Analysis of a Systemic Inflammatory Biomarker in Advanced Bile Tract Carcinoma Treated with Anti-PD-1 Therapy: Prognostic and Predictive Significance of Lung Immune Prognostic Index Score

Yuting Pan; Hanyan Si; Ru Jia; Guochao Deng; Huan Yan; Mengjia Fan; Miaomiao Gou; Shiyun Chen; Nan Zhang; Yue Shi; Niansong Qian; Guanghai Dai

doi:10.1155/2022/1427779

Analysis of a Systemic Inflammatory Biomarker in Advanced Bile Tract Carcinoma Treated with Anti-PD-1 Therapy: Prognostic and Predictive Significance of Lung Immune Prognostic Index Score

J Oncol. 2022 Mar 17:2022:1427779. doi: 10.1155/2022/1427779. eCollection 2022.

Authors

Yuting Pan^{1

2}, Hanyan Si¹, Ru Jia¹, Guochao Deng^{1

2}, Huan Yan¹, Mengjia Fan¹, Miaomiao Gou¹, Shiyun Chen^{1

2}, Nan Zhang^{1

2}, Yue Shi¹, Niansong Qian^{3

4}, Guanghai Dai²

Affiliations

¹ Medical Oncology Department, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
² Chinese People's Liberation Army Medical School, Beijing 100853, China.
³ The Hainan Medical Center, Chinese PLA General Hospital, Sanya 572000, China.
⁴ The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510220, Guangdong Province, China.

Abstract

Background: The application of immunotherapy is gradually increasing in advanced bile tract carcinoma (BTC), but only some patients could benefit from it. Validated biomarkers can screen out the beneficiaries. Therefore, the objective of this research is aimed at exploring the predictive value of lung immune prognostic index (LIPI) in advanced BTC patients receiving immunotherapy.

Methods: This study was conducted on 110 BTC patients. The cut-off value of the derived neutrophil-to-lymphocyte (dNLR) ratio was obtained by the ROC curves to predict the tumor progression rate at the 6^th month. The high levels of dNLR (≥the cut-off value) and lactate dehydrogenase (≥the upper limit of normal) were considered to be two risk factors for LIPI. Based on these two risk factors, patients were categorized into 3 groups based on risk factors: 0 for the good group, 1 for the intermediate group, and 2 for the poor group. Due to the limited number of patients in the poor group, it was integrated into the intermediate group to be the intermediate/poor group. Finally, the subjects were divided into two groups: LIPI-good and LIPI-intermediate/poor.

Results: The results shed light on the 110 BTC patients' LIPI in advanced BTC patients receiving immunotherapy, indicating that the cut-off value of dNLR was 1.74. According to the risk stratification, 38 (34.5%) patients had a good LIPI score, whereas the LIPI score was intermediate/poor in 72 (65.5%). In addition, patients with good LIPI were related to longer progression-free survival (PFS) and overall survival (OS), compared to those with intermediate/poor LIPI (12.17 months vs. 3.17 months; 20.2 months vs. 8.7 months). According to multivariate analysis, the intermediate/poor LIPI group was independently correlated with over 2.3 times greater risk of tumor progression (HR = 2.301; 95% CI, 1.395-3.796; P = 0.001) and over 1.8 times greater risk of death (HR = 1.877; 95% CI, 1.076-3.275; P = 0.027) than the good group. Moreover, the result also revealed that there were significant differences of DCR for patients of the good group and the intermediate/poor group (86.8% vs. 65.3%; P = 0.012).

Conclusion: Finally, this study verifies, for the first time, that LIPI is an independent factor affecting the survival and clinical efficacy of advanced BTC patients receiving immunotherapy. It may be difficult for patients with intermediate/poor LIPI to benefit from immunotherapy.