Validation of the Lung Immune Prognostic Index (LIPI) as a prognostic biomarker in metastatic renal cell carcinoma Journal Article


Authors: Carril-Ajuria, L.; Lavaud, P.; Dalban, C.; Negrier, S.; Gravis, G.; Motzer, R. J.; Chevreau, C.; Tannir, N. M.; Oudard, S.; McDermott, D. F.; Laguerre, B.; Hammers, H. J.; Barthelemy, P.; Plimack, E. R.; Borchiellini, D.; Gross-Goupil, M.; Jiang, R.; Lee, C. W.; de Silva, H.; Rini, B. I.; Escudier, B.; Albigès, L.
Article Title: Validation of the Lung Immune Prognostic Index (LIPI) as a prognostic biomarker in metastatic renal cell carcinoma
Abstract: Background: 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. Methods: 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). Results: 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. Conclusions: 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. © 2024
Keywords: vasculotropin; adult; cancer survival; controlled study; aged; major clinical study; overall survival; bevacizumab; interferon; sunitinib; follow up; biomarkers; ipilimumab; vasculotropin receptor; progression free survival; neutrophil count; retrospective study; renal cell carcinoma; temsirolimus; neutrophil; antiangiogenic therapy; lactate dehydrogenase; blood cell count; leukocyte count; leukocyte; clinical trial (topic); metastatic renal cell carcinoma; demographics; overall response rate; immune checkpoint inhibitor; cancer prognosis; nivolumab; prognosis; human; male; female; article; immune checkpoint inhibitors; patient history of nephrectomy; antiangiogenics; lipi; lung immune prognostic index
Journal Title: European Journal of Cancer
Volume: 204
ISSN: 0959-8049
Publisher: Elsevier Inc.  
Date Published: 2024-06-01
Start Page: 114048
Language: English
DOI: 10.1016/j.ejca.2024.114048
PROVIDER: scopus
PUBMED: 38653033
PMCID: PMC12085868
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Robert Motzer
    1248 Motzer