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Combination of Baseline and Variation of Prognostic Nutritional Index Enhances the Survival Predictive Value of Patients With Advanced Non-Small Cell Lung Cancer Treated With Programmed Cell Death Protein 1 Inhibitor.
- Source :
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Clinical Medicine Insights: Oncology . 11/14/2022, p1-12. 12p. - Publication Year :
- 2022
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Abstract
- Background: Low baseline prognostic nutritional index (PNI) scores are associated with poor survival for various malignancies; however, they vary based on the cohort and time resulting in inaccurate results. We determined the predictive value of the PNI score variations in addition to the baseline PNI scores for patients with advanced non-small cell lung cancer (NSCLC) who received programmed cell death protein 1 (PD-1) inhibitor. Methods: We retrospectively analysed 115 patients with advanced NSCLC who received PD-1 inhibitor. The median follow-up period was 28 months. Patients were clustered into four groups based on the combined PNI scores (combination of baseline and variation of PNI scores): ΔPNI-L-L, ΔPNI-L-H, ΔPNI-H-L, and ΔPNI-H-H subgroups. For instance, if PNI scores of patients with high baseline PNI score increased from baseline to 6 weeks after treatment, they were included in the ΔPNI-H-H subgroup. Cox regression models were used to identify the factors associated with survival. Results: The baseline PNI score was only related to the overall survival (OS) (P =.026), and not to the overall response rate (ORR) (P =.299) and progression-free survival (PFS) (P =.207). The ORR was associated with the combined PNI scores (P =.017). A multivariable Cox regression analysis confirmed that the combined PNI scores were independent factors for PFS (ΔPNI-L-H, 12 months, hazard ratio [HR] = 0.449, P =.009; ΔPNI-H-L, 14 months, HR = 0.500, P =.019; and ΔPNI-H-H, 17 months, HR = 0.390, P =.012; vs ΔPNI-L-L, 8 months) and OS (ΔPNI-L-H, 27 months, HR = 0.403, P =.019; ΔPNI-H-L, 28 months, HR = 0.369, P =.010; and ΔPNI-H-H, not reached, HR = 0.087, P =.002; vs ΔPNI-L-L, 15 months). Conclusions: Patients with high baseline PNI and increased PNI score had the better survival outcome. On dynamic monitoring and comprehensive assessment, the combined PNI scores significantly enhanced the survival predictive ability of patients with NSCLC treated with PD-1 inhibitor. [ABSTRACT FROM AUTHOR]
- Subjects :
- *LUNG cancer prognosis
*LUNG cancer
*PROGRAMMED cell death 1 receptors
*CONFIDENCE intervals
*RETROSPECTIVE studies
*FISHER exact test
*TUMOR classification
*CANCER patients
*T-test (Statistics)
*SURVIVAL analysis (Biometry)
*DESCRIPTIVE statistics
*CHI-squared test
*KAPLAN-Meier estimator
*DATA analysis software
Subjects
Details
- Language :
- English
- ISSN :
- 11795549
- Database :
- Academic Search Index
- Journal :
- Clinical Medicine Insights: Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 160239593
- Full Text :
- https://doi.org/10.1177/11795549221137134