Correlation between the Immune Checkpoint Inhibitors Prognostic Index and Outcomes in Nonsmall Cell Lung Cancer: A Multicentre Analysis

OBJECTIVE: To evaluate the prognostic value of the immune checkpoint inhibitor prognostic index (ICPI), based on the albumin (ALB) and derived neutrophil-to-lymphocyte ratio (dNLR), for nonsmall cell lung cancer (NSCLC) patients receiving immune checkpoint inhibitors (ICIs). METHODS: We conducted a multicentre retrospective study with an ICIs cohort (n = 143) and a chemotherapy control cohort (n = 84). A Cox proportional hazards regression and logistic regression model were used to find the independent risk factor for progression-free survival (PFS) and overall survival (OS) and disease control rate (DCR) in NSCLC patients. The Kaplan–Meier was used to evaluating the PFS and OS. RESULTS: The ALB <35 g/L and dNLR >3 were correlated with worse PFS and OS for NSCLC patients receiving ICIs, respectively. The moderately high-risk ICPI had a significantly increased risk of progression (hazard ratio (HR) 1.83, 95% confidence interval (CI) 1.14–2.91; P=0.012) and of death (HR 2.33, 95% CI 1.12–4.87; P=0.024) and of nondisease control (odds ratio (OR) 3.05, 95% CI 1.19–7.83; P=0.021) and was correlated with worse PFS and 1-year survival rates (4.0 months vs. 7.2 months; P=0.001; 44.3% vs. 76.1%; P=0.001) compared with low-risk ICPI when it was characterized two groups. When ICPI was further divided into three groups, the results showed that the high-risk ICPI was correlated with worse PFS and 1-year survival rates. However, there was no difference in the chemotherapy cohort. CONCLUSION: The ICPI was correlated with worse outcomes for NSCLC patients receiving ICIs but not for patients with chemotherapy.