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2019 ESMO TAT: Predicting Outcomes With Lung Immune Prognostic Index

By: Sarah Campen, PharmD
Posted: Monday, March 4, 2019

The Lung Immune Prognostic Index (LIPI) may be used to stratify patients with some types of metastatic solid tumors into groups that significantly correlate with outcome following treatment with immune checkpoint inhibitors. This association has been demonstrated in patients with head and neck squamous cell carcinoma, non–small cell lung cancer, small cell lung cancer, melanoma, and triple-negative breast cancer. These findings were presented at the 2019 European Society for Medical Oncology (ESMO) International Congress on Targeted Anticancer Therapies (TAT) in Paris (Abstract 30).

LIPI is a score that combines pretreatment-derived neutrophil-to -ymphocyte ratio (dNLR) and lactate dehydrogenase (LDH). “Calculating LIPI prior to starting [immune checkpoint inhibitor] therapy can be useful in identifying patients [who] will not benefit from such a treatment choice,” stated lead author Andrea Varga, MD, senior medical oncologist at Gustave Roussy Cancer Campus, Villejuif, France, and colleagues.

The investigators retrospectively collected dLNR and LDH levels from 360 patients with metastatic disease. The most frequent tumor types were non–small cell lung cancer (14%), colorectal (14%), bladder (13%), renal (8%), breast (7%), head and neck squamous cell carcinoma (7%), and cervical (6%) cancers.

Patients were divided into 3 groups based on their LIPI score: good group (44%), defined as a dNLR less than 3 and normal LDH; intermediate group (44%), with a dNLR less than 3 or an LDH level higher than the upper limit of normal; anda  poor group (11%), with a dNLR greater than 3 and an LDH level higher than the upper limit of normal.

The median overall survival was 17.8 months, 11.68 months, and 3.9 months in the 3 groups, respectively. Progression-free survival was also significantly shorter in the lower dNLR group than in the higher dNLR group.

“Poor LIPI score is associated with a poorer outcome in patients treated with [immune checkpoint inhibitors],” the authors concluded.

Disclosure: The study authors’ disclosure information may be found at ctimeetingtech.com.


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