The prognostic significance of early changes in the lung immune prognostic index in patients treated with immunotherapy for advanced-stage lung cancer.

BACKGROUND/OBJECTIVES: Immune checkpoint inhibitors are frequently used to treat advanced non-small cell lung cancer (NSCLC). Drug clearance also varies depending on patient-related factors. Therefore, the lung immune prognostic index (LIPI), based on inflammatory markers, may help predict prognosis. Early changes in LIPI may predict treatment response and survival. METHODS: This multicenter study included 707 patients with NSCLC. LIPI was calculated at baseline and one month after treatment initiation. Patients were categorized into two groups: those with stable or improved LIPI scores and those with worsened LIPI scores. Survival outcomes and prognostic significance were analyzed. RESULTS: Median progression free survival was 9 months in patients with stable or improved LIPI and 6 months in those with worsened LIPI (p = 0.005). Median overall survival was 15 months in the stable/improved LIPI group and 9 months in the worsened LIPI group (p = 0.001). CONCLUSION: Changes in LIPI can be assessed using routine laboratory tests as early as the second treatment cycle, allowing early prediction of treatment response. Baseline LIPI values and changes in LIPI can predict prognosis.