Back to Search
Start Over
Development and validation of a new tool to estimate early mortality in patients with advanced cancer treated with immunotherapy.
- Source :
-
Cancer immunology, immunotherapy : CII [Cancer Immunol Immunother] 2024 Oct 03; Vol. 73 (12), pp. 246. Date of Electronic Publication: 2024 Oct 03. - Publication Year :
- 2024
-
Abstract
- Background: Immune checkpoint inhibitors (ICIs) are standard treatments for advanced solid cancers. Resistance to ICIs, both primary and secondary, poses challenges, with early mortality (EM) within 30-90 days indicating a lack of benefit. Prognostic factors for EM, including the lung immune prognostic index (LIPI), remain underexplored.<br />Methods: We performed a retrospective, observational study including patients affected by advanced solid tumors, treated with ICI as single agent or combined with other agents. Logistic regression models identified factors associated with EM and 90-day progression risks. A nomogram for predicting 90-day mortality was built and validated within an external cohort.<br />Results: In total, 637 patients received ICIs (single agent or in combination with other drugs) for advanced solid tumors. Most patients were male (61.9%), with NSCLC as the prevalent tumor (61.8%). Within the cohort, 21.3% died within 90 days, 8.4% died within 30 days, and 34.5% experienced early progression. Factors independently associated with 90-day mortality included ECOG PS 2 and a high/intermediate LIPI score. For 30-day mortality, lung metastasis and a high/intermediate LIPI score were independent risk factors. Regarding early progression, high/intermediate LIPI score was independently associated. A predictive nomogram for 90-day mortality combining LIPI and ECOG PS achieved an AUC of 0.76 (95% CI 0.71-0.81). The discrimination ability of the nomogram was confirmed in the external validation cohort (nā=ā255) (AUC 0.72, 95% CI 0.64-0.80).<br />Conclusion: LIPI and ECOG PS independently were able to estimate 90-day mortality, with LIPI also demonstrating prognostic validity for 30-day mortality and early progression.<br /> (© 2024. The Author(s).)
Details
- Language :
- English
- ISSN :
- 1432-0851
- Volume :
- 73
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Cancer immunology, immunotherapy : CII
- Publication Type :
- Academic Journal
- Accession number :
- 39358642
- Full Text :
- https://doi.org/10.1007/s00262-024-03836-w