Abstract
OBJECTIVE: We conducted a meta-analysis to evaluate the prognostic utility of the Lung Immune Prognostic Index (LIPI) in patients with urological malignancies treated with immune checkpoint inhibitors (ICIs). METHODS: We systematically searched PubMed, the Cochrane Library, and EMBASE up to March 3, 2025. Clinical outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). Study quality was assessed using the Newcastle-Ottawa Scale (NOS), with a threshold score ≥6 defining high-quality studies. RESULTS: This meta-analysis incorporated seven studies comprising 2498 patients. Our findings demonstrated that patients with good LIPI index exhibited significantly prolonged OS (good vs. intermediate: HR = 0.51, 95% CI 0.42-0.62, p < 0.001; good vs. poor: HR = 0.15, 95% CI 0.11-0.20, p < 0.001; good vs. Intermediate and poor: HR = 0.48, 95% CI 0.38-0.61, p < 0.001). The data further showed that patients with good LIPI index exhibited significantly prolonged PFS; (good vs. intermediate: HR = 0.66, 95% CI 0.57-0.76, p < 0.001; good vs. poor: HR = 0.23, 95% CI 0.14-0.37, p < 0.001; good vs. Intermediate and poor: HR = 0.73, 95% CI 0.66-0.81, p < 0.001). Additionally, we found that the good LIPI index correlated with higher ORR (good vs. intermediate: OR = 1.50, 95% CI: 0.98-2.28, p = 0.061; good vs. poor: OR = 1.96, 95% CI: 1.01-3.83, p = 0.047). The good LIPI index correlated with higher DCR (good vs. intermediate: OR = 2.15, 95% CI: 1.53-3.01, p < 0.001; good vs. poor: OR = 5.08, 95% CI: 2.85-9.05, p < 0.001). No publication bias existed, and sensitivity analysis confirmed stable results. CONCLUSION: The LIPI emerges as a valuable prognostic biomarker in patients with urological malignancies treated with ICIs therapy.