Background: The Scottish Inflammatory Prognostic Score (SIPS), combining albumin (≥/<35 g/L) and neutrophil count (≤/>7.5 × 109/L), has been identified as a prognostic biomarker for patients with non-small cell lung cancer (NSCLC) undergoing treatment with pembrolizumab monotherapy. We sought to validate this biomarker of systemic inflammation in an external cohort. Methods: Patients treated with first-line pembrolizumab for advanced NSCLC with programmed death-ligand 1 (PD-L1) expression ≥ 50% at an English cancer centre were identified. Pre-treatment clinicopathological characteristics and the SIPS were recorded. The relationship between these and progression-free survival (PFS) and overall survival (OS) was examined. Results: Among 257 patients evaluated, 56% (n= 144) were classified as SIPS 0, 36% (n= 93) as SIPS 1, and 8% (n= 20) as SIPS 2. Factors such as age, performance status (PS) and brain metastases presence were significantly correlated with SIPS categories. Multivariate analysis revealed that both SIPS and PD-L1 status were independently associated with PFS and OS. The combination of SIPS with either PS or PD-L1 expression enhanced the ability to detect patients with the most favourable or poorest survival. Conclusions: Our study confirms the prognostic significance of the SIPS in patients with advanced NSCLC treated with pembrolizumab in the context of high PD-L1 expression. SIPS offers a straightforward, clinically applicable approach to patient stratification, potentially guiding therapeutic decisions and enhancing outcomes in advanced NSCLC. Future research should focus on validating these findings in prospective studies and exploring the integration of SIPS into clinical practice, alongside other prognostic markers, to optimize treatment strategies.
背景：苏格兰炎症预后评分（SIPS）结合了白蛋白水平（≥/<35 g/L）和中性粒细胞计数（≤/>7.5 × 10⁹/L），已被确定为接受帕博利珠单抗单药治疗的非小细胞肺癌（NSCLC）患者的预后生物标志物。本研究旨在外部队列中验证这一全身性炎症生物标志物。方法：我们纳入了一家英国癌症中心收治的程序性死亡配体-1（PD-L1）表达≥50%且接受一线帕博利珠单抗治疗的晚期NSCLC患者。记录治疗前的临床病理特征及SIPS评分，并分析其与无进展生存期（PFS）和总生存期（OS）的关系。结果：在评估的257例患者中，56%（n=144）为SIPS 0，36%（n=93）为SIPS 1，8%（n=20）为SIPS 2。年龄、体能状态（PS）和脑转移等因素与SIPS分级显著相关。多变量分析显示，SIPS和PD-L1状态均与PFS和OS独立相关。将SIPS与PS或PD-L1表达结合，可增强识别生存结局最佳或最差患者的能力。结论：本研究证实了在高PD-L1表达背景下，SIPS对接受帕博利珠单抗治疗的晚期NSCLC患者具有预后意义。SIPS提供了一种简单、临床适用的患者分层方法，可能指导治疗决策并改善晚期NSCLC的预后。未来研究应侧重于在前瞻性研究中验证这些发现，并探索将SIPS与其他预后标志物结合应用于临床实践，以优化治疗策略。
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