Evaluation of LIPI and mGPS as prognostic factors in extensive-stage small-cell lung cancer



Lung immune index, Small cell, Prognostic factor, Extensive stage, Survival


Background/Aim: There is an unmet need for effective prognostic models in small cell lung cancer. Lung immune prognostic index (LIPI) and Modified Glasgow Prognostic Score (mGPS) markers are prognostic in various cancers. We aimed to examine LIPI and GPS markers' prognostic effects on overall survival (OS) in extensive-stage small-cell lung cancer (SCLC) patients. Methods: Patients who were 18 years of age or older, diagnosed with extensive-stage small cell lung carcinoma who received platinum-based chemotherapy as first-line treatment were included in this retrospective observational study. Having concurrent or sequential radiotherapy to the thorax and receiving non-platinum-based chemotherapy as first-line treatment were the criteria for exclusion. We measured their pretreatment LIPI and mGPS markers and performed multivariate Cox regression analyses of progression-free survival (PFS) or OS in extensive stage-SCLC patients. Results: A total of 129 patients were included in the study. Twenty-eight patients (21.7%) were mGPS 0, 65 patients (50.4%) were mGPS 1, and 36 (27.9%) were mGPS 2. Fourteen percent of the patients were LIPI 0 (n=18), %38 were LIPI 1 (n=49), and %48 were LIPI 2 (n=62). The OS of the mGPS 0, mGPS 1, and mGPS 2 patients were 19.0 months (95% CI, 16.3-21.7), 8.4 months (95% CI, 7.1-9.8), and 6.4 months (95% CI, 3.1-9.6) respectively, and those of LIPI 0, LIPI 1, and LIPI 2 patients were 18.3 months (95% CI, 9.9-26.7), 11.7 months (95% CI, 5.3-18.1), and eight months (95% CI, 6.6-9.5), respectively. In the multivariate analysis, ECOG PS 0-1 and LIPI score 0-1 were associated with better PFS (P=0.035 and P=0.03 respectively) and OS (P=0.003 and P=0.036 respectively). Conclusions: LIPI score predicted an unfavorable prognosis, whereas mGPS was not associated with survival. It would be better to consider the use of the LIPI score when managing extensive-stage small cell lung cancer.


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Govindan R, Page N, Morgensztern D, Read W, Tierney R, Vlahiotis A, et al. Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: Analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol. 2006;24:4539–44.

Oronsky B, Reid TR, Oronsky A, Carter CA. What’s new in SCLC? A review. Neoplasia. 2017;19:842–7.

Farago AF, Keane FK. Current standards for clinical management of small cell lung cancer. Transl Lung Cancer Res. 2018 Feb;7(1):69–79.

Socinski MA, Smit EF, Lorigan P, Konduri K, Reck M, Szczesna A, et al.; Phase III study of pemetrexed plus carboplatin compared with etoposide plus carboplatin in chemotherapy naive patients with extensive-stage small-cell lung cancer. J Clin Oncol. 2009 Oct;27(28):4787–92.

Albain KS, Crowley JJ, LeBlanc M, Livingston RB. Determinants of improved outcome in small-cell lung cancer: An analysis of the 2,580-patient southwest oncology group data base. J Clin Oncol. 1990;8:1563–74.

Hong X, Cui B, Wang M, Yang Z, Wang L, Xu Q. Systemic immune-inflammation index, based on platelet counts and neutrophil-lymphocyte ratio, is useful for predicting prognosis in small cell lung cancer. Tohoku J Exp Med. 2015;236:297–304.

Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883–99.

Zhou T, Hong S, Hu Z, Hou X, Huang Y, Zhao H, et al. A systemic inflammation-based prognostic scores (mGPS) predicts overall survival of patients with small-cell lung cancer. Tumour Biol. 2015;36:337–43.

Mezquita L, Auclin E, Ferrara R, Charrier M, Remon J, Planchard D, et al.; Association of the lung immune prognostic index with immune checkpoint inhibitor outcomes in patients with advanced non‐small cell lung cancer. JAMA Oncol. 2018;4:351–7.

Sonehara K, Tateishi K, Komatsu M, Yamamoto H, Hanaoka M, Kanda S, et al.; Modified Glasgow Prognostic Score as a Prognostic Factor in Patients with Extensive Disease-Small-Cell Lung Cancer: A Retrospective Study in a Single Institute. Chemotherapy. 2019;64(3):129-37.

Fan H, Shao Z, Xiao Y, Xie Z, Chen W, Xie H, et al.; Comparison of the Glasgow Prognostic Score (GPS) and the modified Glasgow Prognostic Score (mGPS) in evaluating the prognosis of patients with operable and inoperable non‐small cell lung cancer. J Cancer Res Clin Oncol. 2016;142(6):1285-97.

Zhou T, Zhao Y, Zhao S, Yang Y, Huang Y, Hou X, et al.; Comparison of the Prognostic Value of Systemic Inflammation Response Markers in Small Cell Lung Cancer Patients. J Cancer. 2019;10(7):1685-92.

Minami S, Ogata Y, Ihara S, Yamamoto S, Komuta K. Pretreatment Glasgow prognostic score and prognostic nutritional index predict overall survival of patients with advanced small cell lung cancer. Lung Cancer (Auckl). 2017;8:249-57.

Minami S, Ihara S, Komuta K. Pretreatment Lung Immune Prognostic Index Is a Prognostic Marker of Chemotherapy and Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor. World J Oncol. 2019;10(1):35-45.

Galvano A, Peri M, Guarini A, Castiglia M, Grassadonia A, De Tursi M, et al.; Analysis of systemic inflammatory biomarkers in neuroendocrine carcinomas of the lung: prognostic and predictive significance of NLR, LDH, ALI, and LIPI score. Ther Adv Med Oncol. 2020;12:1758835920942378.

Horn L, Mansfield AS, Szczęsna A, Havel L, Krzakowski M, Hochmair MJ, et al.; IMpower133 Study Group. First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer. N Engl J Med. 2018 Dec;379(23):2220–9.






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Oyman A, Cil I, Özçelik M, Tataroğlu Özyükseler D, Başak M, Gökyer A, Ökten İlker N. Evaluation of LIPI and mGPS as prognostic factors in extensive-stage small-cell lung cancer. J Surg Med [Internet]. 2022 Feb. 1 [cited 2024 Jul. 16];6(2):115-9. Available from: https://jsurgmed.com/article/view/990665