo, Savona, Italy. 8. Medical Oncology Department 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. 9. Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy. 10. Medical Oncology/TSET Phase 1 Program, Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA. 11. Medical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France. 12. Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy. 13. Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain. 14. Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain. 15. Department of Medicine, University of Barcelona, Barcelona, Spain.
Abstract
PURPOSE OF REVIEW: To describe the biological rationale of peripheral blood cells (PBC)-derived inflammatory indexes and assess the related prognostic scores for patients with advanced non-small cell lung cancer (aNSCLC) treated with immune-checkpoint inhibitors (ICI). RECENT FINDINGS: Inflammatory indexes based on PBC may indicate a pro-inflammatory condition affecting the immune response to cancer. The lung immune prognostic index (LIPI), consisting of derived neutrophils-to-lymphocyte ratio (NLR) and lactate dehydrogenase, is a validated prognostic tool, especially for pretreated aNSCLC patients, where the combination of NLR and PD-L1 tumour expression might also be predictive of immunotherapy benefit. In untreated high-PD-L1 aNSCLC patients, the Lung-Immune-Prognostic score (LIPS), including NLR, ECOG PS and concomitant steroids, is prognostic, and its modified version might indicate patients with favourable outcomes despite an ECOG PS of 2. NLR times platelets (i.e., SII), included in the NHS-Lung score, might improve the prognostication for combined chemoimmunotherapy. PBC-derived inflammatory indexes and related scores represent accurate, reproducible and non-expensive prognostic tools with clinical and research utility.
PURPOSE OF REVIEW: To describe the biological rationale of peripheral blood cells (PBC)-derived inflammatory indexes and assess the related prognostic scores for patients with advanced non-small cell lung cancer (aNSCLC) treated with immune-checkpoint inhibitors (ICI). RECENT FINDINGS: Inflammatory indexes based on PBC may indicate a pro-inflammatory condition affecting the immune response to cancer. The lung immune prognostic index (LIPI), consisting of derived neutrophils-to-lymphocyte ratio (NLR) and lactate dehydrogenase, is a validated prognostic tool, especially for pretreated aNSCLC patients, where the combination of NLR and PD-L1 tumour expression might also be predictive of immunotherapy benefit. In untreated high-PD-L1 aNSCLC patients, the Lung-Immune-Prognostic score (LIPS), including NLR, ECOG PS and concomitant steroids, is prognostic, and its modified version might indicate patients with favourable outcomes despite an ECOG PS of 2. NLR times platelets (i.e., SII), included in the NHS-Lung score, might improve the prognostication for combined chemoimmunotherapy. PBC-derived inflammatory indexes and related scores represent accurate, reproducible and non-expensive prognostic tools with clinical and research utility.