The Lung Immune Prognostic Index (LIPI) is associated with immune checkpoint inhibitors (ICI) outcomes across different solid tumors, particularly in non-small cell lung cancer. Data regarding the prognostic and/or predictive role of LIPI in metastatic renal cell carcinoma (mRCC) are still scarce. The aim of this study was to evaluate whether LIPI could be predictive of survival in mRCC patients.
We used patient level data from three different prospective studies (NIVOREN trial: nivolumab; TORAVA trial: VEGF/VEGFR-targeted therapy (TT); CheckMate 214: nivolumab-ipilimumab vs sunitinib). LIPI was calculated based on a derived neutrophils/(leukocyte-neutrophil) ratio > 3 and lactate-dehydrogenase >upper limit of normal, classifying patients into three groups (LIPI good, 0 factors;LIPI intermediate (int), 1 factor;LIPI poor, 2 factors) and/or into two groups (LIPI good, 0 factors;LIPI int/poor, 1-2 factors) according to trial sample size. Primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS).
In the Nivolumab dataset (n = 619), LIPI was significantly associated with OS (LIPI-good 30.1 vs 13.8 months in the LIPI int/poor; HR= 0.47) and PFS (HR=0.74). In the VEGF/VEGFR-TT dataset (n = 159), only a correlation with PFS was observed. In the CheckMate214 dataset (n = 1084), LIPI was significantly associated with OS (nivolumab-ipilimumab OS LIPI good vs int/poor: HR=0.55, p < 0.0001; sunitinib: OS LIPI good vs int/poor: 0.38, p < 0.0001) in both treatment groups in univariate and multivariate analysis.
Pretreatment-LIPI correlated with worse survival outcomes in mRCC treated with either ICI or antiangiogenic therapy, confirming LIPI's prognostic role in mRCC irrespective of systemic treatment used.
European journal of cancer (Oxford, England : 1990). 2024 Apr 08 [Epub ahead of print]
Lucia Carril-Ajuria, Pernelle Lavaud, Cecile Dalban, Sylvie Negrier, Gwénaëlle Gravis, Robert J Motzer, Christine Chevreau, Nizar M Tannir, Stéphane Oudard, David F McDermott, Brigitte Laguerre, Hans J Hammers, Philippe Barthelemy, Elizabeth R Plimack, Delphine Borchiellini, Marine Gross-Goupil, Ruiyun Jiang, Chung-Wei Lee, Heshani de Silva, Brian I Rini, Bernard Escudier, Laurence Albigès
Gustave Roussy, Villejuif, France. Electronic address: ., Gustave Roussy, Villejuif, France., Department of Biostatistics, Centre Leon Bernard, Lyon, France., Université de Lyon, Centre Leon Bernard, Lyon, France., Institut Paoli-Calmettes, Aix-Marseille, France., Memorial Sloan Kettering Cancer Center, New York, NY, USA., Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse, France., University of Texas MD Anderson Cancer Center, Houston, TX, USA., Hôpital Européen Georges Pompidou, Oncology department, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France., Dana-Farber/Harvard Cancer Center, Boston, MA, USA., Centre Eugene Marquis, Rennes, France., UT Southwestern Kidney Cancer Program, Dallas, TX, USA., Institut de Cancérologie Strasbourg Europe, Strasbourg, France., Fox Chase Cancer Center, Philadelphia, PA, USA., Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France., Department of Medical Oncology, Bordeaux University Hospital, Bordeaux, France., Bristol Myers Squibb, Princeton, USA., Vanderbilt-Ingram Cancer Center, Nashville, USA., Gustave Roussy, Villejuif, France. Electronic address: .