Pre-treatment systemic immune-inflammation represents a prognostic factor in patients with advanced non-small cell lung cancer

• Published in: Annals of translational medicine Vol. 7; no. 20; p. 572
• Main Authors: Berardi, Rossana, Santoni, Matteo, Rinaldi, Silvia, Bower, Marc, Tiberi, Michela, Morgese, Francesca, Caramanti, Miriam, Savini, Agnese, Ferrini, Consuelo, Torniai, Mariangela, Fiordoliva, Ilaria, Newsom-Davis, Thomas
• Format: Journal Article
• Language: English
• Published: China AME Publishing Company 01.10.2019
• Subjects: Original; systemic immune-inflammation index; targeted therapy; platinum-base chemotherapy; prognosis; Lung cancer
• ISSN: 2305-5839; 2305-5839
• DOI: 10.21037/atm.2019.09.18

Inflammation plays an important role in pathogenesis, development and progression of lung cancer. The aim of the study is to assess the prognostic role of Systemic Immune-Inflammation Index (SII), obtained by analyzing the neutrophil, lymphocyte and platelet counts, and to design prognostic models for patients receiving first-line chemo- or targeted therapy for advanced non-small cell lung cancer (NSCLC). We conducted an analysis on 311 patients with advanced NSCLC, treated with first line chemo- or targeted therapy till June 2015 at our Institution. Patients were stratified in two groups with SII ≥1,270 (Group A) SII <1,270 (Group B). Progression free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier method. The best SII cutoff was identified by X-tiles program. A Cox regression model was carried out for univariate and multivariate analyses. At baseline, 179 patients had SII ≥1,270 (Group A), whilst 132 had lower SII (Group B). The median OS was 12.4 months in Group A and 21.7 months in Group B (P<0.001), whilst the median PFS was 3.3 and 5.2 months, respectively (P=0.029). At multivariate analysis, male gender, ECOG-PS ≥2 and SII >1,270 were predictors of worst OS, whilst IV tumor stage was only slightly significant (P=0.08). Otherwise, only wild-type EGFR status and SII ≥1,270 were independent prognostic factors for worst PFS. Pre-treatment SII is an independent prognostic factor for patients with advanced NSCLC treated with first-line therapies.