Evaluation of six clinical prognostic scores in NSCLC patients undergoing first line chemoimmunotherapy.
[BACKGROUND] The study aimed to evaluate the effectiveness of six prognostic scores for predicting the outcomes to first-line chemoimmunotherapy (CIT) in non-small cell lung cancer (NSCLC) patients.
- p-value P = 0.003
- 95% CI 11.9-17.1
APA
Sun J, Li D, et al. (2026). Evaluation of six clinical prognostic scores in NSCLC patients undergoing first line chemoimmunotherapy.. Frontiers in immunology, 17, 1695859. https://doi.org/10.3389/fimmu.2026.1695859
MLA
Sun J, et al.. "Evaluation of six clinical prognostic scores in NSCLC patients undergoing first line chemoimmunotherapy.." Frontiers in immunology, vol. 17, 2026, pp. 1695859.
PMID
41782884
Abstract
[BACKGROUND] The study aimed to evaluate the effectiveness of six prognostic scores for predicting the outcomes to first-line chemoimmunotherapy (CIT) in non-small cell lung cancer (NSCLC) patients.
[MATERIALS AND METHODS] NSCLC patients receiving first-line CIT were included. The prognostic scores evaluated were RMH, MDACC, MDACC+NLR, MDA-ICI, LIPI, and GRIm. Survival curves were generated using the Kaplan-Meier method, and univariate and multivariate analyses were conducted via the Cox proportional hazards regression model. The C-index and time-dependent AUC were calculated to comprehensively quantify and compare the predictive performance of each system. The Log-rank test and False Discovery Rate (FDR) correction was employed to compare survival outcomes across different risk groups defined by the six prognostic scoring systems.
[RESULTS] A cohort of 298 NSCLC patients was analyzed. The median overall survival (mOS) of patients receiving first-line CIT was 36.5 months (95%CI: NE-NE), and the median progression-free survival (mPFS) was 14.5 months (95%CI: 11.9-17.1). Multivariate analysis showed that bone metastasis ( = 0.042), and more than two metastatic sites ( = 0.031) as independent predictors of poor OS. In quantitative performance comparison, RMH achieved the highest C-indices for both OS (0.672, 95%CI: 0.531-0.813) and PFS (0.652, 0.564-0.737); MDACC also performed well, with C-indices for OS (0.651, 0.564-0.737) and PFS (0.615, 0.554-0.738). Time-dependent AUC analysis showed that MDA-ICI attained the highest 1-year OS and PFS AUC (0.630 and 0.592), followed by the MDACC+NLR (0.600 and 0.571). Based on log-rank testing and following FDR correction, only the MDACC maintained a statistically significant association with OS (high-risk 14.0 vs. intermediate-risk 34.6 vs. low-risk NR months; P = 0.003, Q = 0.036). For PFS, the MDACC+NLR score showed a marginal significance after FDR correction (Q = 0.054).
[CONCLUSIONS] The RMH, MDACC, and MDACC+NLR scoring systems all demonstrate prognostic utility in the NSCLC patients treated with first-line CIT, and the optimal choice among them may depend on the specific clinical context and the outcome metric of primary interest.
[MATERIALS AND METHODS] NSCLC patients receiving first-line CIT were included. The prognostic scores evaluated were RMH, MDACC, MDACC+NLR, MDA-ICI, LIPI, and GRIm. Survival curves were generated using the Kaplan-Meier method, and univariate and multivariate analyses were conducted via the Cox proportional hazards regression model. The C-index and time-dependent AUC were calculated to comprehensively quantify and compare the predictive performance of each system. The Log-rank test and False Discovery Rate (FDR) correction was employed to compare survival outcomes across different risk groups defined by the six prognostic scoring systems.
[RESULTS] A cohort of 298 NSCLC patients was analyzed. The median overall survival (mOS) of patients receiving first-line CIT was 36.5 months (95%CI: NE-NE), and the median progression-free survival (mPFS) was 14.5 months (95%CI: 11.9-17.1). Multivariate analysis showed that bone metastasis ( = 0.042), and more than two metastatic sites ( = 0.031) as independent predictors of poor OS. In quantitative performance comparison, RMH achieved the highest C-indices for both OS (0.672, 95%CI: 0.531-0.813) and PFS (0.652, 0.564-0.737); MDACC also performed well, with C-indices for OS (0.651, 0.564-0.737) and PFS (0.615, 0.554-0.738). Time-dependent AUC analysis showed that MDA-ICI attained the highest 1-year OS and PFS AUC (0.630 and 0.592), followed by the MDACC+NLR (0.600 and 0.571). Based on log-rank testing and following FDR correction, only the MDACC maintained a statistically significant association with OS (high-risk 14.0 vs. intermediate-risk 34.6 vs. low-risk NR months; P = 0.003, Q = 0.036). For PFS, the MDACC+NLR score showed a marginal significance after FDR correction (Q = 0.054).
[CONCLUSIONS] The RMH, MDACC, and MDACC+NLR scoring systems all demonstrate prognostic utility in the NSCLC patients treated with first-line CIT, and the optimal choice among them may depend on the specific clinical context and the outcome metric of primary interest.
MeSH Terms
Humans; Carcinoma, Non-Small-Cell Lung; Male; Female; Lung Neoplasms; Middle Aged; Aged; Prognosis; Immunotherapy; Adult; Aged, 80 and over; Treatment Outcome; Retrospective Studies; Antineoplastic Combined Chemotherapy Protocols
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