Low Prognostic Nutritional Index Correlates with Worse Survival in Patients with Advanced NSCLC following EGFR-TKIs

• Published in: PloS one Vol. 11; no. 1; p. e0147226
• Main Authors: Sheng, Jin, Yang, Yun-Peng, Ma, Yu-Xiang, Qin, Tao, Hu, Zhi-Huang, Hong, Shao-Dong, Zhou, Ting, Huang, Yan, Zhao, Hong-Yun, Zhang, Li
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.01.2016; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; c-Met protein; C-reactive protein; Cancer patients; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Cell number; Collaboration; Correlation; Development and progression; Dosage and administration; Drug therapy; Enzyme inhibitors; Epidermal growth factor; Epidermal growth factor receptors; ErbB Receptors - antagonists & inhibitors; Female; Food and nutrition; Humans; Inflammation; Laboratories; Lung cancer; Lung cancer, Non-small cell; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lymphocytes; Male; Medical prognosis; Medicine; Metastasis; Middle Aged; Multivariate analysis; Mutation; Neoplasm Staging; Non-small cell lung carcinoma; Nutrition Assessment; Nutritional Status; Oncology; Patient outcomes; Patients; Pilot Projects; Prognosis; Protein Kinase Inhibitors - therapeutic use; Protein-tyrosine kinase; Quality of life; Retrospective Studies; Serum albumin; Survival; Survival Rate; Tyrosine; China
• DOI: 10.1371/journal.pone.0147226
• ISSN: 1932-6203

This study was designed to demonstrate the prognostic value of prognostic nutritional index (PNI), a reflection systemic immunonutritional status, on the long-term survival of patients taking epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs). In this retrospective study, eligible advanced NSCLC patients with sensitive EGFR mutations (exon 19 deletion or L858R in exon 21) were included to investigate the correlation between the PNI and overall survival (OS). The PNI was calculated as 10 x serum albumin value (g/dl) + 0.005 x peripheral lymphocyte count (per mm3). The prognostic significance of PNI and other clinicopathologic factors was identified by univariate and multivariate analysis. Finally, 144 patients met the inclusion criteria. The optimal cut-off value of PNI for survival stratification was 48.78. Compared with high PNI group (n = 81), low PNI (n = 63) was significantly associated with elevated C-reactive protein (CRP) level and non-response to TKIs. Overall survival was superior in the high PNI group (HR, 0.44, p = 0.004), especially for patient with L858R (HR, 0.37, p = 0.009) rather than 19 deletion (HR, 0.69, p = 0.401). The independent prognostic value of PNI was validated by multivariate analysis. This pilot investigation demonstrated that low prognostic nutritional index correlates with worse survival for patients with advanced NSCLC and taking EGFR-TKIs. The assessment of a convenient index, known as PNI, worth attention in routine clinical practice for patients following EGFR-TKIs treatment.