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. 2019 Oct;7(20):572.
doi: 10.21037/atm.2019.09.18.

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

Rossana Berardi  1 , Matteo Santoni  1 , Silvia Rinaldi  1 , Marc Bower  2 , Michela Tiberi  3 , Francesca Morgese  1 , Miriam Caramanti  1 , Agnese Savini  1 , Consuelo Ferrini  1 , Mariangela Torniai  1 , Ilaria Fiordoliva  1 , Thomas Newsom-Davis  2
Affiliations

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

Rossana Berardi et al. Ann Transl Med. 2019 Oct.

Abstract

Background: 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).

Methods: 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) vs. 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.

Results: 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.

Conclusions: Pre-treatment SII is an independent prognostic factor for patients with advanced NSCLC treated with first-line therapies.

Keywords: Lung cancer; platinum-base chemotherapy; prognosis; systemic immune-inflammation index; targeted therapy.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
OS (A) and PFS (B) stratified by Systemic Immune-Inflammation Index (SII) in patients treated with first-line therapy for locally advanced or metastatic NSCLC. NSCLC, non-small cell lung cancer; PFS, progression free survival; OS, overall survival.
Figure 2
Figure 2
Prognostic models for OS (A) and PFS (B) in patients treated with first-line therapy for locally advanced or metastatic NSCLC. NSCLC, non-small cell lung cancer; PFS, progression free survival; OS, overall survival.
See this image and copyright information in PMC

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