Introduction: In recent years, several inflammation-related factors and nutritional parameters have been evaluated to develop prognostic scores as potential biomarkers in non-small-cell lung cancer (NSCLC) patients receiving immune checkpoint inhibitors (ICIs). The aim of this study was to retrospectively investigate the prognostic role of the advanced lung cancer inflammation (ALI) index, lung immune prognostic index (LIPI), prognostic nutritional index (PNI) and systemic inflammation score (SIS) in metastatic NSCLC patients receiving ICI alone or in combination with chemotherapy. Methods and patients: We retrospectively included 191 patients with advanced NSCLC who received first-line ICI with or without chemotherapy from 2017 to 2024. The association between pretreatment ALI, LIPI, PNI, and SIS and overall survival (OS) was evaluated using the Kaplan–Meier method and Cox regression models. Results: After a median follow-up of 27.7 months, significantly longer OS was associated with an ALI score > 18 vs. ≤18 (18.0 vs. 7.3 months;p= 0.00111), LIPI score 0 vs. 1 and 2 [18.9 vs. 8.2 and 4.2 months; (p= 0.001)], PNI ≥ 45 vs. <45 (22.7 vs. 9.6 months;p= 0.002), and SIS score 0 vs. 1 and 2 (27.4 vs. 7.1 and 8.6 months, respectively;p< 0.001). The OS benefit was independent of treatment (ICI vs. ICI + chemotherapy). At multivariate analysis, pretreatment albumin was positively associated with OS, while ECOG PS 1 and liver metastases were negatively associated with OS. Conclusions: Inflammatory and nutritional biomarkers such as the ALI, LIPI, PNI, and SIS represent useful tools to prognosticate survival in metastatic lung cancer patients treated with ICI alone or in combination with chemotherapy as first-line.
引言：近年来，多项炎症相关因子与营养参数被用于构建预后评分体系，以探索其作为接受免疫检查点抑制剂（ICIs）治疗的非小细胞肺癌（NSCLC）患者潜在生物标志物的价值。本研究旨在回顾性探讨晚期肺癌炎症指数（ALI）、肺癌免疫预后指数（LIPI）、预后营养指数（PNI）及全身炎症评分（SIS）对接受单药ICI或联合化疗治疗的转移性NSCLC患者的预后意义。方法与患者：我们回顾性纳入2017年至2024年间接受一线ICI单药或联合化疗治疗的191例晚期NSCLC患者。采用Kaplan-Meier法与Cox回归模型评估治疗前ALI、LIPI、PNI及SIS与总生存期（OS）的相关性。结果：中位随访27.7个月后，ALI评分>18分与≤18分（18.0个月 vs 7.3个月；p=0.00111）、LIPI评分0分与1-2分[18.9个月 vs 8.2个月及4.2个月；（p=0.001）]、PNI≥45分与<45分（22.7个月 vs 9.6个月；p=0.002）、SIS评分0分与1-2分（分别为27.4个月 vs 7.1个月及8.6个月；p<0.001）均显示OS存在显著差异。该生存获益与治疗方案（单药ICI vs ICI联合化疗）无关。多变量分析显示，治疗前白蛋白水平与OS呈正相关，而ECOG PS 1分及肝转移与OS呈负相关。结论：ALI、LIPI、PNI及SIS等炎症与营养生物标志物可作为有效工具，用于预测接受一线单药ICI或联合化疗治疗的转移性肺癌患者的生存预后。
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