Prognostic Value of the Lung Immune Prognostic Index for Metastatic Non-Small Cell Lung Cancer Patients: A Chinese Cohort Study

Figures & data

Table 1 Characteristics of Baseline in 350 Patients with mNSCLC

Variable, N (%)	ICIs Set (N=147)	TT Set (N=103)	CCT Set (N=100)	P value
Age, y,				0.115
<65	104 (70.75%)	68 (66.02%)	79 (79.00%)
≥65	43 (29.25%)	35 (33.98%)	21 (21.00%)
Sex				<0.001
Female	24 (16.33%)	58 (56.31%)	37 (37.00%)
Male	123 (83.67%)	45 (43.69%)	63 (63.00%)
Performance status				<0.001
<2	92 (62.59%)	94 (91.26%)	96 (96.00%)
≥2	55 (37.41%)	9 (8.74%)	4 (4.00%)
Smoking history				<0.001
Nonsmoker	60 (40.82%)	77 (74.76%)	59 (59.00%)
Smoker	87 (59.18%)	26 (25.24%)	41 (41.00%)
Stage				<0.001
Stage of I–III	38 (25.85%)	0 (0.00%)	0 (0.00%)
Stage of IV	109 (74.15%)	103 (100.00%)	100 (100.00%)
Histologic subtype				<0.001
Non squamous	85 (57.82%)	99 (96.12%)	85 (85.00%)
Squamous	62 (42.18%)	4 (3.88%)	15 (15.00%)
Gene Status				<0.001
Negative	129 (87.76%)	26 (25.24%)	100 (100.00%)
Positive	18 (12.24%)	77 (74.76%)	0 (0.00%)
White Blood Cell Count				0.376
Normal (3.5–9.5)	111 (75.51%)	85 (82.52%)	76 (76.00%)
Abnormal	36 (24.49%)	18 (17.48%)	24 (24.00%)
Lymphocyte Count				<0.001
Normal (1.1–3.2)	92 (62.59%)	83 (80.58%)	87 (87.00%)
Abnormal	55 (37.41%)	20 (19.42%)	13 (13.00%)
Neutrophil Count				0.169
Normal (1.8–6.3)	91 (61.90%)	75 (72.82%)	63 (63.00%)
Abnormal	56 (38.10%)	28 (27.18%)	37 (37.00%)
Albumin				0.684
≥35 g/L	132 (89.80%)	94 (91.26%)	93 (93.00%)
<35 g/L	15 (10.20%)	9 (8.74%)	7 (7.00%)
LDH				0.044
≤ULN (245 U/L)	96 (65.31%)	65 (63.11%)	78 (78.00%)
>ULN	51 (34.69%)	38 (36.89%)	22 (22.00%)
dNLR				0.896
≥3	108 (73.47%)	76 (73.79%)	76 (76.00%)
<3	39 (26.53%)	27 (26.21%)	24 (24.00%)
LIPI groups				0.151
Good	71 (48.30%)	50 (48.54%)	63 (63.00%)
Intermediate	62 (42.18%)	41 (39.81%)	28 (28.00%)
Poor	14 (9.52%)	12 (11.65%)	9 (9.00%)

Abbreviations: ICIs, immune checkpoint inhibitors; TT, targeted therapy; CCT, cytotoxic chemotherapy; LDH, Lactate Dehydrogenase; ULN, upper limit of normal; dNLR, absolute neutrophil count/[white blood cell count-absolute neutrophil count]; LIPI, lung immune prognostic index.

