World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website https://www.wjon.org

Original Article

Volume 15, Number 2, April 2024, pages 223-238


Predictors of Immunotherapy Efficacy in Metastatic Non-Small Cell Lung Cancer: Lung Immune Prognostic Index and Immune-Related Toxicity

Figures

Figure 1.
Figure 1. Disease response rate according to appearance of irAEs for patients with first- and second-line treatment. irAEs: immune-related adverse events.
Figure 2.
Figure 2. Disease response rate according to histology and appearance of irAEs. irAEs: immune-related adverse events.
Figure 3.
Figure 3. Frequency of appearance of irAEs according to disease reassessment. irAEs: immune-related adverse events.
Figure 4.
Figure 4. PFS (a) and OS (b) according to appearance of irAEs. irAEs: immune-related adverse events; OS: overall survival; PFS: progression-free survival.
Figure 5.
Figure 5. Frequency of occurrence of toxicity according to LIPI (a), and LIPI and treatment (b). LIPI: lung immune prognostic index.
Figure 6.
Figure 6. Response rate according to LIPI three subgroups (a), and two subgroups (b). LIPI: lung immune prognostic index.
Figure 7.
Figure 7. Response rate according to ICI and LIPI three subgroups (a), and two subgroups (b). ICI: immune checkpoint inhibitor; LIPI: lung immune prognostic index.
Figure 8.
Figure 8. Probability of remission study according to LIPI. LIPI: lung immune prognostic index.
Figure 9.
Figure 9. PFS according to LIPI three subgroups (a), and LIPI two subgroups (b). LIPI: lung immune prognostic index; PFS: progression-free survival.
Figure 10.
Figure 10. OS according to LIPI three subgroups (a), and LIPI two subgroups (b). LIPI: lung immune prognostic index; OS: overall survival.

Tables

Table 1. General Characteristics According to LIPI
 
All (N = 168)Good (N = 82)Intermediate (N = 73)Poor (N = 13)P overall
Means (standard deviation) for continuous variables and number of cases (%) for categorical variables. Comparisons between groups are made using ANOVA (continuous variables) and Chi-square with Yates correction (categorical variables). ANOVA: analysis of variance; CR: complete response; LDH: lactate dehydrogenase; LIPI: lung immune prognostic index; NE: not evaluated; NLR: neutrophil-to-lymphocyte ratio; PD: progressive disease; PR: partial response; SD: stable disease.
Age64.3 (9.11)66.0 (8.23)63.5 (9.59)58.2 (8.99)0.009
Sex0.663
  Men130 (77.4%)65 (79.3%)56 (76.7%)9 (69.2%)
  Female38 (22.6%)17 (20.7%)17 (23.3%)4 (30.8%)
Histology0.543
  Adenocarcinoma116 (69%)53 (64.6%)53 (72.6%)10 (76.9%)
  Squamous52 (31%)29 (35.4%)20 (27.4%)3 (23.1%)
Drug0.912
  Atezolizumab41 (24.4%)21 (25.6%)18 (24.7%)2 (15.4%)
  Nivolumab18 (10.7%)9 (11.0%)7 (9.59%)2 (15.4%)
  Pembrolizumab109 (64.9%)52 (63.4%)48 (65.8%)9 (69.2%)
NLR2.46 (1.95)1.68 (0.60)2.68 (1.45)6.18 (4.27)< 0.001
LDH244 (132)179 (25.8)294 (163)359 (143)< 0.001
Response
  CR15 (8.93%)10 (12.2%)4 (5.48%)1 (7.69%)
  PR5 (29.8%)30 (36.6%)17 (23.3%)3 (23.1%)
  SD39 (23.2%)22 (26.8%)15 (20.5%)2 (15.4%)
  PD45 (26.8%)12 (14.6%)28 (38.4%)5 (38.5%)
  NE19 (11.3%)8 (9.76%)9 (12.3%)2 (15.4%)
Progression103 (61.3%)46 (56.1%)46 (63.0%)11 (84.6%)0.135
Death114 (67.9%)46 (56.1%)56 (76.7%)12 (92.3%)0.003
Alive54 (32.1%)36 (43.9%)17 (23.2%)1 (7.7%)

