NRS2002 score as a prognostic factor in solid tumors treated with immune checkpoint inhibitor therapy: a real-world evidence analysis

Figures & data

Table 1. Clinical characteristics of 341 patients with different nutritional risks.

Clinical characteristics	NRS2002 ≥ 3 n(%)	NRS2002 0–2 n(%)	P-value
Age (years)			.001
≤65	23(31.94)	148(55.02)
>65	49(68.06)	121(44.98)
Gender			.743
Male	55(76.39)	198(73.61)
Female	17(23.61)	71(26.39)
PS*			.078
0	8(11.11)	57(21.19)
1–2	64(88.89)	212(78.81)
NPS**			.003
1	3(4.17)	52(19.33)
2	69(95.83)	217(80.67)
SII***			.117
Low	59(81.94)	241(89.59)
High	13(18.06)	28(10.41)
LCR****
Low	23(31.94)	111(41.26)	.006
High	40(55.56)	95(35.32)
Unknown	9(12.5)	63(23.42)
Primary tumor location			.045
Bladder	1(1.39)	16(5.95)
Breast	2(2.78)	3(1.12)
Cervix	2(2.78)	6(2.23)
Colorectal	6(8.33)	21(7.81)
Easophage	16(22.22)	20(7.43)
Biliary system	3(4.17)	8(2.97)
Gastric	7(9.72)	23(8.55)
Head and neck	1(1.39)	10(3.72)
Liver	4(5.56)	5(1.86)
Lung	20(27.77)	104(38.66)
Multiple primary tumors	6(8.33)	22(8.18)
Other	4(5.56)	27(10.04)
Unknown	0(0)	4(1.48)
Line of thrapy			.537
1	49(68.06)	199(73.98)
2	16(22.22)	45(16.73)
≥3	7(9.72)	25(9.29)
Nutritional Support			<.001
No	31(43.06)	218(81.04)
Yes	41(56.94)	51(18.96)
Comorbidity			.097
No	36(50.00)	166(61.71)
Yes	36(50.00)	103(38.29)

*PS: Performance Status.

**NPS: Naples Prognostic Score.

***SII: System Immune Inflammation Index.

****LCR: Lymphocyte and C-reactive protein ratio.

Figure 1. The Kaplan-Meier curves of PFS (a) and OS (b).

Figure 2. a-j the Kaplan-Meier curves of PFS and OS based on significant clinical factors.

Figure 2. (Contiuned).

Figure 3. a-f the Kaplan-Meier curves of PFS and OS based on different treatment lines.

Table 2. Univariate and multivariate analysis for PFS.

Variable	median PFS(m)(95%CI)	Univariate		Multivariate
		HR(95%CI)	P-value	HR(95%CI)	P-value
Age (years)
≤65	6.2(4.5–7.4)	1		–
>65	5.6(4.5–7.7)	1.07(0.81–1.41)	.653	–	–
Gender
Male	5.6(4.7–7.4)	1		–
Female	5.8(3.4–8.3)	1.03(0.75–1.42)	.836	–	–
PS
0	9.7(6.1-NA)	1		1
1–2	4.9(4.2–6.5)	1.72(1.17–2.52)	.006	1.38(1.03–1.83)	.028
NRS 2002
0–2	6.6(4.9–8.1)	1		1
≥3	2.9(2.0–6.2)	1.82(1.30–2.54)	<.001	1.46(1.08–1.95)	.013
NPS
1	8.2(6.2–13.6)	1		1
2	4.9(4.4–6.8)	1.43 (1.07–1.91)	.016	1.32(0.97–1.80)	.080
SII
Low	6.1(4.7–8.0)	1		–
High	5.6(3.9–7.1)	0.97(0.78–1.20)	.770	–	–
LCR
Low	8.0(6.3–13.6)	1		1
High	4.4(3.3–6.1)	1.27(1.00–1.62)	.048	1.12(0.87–1.44)	.384
Unknown	5.6(3.2–8.2)	0.99(0.74–1.33)	.956	1.08(0.80–1.45)	.627
Line of thrapy
1	7.7(6.6–9.9)	1		1
2	2.5(1.7–3.5)	2.80(1.98–3.96)	<.001	1.91(1.43–2.55)	<.001
≥3	2.2(1.4–4.9)	3.52(2.30–5.38)	<.001	2.10(1.42–3.10)	<.001
Nutritional support
No	6.8(5.8–8.3)	1		1
Yes	2.5(1.9–4.1)	1.60(1.26–2.04)	<.001	1.22(0.92–1.61)	.172
Comorbidity
No	5.8(4.6–7.4)	1		-
Yes	5.0(3.7–8.2)	1.00(0.80–1.24)	.965	-	-

Table 3. Univariate and multivariate analysis for OS.

Variable	median OS(m)(95%CI)	Univariate		Multivariate
		HR(95%CI)	P-value	HR(95%CI)	P-value
Age (years)
≤65	12.0(10.2–16.6)	1		–
>65	12.7(8.6–17.1)	1.02(0.74–1.43)	.892	–	–
Gender
Male	12.4(9.9–14.6)	1		–
Female	15.0(9.7-NA)	0.89(0.61–1.30)	.539	–	–
PS
0	22.9(11.8-NA)	1		1
1–2	11.4(9.6–13)	1.87(1.17–2.98)	.009	1.45(0.89–2.36)	.139
NRS 2002
0–2	14.2(11.8–17.8)	1		1
≥3	4.5(3.0–12.5)	2.49 (1.73–3.59)	<.001	1.61(1.05–2.47)	.028
NPS
1	24.1(10.6-NA)	1		1
2	12.0(8.6–14.2)	2.25 (1.33–3.82)	.003	1.84(1.05–3.23)	.033
SII
Low	12.7(10.7–17.8)	1		–
High	10.6(8.5–14.7)	1.23 (0.88–1.71)	.231	–	–
LCR
Low	16.6(12.7-NA)	1		1
High	9.6(7.1–12.7)	1.67(1.14–2.43)	.008	1.30(0.88–1.93)	.193
Unknown	11.8(9.7–22.9)	1.24(0.78–1.95)	.365	1.40(0.88–2.22)	.156
Line of thrapy
1	14.9(12.7–24.6)	1		1
2	6.3(4.0–8.2)	3.04(2.05–4.51)	<.001	3.40(2.27–5.09)	<.001
≥3	4.1(2.9–10.6)	3.38(2.12–5.39)	<.001	3.07(1.89–4.99)	<.001
Nutritional support
No	14.9(12.7–24.1)	1		1
Yes	4.1(3.1–8.6)	3.01 (2.15–4.21)	<.001	1.81(1.21–2.70)	.004
Comorbidity
No	12.6(10.6–18.0)	1		–
Yes	12.0(8.2–14.9)	1.25(0.90–1.74)	.185	–	–

Table 4. Objective response of ICI treatment among different nutritional risk groups.

Objective response	Total(n)	NRS2002 ≥ 3 n(%)	NRS2002 0–2 n(%)	p-Value
CR	3	0(0)	3(1.12)	.104
PR	56	6(8.33)	50(18.59)
NonCR/nonPD	88	22(30.56)	66(24.54)
SD	84	14(19.44)	70(26.02)
PD	110	30(41.67)	80(29.73)
ORR(CR+PR)	59	6(8.33)	53(19.71)	.037

Data availability statement

The data in this study can be obtained from the corresponding author’s e-mail address ([email protected]).