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Review
. 2022 May 27;14(11):2675.
doi: 10.3390/cancers14112675.

The Association between the Pan-Immune-Inflammation Value and Cancer Prognosis: A Systematic Review and Meta-Analysis

Deniz Can Guven  1 , Taha Koray Sahin  2 , Enes Erul  2 , Saadettin Kilickap  1   3 , Thilo Gambichler  4 , Sercan Aksoy  1
Affiliations
Review

The Association between the Pan-Immune-Inflammation Value and Cancer Prognosis: A Systematic Review and Meta-Analysis

Deniz Can Guven et al. Cancers (Basel). .

Abstract

Background: Prognostic scores derived from the blood count have garnered significant interest as an indirect measure of the inflammatory pressure in cancer. The recently developed pan-immune-inflammation value (PIV), an equation including the neutrophil, platelet, monocyte, and lymphocyte levels, has been evaluated in several cohorts, although with variations in the tumor types, disease stages, cut-offs, and treatments. Therefore, we evaluated the association between survival and PIV in cancer, performing a systematic review and meta-analysis. Methods: We conducted a systematic review from the Pubmed, Medline, and Embase databases to filter the published studies until 17 May 2022. The meta-analyses were performed with the generic inverse-variance method with a random-effects model. Results: Fifteen studies encompassing 4942 patients were included. In the pooled analysis of fifteen studies, the patients with higher PIV levels had significantly increased risk of death than those with lower PIV levels (HR: 2.00, 95% CI: 1.51−2.64, p < 0.001) and increased risk of progression or death (HR: 1.80, 95% CI: 1.39−2.32, p < 0.001). Analyses were consistent across several clinical scenarios, including non-metastatic or metastatic disease, different cut-offs (500, 400, and 300), and treatment with targeted therapy or immunotherapy (p < 0.001 for each). Conclusion: The available evidence demonstrates that PIV could be a prognostic biomarker in cancer. However, further research is needed to explore the promise of PIV as a prognostic biomarker in patients with non-metastatic disease or patients treated without immunotherapy or targeted therapy.

Keywords: PIV; biomarker; cancer; immunotherapy; pan-immune-inflammation value; targeted therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The association between PIV levels and OS (a) and DFS/PFS (b). Lines (○) indicate 95% CIs. Diamond (♦) indicates the pooled effect size.
Figure 2
Figure 2
Subgroup analyses according to disease stage in OS (a) and DFS/PFS (b). Lines (○) indicate 95% CIs. Diamond (♦) indicates the pooled effect size.
Figure 3
Figure 3
Subgroup analyses according to treatment type in OS (a) and DFS/PFS (b). Lines (○) indicate 95% CIs. Diamond (♦) indicates the pooled effect size.
Figure 4
Figure 4
Subgroup analyses according to PIV cut-off in OS (a) and DFS/PFS (b). Lines (○) indicate 95% CIs. Diamond (♦) indicates the pooled effect size.
See this image and copyright information in PMC

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