Cancer treatment and research communications · 2026
Prognostic value of the baseline triglyceride-glucose-body mass index in small cell lung cancer undergoing chemoimmunotherapy: A multicenter retrospective study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Zhu Dongyong, Guo Yusheng, Liu Weiwei, Gong Bingxin, Li Yi, Jiang Shanshan, Li Yuanxi, Miao Lianwei, Li Lingli, Yang Lian
Аннотация
BACKGROUND: The prognostic role of the triglyceride-glucose-body mass index (TyG-BMI), a surrogate marker for insulin resistance, in small cell lung cancer (SCLC) patients treated with immune checkpoint inhibitors remains undefined.
METHODS: In this multicenter retrospective study, SCLC patients who initiated first-line chemoimmunotherapy or chemotherapy alone between March 2015 and December 2023 were enrolled. The association between baseline TyG-BMI index and survival was analyzed using Kaplan-Meier and Cox regression methods. A prognostic nomogram was developed and validated via time-dependent ROC and calibration analyses.
RESULTS: Among 437 patients, a low TyG-BMI index was significantly associated with improved overall survival (OS) in the chemoimmunotherapy cohort (P < 0.001). In the chemotherapy-alone cohort, a high index predicted worse progression-free survival (PFS, P = 0.031). The TyG-BMI index was an independent prognostic factor for both PFS (HR = 1.44, P = 0.005) and OS (HR = 1.42, P = 0.002). The nomogram demonstrated good predictive accuracy for OS (9-18 month AUCs: 0.72-0.73; C-index=0.66, 95 % CI: 0.63-0.69) and was well-calibrated.
CONCLUSION: The baseline TyG-BMI index is a treatment-specific prognostic biomarker. A low index identifies SCLC patients most likely to achieve long-term survival benefit from chemoimmunotherapy, offering a practical tool for risk stratification and therapeutic guidance.
METHODS: In this multicenter retrospective study, SCLC patients who initiated first-line chemoimmunotherapy or chemotherapy alone between March 2015 and December 2023 were enrolled. The association between baseline TyG-BMI index and survival was analyzed using Kaplan-Meier and Cox regression methods. A prognostic nomogram was developed and validated via time-dependent ROC and calibration analyses.
RESULTS: Among 437 patients, a low TyG-BMI index was significantly associated with improved overall survival (OS) in the chemoimmunotherapy cohort (P < 0.001). In the chemotherapy-alone cohort, a high index predicted worse progression-free survival (PFS, P = 0.031). The TyG-BMI index was an independent prognostic factor for both PFS (HR = 1.44, P = 0.005) and OS (HR = 1.42, P = 0.002). The nomogram demonstrated good predictive accuracy for OS (9-18 month AUCs: 0.72-0.73; C-index=0.66, 95 % CI: 0.63-0.69) and was well-calibrated.
CONCLUSION: The baseline TyG-BMI index is a treatment-specific prognostic biomarker. A low index identifies SCLC patients most likely to achieve long-term survival benefit from chemoimmunotherapy, offering a practical tool for risk stratification and therapeutic guidance.