 

Table 2. irAEs and Response Rate According to Histology
 
HistologyToxicityRe-evaluation
CRPRSEPDNE
CR: complete response; irAEs: immune-related adverse events; NE: not evaluated; PD: progressive disease; PR: partial response; SD: stable disease.
AdenocarcinomaYes (77)13312184
No (39)036219
SquamousYes (27)212940
No (25)043126

 

Table 3. Response Rate According to Appearance of irAEs for Patients With First- and Second-Line Treatment
 
First-lineSecond-line
No toxicity (N = 33)Toxicity (N = 62)P overallNo toxicity (N = 31)Toxicity (N = 42)P overall
CR: complete response; irAEs: immune-related adverse events; NE: not evaluated; PD: progressive disease; PR: partial response; SD: stable disease.
Response rate< 0.001< 0.001
CR0 (0.00%)12 (100%)0 (0.00%)3 (100%)
PR5 (14.3%)30 (85.7%)2 (13.3%)13 (86.7%)
SD5 (26.3%)14 (73.7%)4 (20.0%)16 (80.0%)
PD17 (85.0%)3 (15.0%)16 (64.0%)9 (36.0%)
NE6 (66.7%)3 (33.3%)9 (90.0%)1 (10.0%)

 

Table 4. irAEs Profile According to LIPI
 
All (N = 168)Good (N = 82)Intermediate (N = 73)Poor (N = 13)P overall
irAEs: immune-related adverse events; LIPI: lung immune prognostic index.
Toxicity104 (61.9%)61 (74.4%)36 (49.3%)7 (53.8%)0.004
Dermatological
  No142 (84.5%)69 (84.1%)62 (84.9%)11 (84.6%)1.000
  Yes26 (15.5%)13 (15.9)11 (15.1%)2 (15.4%)1.000
Gastrointestinal
  No126 (75.0%)61 (74.4%)55 (75.3%)10 (76.9%)1.000
  Yes42 (25.0%)21 (25.6%)18 (24.7%)3 (23.1%)1.000
Lung
  No152 (90.5%)72 (87.8%)68 (93.2%)12 (92.3%)0.520
  Yes16 (9.5%)10 (12.2%)5 (6.85%)1 (7.7%)0.520
Endocrine
  No111 (66.1%)51 (62.2%)52 (71.2%)8 (61.5%)0.457
  Yes57 (33.9%)31 (37.8%)21 (28.8%)5 (38.5%)0.457
Musculoeskeletal
  No147 (87.5%)71 (86.6%)64 (87.7%)12 (92.3%)1.000
  Yes21 (12.5%)11 (13.4%)9 (12.3%)1 (7.69%)1.000
Renal
  No159 (94.6%)77 (93.9%)69 (94.5%)13 (100%)1.000
  Yes9 (5.4%)5 (6.1%)4 (5.5%)0 (0%)1.000
Neurological
  No163 (97.0%)79 (96.3%)72 (98.6%)12 (92.3%)0.267
  Yes5 (3%)3 (3.7%)1 (1.4%)1 (7.7%)0.267
Hematological
  No161 (96.4%)75 (92.6%)73 (100%)13 (100%)0.039
  Yes6 (3.6%)6 (7.4%)0 (0%)0 (0%)0.039
Cardiovascular
  No161 (95.8%)76 (92.7%)72 (98.6%)13 (100%)0.196
  Yes7 (4.2%)6 (7.3%)1 (1.4%)0 (0%)0.196
Ophthalmological
  No159 (94.6%)79 (96.3%)68 (93.2%)12 (92.3%)0.473
  Yes9 (5.4%)3 (3.7%)5 (6.8%)1 (7.3%)0.473