Can Systematic Immune Inflammation Predict Survival in Patients Receiving Immune Checkpoint Inhibitors for NSCLC?

A high pretreatment systemic immune-inflammation index level is associated with worse survival outcomes in patients with non-small cell lung cancer (NSCLC) who receive immune checkpoint inhibitors, according to a recent study.

A team from the Peking Union Medical College and Chinese Academy of Medical Sciences conducted the study and published their findings in Critical Reviews in Oncology/Hematology.

They conducted the meta-analysis to evaluate the relationship between pretreatment systemic immune inflammation index levels and survival outcomes, including progression-free survival (PFS) and overall survival (OS) among patients with NSCLC who receive immune checkpoint inhibitors.

The study showed that a high pretreatment systemic immune inflammation index level had a significant association with reduced PFS, with a hazard ratio (HR) of 2.05 (95% CI, 1.59–2.64; P<0.001; I² = 42%). It was also associated with reduced OS, with an HR of 1.54 (95% CI, 1.29–1.82, P< 0.001; I² = 22%).

When the researchers conducted subgroup analyses by country of the study, lines of treatment, cancer stage, methods for determining the cutoffs for systemic immune inflammation index levels, and the analytic models, they found there were “consistent results,” with P values for subgroup differences all greater than 0.05.

“Interestingly, the subgroup analyses indicated a stronger association in patients receiving immune checkpoint inhibitions alone versus those receiving concurrent chemotherapy (P for subgroup difference = 0.04),” the study authors noted.

Based on these results, the study authors concluded that a high pretreatment systemic immune-inflammation index level is linked with reduced PFS and OS in patients with NSCLC who are receiving immune checkpoint inhibitor therapy, especially for those who are not receiving concurrent chemotherapy. They also noted that the systemic immune-inflammation index is a “cost-effective, accessible biomarker for risk stratification in NSCLC,” and these findings support its “integration into personalized treatment plans for NSCLC.”

Reference

Zhang Y, Chen Y, Guo C, Li S, Huang C. Systemic Immune-Inflammation Index as a Predictor of Survival in Non-Small Cell Lung Cancer Patients Undergoing Immune Checkpoint Inhibition: A Systematic Review and Meta-Analysis. Critical Reviews in Oncology/Hematology. Published online February 18, 2025:104669. doi:https://doi.org/10.1016/j.critrevonc.2025.104669