The Role Of PNI In Predicting The Efficacy And Prognosis Of ICIs In Patients With Advanced NSCLC

Objective:To study the role of prognostic nutritional index(PNI)in predicting the efficacy and prognosis of immune checkpoint inhibitors(ICIs)in patients with advanced non-small cell lung cancer(NSCLC).Methods:We Selected 89 patients with advanced non-small cell lung cancer treated with PD-(L)1 inhibitors or CTLA-4 inhibitors who were admitted to the Department of Oncology from August 2018 to May 2020.Then we divided all the patients into the low PNI group(L-PNI group)and high PNI group(H-PNI group)after the critical value of PNI was processed.The distinction in the curative effect and prognosis of the two groups of patients to immune checkpoint inhibitor treatment were analyzed.And the relevant factors affecting the efficacy and prognosis of immune checkpoint inhibitors were analyzed in the same way.Results: There was no obvious distinction in objective remission rate(ORR)between the two groups after treatment(P>0.05).The distinction in disease control rate(DCR)between the two groups was statistically obvious(P<0.05).The DCR of L-PNI group was 71.1%,and that of HPNI group was 88.2%.The contrast of survival curves between the L-PNI group and H-PNI group showed that PFS and OS of the former were obviously shorter than those of the latter(median PFS: L-PNI group vs HPNI group = 3 months vs 9 months,P<0.05;median OS: L-PNI group vs H-PNI group = 10 months vs 18 months,P<0.05).In univariate analysis and multivariate analysis,PNI level before immunotherapy was associated with PFS and OS(PFS: OR = 5.100,95% CI: 1.745-14.905,P<0.05;OS: OR= 2.822,95% CI: 1.301-6.119,P<0.05).Conclusion:There is no significant correlation between PNI level before immunotherapy and the ORR of patients with advanced NSCLC treated with immune checkpoint inhibitors,but there is a significant correlation with DCR.A higher level of PNI indicates a relatively good treatment response.The level of PNI before immunotherapy is significantly correlated with the PFS and OS of the patients.It can predict the efficacy and prognosis of immunotherapy in patients with advanced NSCLC.