肺免疫预后指数对免疫检查点抑制剂治疗的非小细胞肺癌临床疗效预测的meta分析

Prediction of lung immune prognostic index in treating non-small cell lung cancer by immune checkpoint inhibitor:a meta analysis

目的评价肺免疫预后指数(LIPI)对免疫检查点抑制剂(ICI)治疗的非小细胞肺癌(NSCLC)患者预后的预测价值。方法对Pubmed、Cochrane Library、Embase、Web of Science、万方、维普和知网等数据库进行系统的文献检索,使用危险比(HR)及其95%置信区间(CI)来评估LIPI与ICI治疗的NSCLC患者总生存期(OS)、无进展生存期(PFS)和疾病控制率(DCR)之间的关系。结果包含5293例患者的8篇研究纳入此项meta分析,结果显示低危组[衍生的中性粒细胞与淋巴细胞比值(dNLR)≤3且乳酸脱氢酶(LDH)≤正常值上限]和高危组(dNLR≥3且LDH≥正常值上限)及中危组(dNLR≥3或LDH≥正常值上限)相比,可以提高ICI治疗的NSCLC患者的PFS(HR=0.49,95%CI:0.42~0.58,P<0.00001),OS(HR=0.29,95%CI:0.27~0.32,P<0.00001)和DCR(HR=0.38,95%CI:0.25~0.59,P<0.00001)。结论LIPI评分可以成为预测ICI治疗的NSCLC临床疗效的生物学指标。

Objective To evaluate the predictive value of the lung immune prognostic index(LIPI)in the prognosis in the patients with advanced non-small cell lung cancer(NSCLC)treated by immune checkpoint inhibitor(ICI).Methods A systematical literature retrieval was performed by PubMed,Cochrane Library,EMBASE,Web of Science,Wan Fang,Wei Pu and CNKI databases.The hazard ratio(HR)and its 95%confidence interval(CI)were used to assess the associations between LIPI with the overall survival(OS),progression-free survival(PFS)and disease control rate(DCR)in NSCLC patients treated by ICI.Results Eight studies including 5293 patients were included in this meta-analysis.The results showed that the low risk group(DNLR≤3 and LDH≤the normal upper limit)was compared with the high risk group(DNLR≥3 and LDH≥the normal upper limit)and the middle risk group(DNLR≥3 or LDH≥the normal upper limit),PFS(HR=0.49,95%CI:0.42-0.58,P<0.00001),OS(HR=0.29,95%CI:0.27-0.32,P<0.00001)and DCR(HR=0.38,95%CI:0.25-0.59,P<0.00001)could be improved in NSCLC patients treated by ICI.Conclusion The LIPI score could be used as the biological indicators to predict the clinical efficacy of ICI treating NSCLC.