Cargando…

Predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis

PURPOSE: The prognostic nutritional index (PNI), which is derived from the albumin concentration and absolute lymphocyte number, is an effective indicator of cancer patients’ nutritional and immunological status. According to multiple studies, PNI was strongly linked to the prognosis of patients wit...

Descripción completa

Detalles Bibliográficos
Autores principales: Xia, Handai, Zhang, Wengang, Zheng, Qi, Zhang, Yuqing, Mu, Xin, Wei, Chenxi, Wang, Xiuwen, Liu, Yanguo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374926/
https://www.ncbi.nlm.nih.gov/pubmed/37520982
http://dx.doi.org/10.1016/j.heliyon.2023.e17400
_version_ 1785078884321984512
author Xia, Handai
Zhang, Wengang
Zheng, Qi
Zhang, Yuqing
Mu, Xin
Wei, Chenxi
Wang, Xiuwen
Liu, Yanguo
author_facet Xia, Handai
Zhang, Wengang
Zheng, Qi
Zhang, Yuqing
Mu, Xin
Wei, Chenxi
Wang, Xiuwen
Liu, Yanguo
author_sort Xia, Handai
collection PubMed
description PURPOSE: The prognostic nutritional index (PNI), which is derived from the albumin concentration and absolute lymphocyte number, is an effective indicator of cancer patients’ nutritional and immunological status. According to multiple studies, PNI was strongly linked to the prognosis of patients with non-small cell lung cancer (NSCLC). The predictive value of PNI for survival outcomes in NSCLC patients receiving immune checkpoint inhibitors (ICIs) is still in dispute at present. This meta-analysis is devoted to fill this information gap and investigate the predictive ability of PNI in NSCLC patients treated with ICIs. METHODS: The PubMed, Embase, Cochrane Library databases, and conference proceedings were searched for eligible studies without language restriction. Overall survival (OS) and progression-free survival (PFS) were included. The predictive value of PNI was estimated using hazard ratios and their 95% confidence intervals. RESULTS: Thirteen relevant retrospective cohort studies were included and these studies included 1119 patients with stage III-IV NSCLC. Lower PNI status was found to be an independent risk factor for worse survival outcomes in patients with NSCLC (OS HR = 2.68; 95%CI: 1.76–4.06; P < 0.0001; PFS HR = 1.84; 95%CI: 1.39–2.42; P < 0.0001). According to the subgroup analysis, PNI was similarly connected to OS in most subgroups of NSCLC patients receiving ICIs, except for those receiving chemoimmunotherapy or first-line treatment, and those with a cut-off value < 45. CONCLUSION: Our findings indicated that lower PNI was associated with poorer prognosis in NSCLC patients undergoing ICI therapy. Further prospective research with bigger patient groups is required. SYSTEMATIC REVIEW REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO), identifier CRD42022327528.
format Online
Article
Text
id pubmed-10374926
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-103749262023-07-29 Predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis Xia, Handai Zhang, Wengang Zheng, Qi Zhang, Yuqing Mu, Xin Wei, Chenxi Wang, Xiuwen Liu, Yanguo Heliyon Review Article PURPOSE: The prognostic nutritional index (PNI), which is derived from the albumin concentration and absolute lymphocyte number, is an effective indicator of cancer patients’ nutritional and immunological status. According to multiple studies, PNI was strongly linked to the prognosis of patients with non-small cell lung cancer (NSCLC). The predictive value of PNI for survival outcomes in NSCLC patients receiving immune checkpoint inhibitors (ICIs) is still in dispute at present. This meta-analysis is devoted to fill this information gap and investigate the predictive ability of PNI in NSCLC patients treated with ICIs. METHODS: The PubMed, Embase, Cochrane Library databases, and conference proceedings were searched for eligible studies without language restriction. Overall survival (OS) and progression-free survival (PFS) were included. The predictive value of PNI was estimated using hazard ratios and their 95% confidence intervals. RESULTS: Thirteen relevant retrospective cohort studies were included and these studies included 1119 patients with stage III-IV NSCLC. Lower PNI status was found to be an independent risk factor for worse survival outcomes in patients with NSCLC (OS HR = 2.68; 95%CI: 1.76–4.06; P < 0.0001; PFS HR = 1.84; 95%CI: 1.39–2.42; P < 0.0001). According to the subgroup analysis, PNI was similarly connected to OS in most subgroups of NSCLC patients receiving ICIs, except for those receiving chemoimmunotherapy or first-line treatment, and those with a cut-off value < 45. CONCLUSION: Our findings indicated that lower PNI was associated with poorer prognosis in NSCLC patients undergoing ICI therapy. Further prospective research with bigger patient groups is required. SYSTEMATIC REVIEW REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO), identifier CRD42022327528. Elsevier 2023-07-19 /pmc/articles/PMC10374926/ /pubmed/37520982 http://dx.doi.org/10.1016/j.heliyon.2023.e17400 Text en © 2023 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Xia, Handai
Zhang, Wengang
Zheng, Qi
Zhang, Yuqing
Mu, Xin
Wei, Chenxi
Wang, Xiuwen
Liu, Yanguo
Predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis
title Predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis
title_full Predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis
title_fullStr Predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis
title_full_unstemmed Predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis
title_short Predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis
title_sort predictive value of the prognostic nutritional index in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374926/
https://www.ncbi.nlm.nih.gov/pubmed/37520982
http://dx.doi.org/10.1016/j.heliyon.2023.e17400
work_keys_str_mv AT xiahandai predictivevalueoftheprognosticnutritionalindexinadvancednonsmallcelllungcancerpatientstreatedwithimmunecheckpointinhibitorsasystematicreviewandmetaanalysis
AT zhangwengang predictivevalueoftheprognosticnutritionalindexinadvancednonsmallcelllungcancerpatientstreatedwithimmunecheckpointinhibitorsasystematicreviewandmetaanalysis
AT zhengqi predictivevalueoftheprognosticnutritionalindexinadvancednonsmallcelllungcancerpatientstreatedwithimmunecheckpointinhibitorsasystematicreviewandmetaanalysis
AT zhangyuqing predictivevalueoftheprognosticnutritionalindexinadvancednonsmallcelllungcancerpatientstreatedwithimmunecheckpointinhibitorsasystematicreviewandmetaanalysis
AT muxin predictivevalueoftheprognosticnutritionalindexinadvancednonsmallcelllungcancerpatientstreatedwithimmunecheckpointinhibitorsasystematicreviewandmetaanalysis
AT weichenxi predictivevalueoftheprognosticnutritionalindexinadvancednonsmallcelllungcancerpatientstreatedwithimmunecheckpointinhibitorsasystematicreviewandmetaanalysis
AT wangxiuwen predictivevalueoftheprognosticnutritionalindexinadvancednonsmallcelllungcancerpatientstreatedwithimmunecheckpointinhibitorsasystematicreviewandmetaanalysis
AT liuyanguo predictivevalueoftheprognosticnutritionalindexinadvancednonsmallcelllungcancerpatientstreatedwithimmunecheckpointinhibitorsasystematicreviewandmetaanalysis