{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:12:18Z","timestamp":1780636338515,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with programmed cell death\u2010ligand 1 (PD\u2010L1) \u226550% metastatic non\u2010small cell lung cancer (mNSCLC) and ECOG performance status (PS) of 2 treated with first\u2010line immunotherapy have heterogeneous clinical assessment and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To explore the role of immune\u2010inflammatory surrogates by the validated lung immuno\u2010oncology prognostic score (LIPS) score, including the neutrophil\u2010to\u2010lymphocyte ratio (NLR) and the pretreatment use of steroids, alongside other prognostic variables. A retrospective analysis of 128 patients with PS2 and PD\u2010L1 \u226550% mNSCLC treated between April 2018 and September 2019 with first\u2010line pembrolizumab in a real\u2010world setting was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>With a median follow\u2010up of 15.3\u2009months, the 1\u2010year overall survival (OS) and median progression\u2010free survival (PFS) were 32.3% (95% CI: 30.9\u201333.9) and 3.3\u2009months (95% CI: 1.8\u20134.7), respectively. The NLR, lactate dehydrogenase (LDH) and pretreatment steroids results were the only significant prognostic factors on the univariate analysis and independent prognostic factors by the multivariate analysis on both OS and PFS. The LIPS score, including the NLR and pretreatment steroids, identified 29 (23%) favourable\u2010risk patients, with 0 factors, 1\u2010year OS of 67.6% and median PFS of 8.2\u2009months; 57 (45%) intermediate\u2010risk patients, with 1 factor, 1\u2010year OS 32.1% and median PFS 2.7\u2009months; 42 (33%) poor\u2010risk patients, with both factors, 1\u2010year OS of 10.7% and median PFS of 1.2\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The assessment of pre\u2010existing imbalance of the host immune response by combined blood and clinical immune\u2010inflammatory markers may represent a way to unravel the heterogeneous outcome and assessment of patients with mNSCLC and poor PS in the immune\u2010oncology setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.14256","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T08:34:11Z","timestamp":1640248451000},"page":"483-488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Host immune\u2010inflammatory markers to unravel the heterogeneous outcome and assessment of patients with <scp>PD\u2010L1<\/scp> \u226550% metastatic non\u2010small cell lung cancer and poor performance status receiving first\u2010line immunotherapy"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0764-3650","authenticated-orcid":false,"given":"Giuseppe L.","family":"Banna","sequence":"first","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2010IRCCS  Candiolo, Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Tiseo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Parma  Parma Italy"},{"name":"Medical Oncology Unit University Hospital of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego L.","family":"Cortinovis","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit ASST San Gerardo Hospital Monza  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Facchinetti","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay, Institut Gustave Roussy, Inserm, Biomarqueurs Pr\u00e9dictifs et Nouvelles Strat\u00e9gies Th\u00e9rapeutiques en Oncologie  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim G. J. V.","family":"Aerts","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases Erasmus Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Baldessari","sequence":"additional","affiliation":[{"name":"Dipartimento di Oncologia ed Ematologia Azienda Ospedaliero\u2010Universitaria di Modena  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Giusti","sequence":"additional","affiliation":[{"name":"Medical Oncolgy St. Andrea Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Bria","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center, Fondazione Policlinico Universitario \"A. Gemelli\" IRCCS  Rome Italy"},{"name":"Department of Translational Medicine and Surgery Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Grossi","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology University of Insubria  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Berardi","sequence":"additional","affiliation":[{"name":"Oncology Clinic Universit\u00e0 Politecnica Delle Marche, Ospedali Riuniti Di Ancona  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Morabito","sequence":"additional","affiliation":[{"name":"Thoracic Medical Oncology Istituto Nazionale Tumori \u2018Fondazione G Pascale\u2019, IRCCS  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Catino","sequence":"additional","affiliation":[{"name":"Thoracic Oncology Unit Clinical Cancer Center IRCCS Istituto Tumori \"Giovanni Paolo II\"  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Genova","sequence":"additional","affiliation":[{"name":"Lung Cancer Unit; IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mazzoni","sequence":"additional","affiliation":[{"name":"Department of Oncology Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Gelibter","sequence":"additional","affiliation":[{"name":"Medical Oncology (B) Policlinico Umberto I, \"Sapienza\" University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Rastelli","sequence":"additional","affiliation":[{"name":"UOC Oncologia Ascoli Piceno \u2013 San Benedetto del Tronto  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Macerelli","sequence":"additional","affiliation":[{"name":"Department of Oncology University Hospital Santa Maria Della Misericordia  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Chiari","sequence":"additional","affiliation":[{"name":"Medical Oncology Ospedali Riuniti Padova Sud \"Madre Teresa Di Calcutta\"  Monselice Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Gori","sequence":"additional","affiliation":[{"name":"Oncology Unit IRCCS Ospedale Sacro Cuore Don Calabria  Negrar Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Mansueto","sequence":"additional","affiliation":[{"name":"Medical Oncology F. Spaziani Hospital  Frosinone Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3096-4452","authenticated-orcid":false,"given":"Fabrizio","family":"Citarella","sequence":"additional","affiliation":[{"name":"Medical Oncology Campus Bio\u2010Medico University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Cantini","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases Erasmus Medical Center  Rotterdam the Netherlands"},{"name":"Oncology Clinic Universit\u00e0 Politecnica Delle Marche, Ospedali Riuniti Di Ancona  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Rijavec","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Bertolini","sequence":"additional","affiliation":[{"name":"Dipartimento di Oncologia ed Ematologia Azienda Ospedaliero\u2010Universitaria di Modena  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Cappuzzo","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology 2 IRCCS Regina Elena National Cancer Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"De Toma","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Friedlaender","sequence":"additional","affiliation":[{"name":"Oncology Department University Hospital of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Metro","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Pensieri","sequence":"additional","affiliation":[{"name":"Department of Biotechnology and Applied Clinical Sciences University of L'Aquila  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampiero","family":"Porzio","sequence":"additional","affiliation":[{"name":"Medical Oncology St. Salvatore Hospital  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Ficorella","sequence":"additional","affiliation":[{"name":"Department of Biotechnology and Applied Clinical Sciences University of L'Aquila  L'Aquila Italy"},{"name":"Medical Oncology St. Salvatore Hospital  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Pinato","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Imperial College London, Hammersmith Hospital  London UK"},{"name":"Department of Translational Medicine Universit\u00e0 del Piemonte Orientale \u201cA. 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