Table 2 Univariable Analyses of Progression-Free Survival (PFS)

Variable	Hazard Ratio (95% CI)
	ICIs Set (n=147)	TT Set (n=103)	CCT Set (n=100)
Age, y
<65	1[Reference]	1[Reference]	1[Reference]
≥65	1.36 (0.93, 1.97)	0.90 (0.56, 1.46)	0.68 (0.40, 1.15)
P value	0.112	0.678	0.152
Sex
Female	1[Reference]	1[Reference]	1[Reference]
Male	1.25 (0.78, 2.01)	0.96 (0.62, 1.50)	1.20 (0.79, 1.82)
P value	0.358	0.872	0.392
Performance status
<2	1[Reference]	1[Reference]	1[Reference]
≥2	1.60 (1.13, 2.29)	1.15 (0.52, 2.56)	1.24 (0.45, 3.40)
P value	0.009	0.732	0.675
Smoking history
Nonsmoker	1[Reference]	1[Reference]	1[Reference]
Smoker	1.23 (0.86, 1.76)	0.88 (0.53, 1.45)	0.94 (0.62, 1.43)
P value	0.257	0.607	0.786
Histologic subtype
Non squamous	1[Reference]	1[Reference]	1[Reference]
Squamous	1.18 (0.83, 1.67)	2.24 (0.54, 9.28)	0.96 (0.54, 1.71)
P value	0.367	0.265	0.890
Gene Status
Negative	1[Reference]	1[Reference]	1[Reference]
Positive	1.18 (0.71, 1.98)	0.73 (0.44, 1.22)	NA
P value	0.525	0.226
White Blood Count
Normal (3.5–9.5)	1[Reference]	1[Reference]	1[Reference]
Abnormal	0.83 (0.55, 1.24)	0.76 (0.42, 1.36)	1.73 (1.08, 2.78)
P value	0.363	0.355	0.023
Lymphocyte Count
Normal (1.1–3.2×10^9/L)	1[Reference]	1[Reference]	1[Reference]
Abnormal	0.69 (0.48, 1.00)	1.17 (0.68, 2.01)	1.47 (0.81, 2.66)
P value	0.051	0.582	0.207
Neutrophil Count
Normal (1.8–6.3)	1[Reference]	1[Reference]	1[Reference]
Abnormal	0.63 (0.44, 0.92)	0.71 (0.42, 1.21)	1.87 (1.22, 2.87)
P value	0.015	0.206	0.004
Albumin
≥35 g/L	1[Reference]	1[Reference]	1[Reference]
<35 g/L	1.39 (0.78, 2.48)	0.47 (0.17, 1.32)	1.83 (0.83, 3.99)
P value	0.260	0.151	0.132
LDH
≤ULN (245 U/L)	1[Reference]	1[Reference]	1[Reference]
>ULN	1.31 (0.91, 1.88)	1.58 (0.99, 2.53)	1.97 (1.20, 3.22)
P value	0.144	0.055	0.007
dNLR
≥3	1[Reference]	1[Reference]	1[Reference]
<3	0.94 (0.64, 1.39)	1.28 (0.77, 2.13)	1.79 (1.10, 2.90)
P value	0.765	0.344	0.018
LIPI group
Poor	1[Reference]	1[Reference]	1[Reference]
Intermediate	0.92 (0.49, 1.73)	0.41 (0.19, 0.88)	0.73 (0.35, 1.56)
P value	0.802	0.023	0.422
Good	0.81 (0.44, 1.51)	0.35 (0.16, 0.74)	0.39 (0.19, 0.80)
P value	0.510	0.006	0.010

