Abstract
BACKGROUND AND AIMS: To evaluate the efficacy and prognostic value of various immunoprognostic scoring systems-Lung Immune Prognostic Index (LIPI), modified Glasgow Prognostic Score (mGPS), and Gustave Roussy Immune Score (GRIm)-in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs). METHODS: We conducted a retrospective analysis of clinical data from 219 NSCLC patients treated with ICIs at Zhongshan Hospital (Xiamen), Fudan University from June 1, 2019 to January 31, 2024. The therapeutic efficacy and predictive capabilities of the scoring systems were assessed using Kaplan-Meier curves, Cox proportional hazards models, time-dependent ROC curves, and random survival forest models. RESULTS: The median follow-up was 29 months (IQR: 25.96-32.04), resulting in 93 observed deaths. Both LIPI and GRIm scores correlated with declining overall survival (OS) and progression-free survival (PFS) as risk levels increased. LIPI demonstrated superior predictive performance at 12, 24, and 36 months (AUC: 0.70, 0.62, 0.61, respectively). Multivariate analysis identified immune-related adverse events (irAEs) and lactate dehydrogenase (LDH) levels as independent prognostic factors for OS. CONCLUSION: LIPI serves as an effective prognostic tool for NSCLC patients receiving immunotherapy, outperforming individual inflammatory markers. Additionally, irAEs and LDH levels are significant independent prognostic factors for OS.