Author of

• 35152

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  P18 - Locoregional and Oligometastatic Disease - Misc. Topics (ID 128)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Locoregional and Oligometastatic Disease
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35153

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    P18.01 - Prognostic Value of the LIPI in Patients with LA-NSCLC Receiving Definitive RT: A Retrospective Study of 1079 Patients (ID 1898)

    00:00 - 00:00  |  Presenting Author(s): Wenji Xue
    • Abstract
    • Slides

    Introduction
    

    Previous study demonstrated that the baseline lung immune prognostic index (LIPI) was a potential biomarker which can identify advanced non-small cell lung cancer (NSCLC) patients who will benefit from treatment with immune checkpoint inhibitor (ICI). However, a recent study found that the LIPI might be an important prognostic biomarker irrespective of treatment modality for patients with metastatic NSCLC. It remains unclear whether LIPI is associated with long-term outcomes in unresected stage III NSCLC.

    Methods
    

    Patients with LA-NSCLC treated with definitive radiotherapy (RT) between 2000 to 2017 were retrospectively reviewed. The pretreatment derived neutrophils/ (leukocytes minus neutrophils) ratio (dNLR) and lactate dehydrogenase (LDH) made up the LIPI and divided it into two groups (good, 0 score; poor, 1 to 2 scores). Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) were calculated from the date of diagnosis. Kaplan-Meier method and Cox hazards regression analysis were used to explore associations between the LIPI and LA-NSCLC prognosis. Propensity score matching (PSM) was conducted to balance the confounding variables.

    Results
    

    A total of 1079 patients were eligible for analysis. Patients with a poor pretreatment LIPI had significantly inferior OS, PFS, LRRFS, and DMFS than those with a good LIPI (median OS, 19.0 vs 25.0 months, Log-rank P < 0.001; median PFS, 10.0 vs 13.0 months, Log-rank P = 0.001; median LRRFS, 13.0 vs 18.0 months, Log-rank P < 0.001; median DMFS, 15.0 vs 17.0 months, Log-rank P = 0.002). According to multivariate analysis, it was also found that the LIPI was an independent prognostic marker for OS (P = 0.026, HR = 1.19, 95% CI: 1.02-1.40), PFS (P = 0.024, HR = 1.18, 95% CI: 1.02-1.36), and LRRFS (P = 0.009, HR = 1.22, 95% CI: 1.05-1.41) in patients with inoperable LA-NSCLC. PSM analysis further verified that poor LIPI was an independent prognostic factor for shorter survivals (OS, PFS, and LRRFS). In subgroup analyses, the poor LIPI was remained significantly associated with increased risks of death in male patients (HR = 1.44, 95% CI: 1.22-1.69), who had smoking history (HR = 1.40, 95% CI: 1.18-1.65), with KPS ≥ 80 (HR = 1.32, 95% CI: 1.12-1.57). Similar results were also observed in PFS except for the subgroup of histological type and era of diagnosis.

    Conclusion
    

    To our knowledge, this study first revealed that the LIPI is a simple and promising prognostic marker for patients with unresectable LA-NSCLC. Further prospected studies are warranted to validate these findings.

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