Table 3 Multivariable Analyses of Progression-Free Survival

Variable	Hazard Ratio (95% CI)	Hazard Ratio (95% CI)	Hazard Ratio (95% CI)
	ICIs (n=147)	TT (n=103)	CCT (n=100)
Age, y
<65	1[Reference]	1[Reference]	1[Reference]
≥65	0.95 (0.58–1.56)	0.82 (0.49–1.36)	0.75 (0.42–1.32)
P value	0.842	0.434	0.317
Sex
Female	1[Reference]	1[Reference]	1[Reference]
Male	1.21 (0.66–2.21)	0.85 (0.44–1.64)	1.48 (0.81–2.70)
P value	0.543	0.625	0.198
Performance status
<2	1[Reference]	1[Reference]	1[Reference]
≥2	1.56 (1.01–2.43)	1.78 (0.51–6.16)	1.86 (0.66–5.30)
P value	0.047	0.363	0.243
Smoking history
Nonsmoker	1[Reference]	1[Reference]	1[Reference]
Smoker	1.06 (0.67–1.68)	0.97 (0.46–2.06)	0.74 (0.41–1.31)
P value	0.800	0.944	0.300
Histologic subtype
Non squamous	1[Reference]	1[Reference]	1[Reference]
Squamous	1.06 (0.72–1.55)	0.687 (0.09–5.03)	1.06 (0.55–2.04)
P value	0.78	0.712	0.866
White Blood Count
Normal (3.5–9.5)	1[Reference]	1[Reference]	1[Reference]
Abnormal	0.90 (0.58–1.40)	0.87 (0.42–1.80)	1.58 (0.92–2.70)
P value	0.643	0.701	0.096
Albumin
≥35 g/L	1[Reference]	1[Reference]	1[Reference]
<35 g/L	1.15 (0.58–2.28)	0.21 (0.05–0.95)	2.09 (0.93–4.67)
P value	0.699	0.042	0.073
LDH
≤ULN (245 U/L)	1[Reference]	1[Reference]	1[Reference]
>ULN	1.29 (0.89–1.87)	1.58 (0.96–2.60)	1.97 (1.18–3.28)
P value	0.177	0.072	0.009
dNLR
≥3	1[Reference]	1[Reference]	1[Reference]
<3	1.02 (0.65–1.58)	1.81 (0.96–3.43)	1.33 (0.78–2.26)
P value	0.943	0.067	0.301

Table 4 Adjusted Hazard Ratios of Progression-Free Survival by LIPI

Variable	ICIs	P value	TT	P value	CCT	P value
	Hazard Ratio (95% CI)		Hazard Ratio (95% CI)		Hazard Ratio (95% CI)
Model 1
LIPI
LIPI=2	1[Reference]		1[Reference]		1[Reference]
LIPI=1	0.92 (0.49, 1.73)	0.802	0.41 (0.19, 0.88)	0.023	0.73 (0.35, 1.56)	0.422
LIPI=0	0.81 (0.44, 1.51)	0.510	0.35 (0.16, 0.74)	0.006	0.39 (0.19, 0.80)	0.010
Model 2
LIPI
LIPI=2	1[Reference]		1[Reference]		1[Reference]
LIPI=1	1.02 (0.54, 1.92)	0.959	0.40 (0.18, 0.89)	0.025	0.81 (0.38, 1.75)	0.594
LIPI=0	0.81 (0.43, 1.51)	0.509	0.34 (0.16, 0.74)	0.006	0.43 (0.21, 0.89)	0.023
Model 3
LIPI
LIPI=2	1[Reference]		1[Reference]		1[Reference]
LIPI=1	1.12 (0.66, 2.45)	0.959	0.31 (0.17, 0.92)	0.034	1.24 (0.49, 4.55)	0.867
LIPI=0	0.52 (0.15, 1.57)	0.253	0.20 (0.10, 0.92)	0.047	0.82 (0.11, 4.97)	0.921

Notes: Model 1 was unadjusted. Model 2 was adjusted for age (<65 vs ≥65), and sex (male vs female). Model 3 was adjusted for age (<65 vs ≥65), sex (male vs female), performance status (<2 vs ≥2), Smoking history (nonsmoker vs smoker), histologic subtype (nonsquamous vs squamous), white Blood Count (normal vs abnormal), Albumin (≥35 g/L vs <35 g/L), LDH (≥ULN (245 U/L vs <ULN)), dNLR (≥3 vs <3).

Figure 1 Progression-free survival based on LIPI score and treatment. (A) PFS according to LIPI groups in the ICIs set; (B) PFS according to LIPI groups in the TT set; (C) PFS according to LIPI groups in the CCT set; LIPI, lung immune prognostic index.