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Ferroptosis and Cancer Prognosis · Journal article
Diagnostics · September 8, 2026
Encouraging direction, but not yet definitive.
This retrospective single-center study of 158 patients demonstrates that pretreatment LIPI independently predicts progression-free and overall survival in advanced NSCLC patients treated with second-line nivolumab, with strong stratification (LIPI 0 vs LIPI 2: median OS 841 vs 201 days, p < 0.001) and incremental prognostic value over PD-L1 expression and clinical variables. The finding is clinically suggestive but requires prospective external validation before routine implementation.
Retrospective, single-center cohort study. Advanced NSCLC patients receiving nivolumab after first-line therapy at a single center; PD-L1 expression data available for 145 of 158 patients. Intervention: Pretreatment LIPI score stratification (LIPI 0, 1, or 2) in patients treated with nivolumab. Compared with: LIPI groups compared against each other; prognostic value of LIPI compared with clinical variables and PD-L1 expression using concordance index. n = 158. Single center (location not specified in source).
Median PFS: LIPI 0 = 566 days, LIPI 1 = 340 days, LIPI 2 = 109 days (p < 0.001) Median OS: LIPI 0 = 841 days, LIPI 1 = 760 days, LIPI 2 = 201 days (p < 0.001) ORR by LIPI group: LIPI 0 = 55.6%, LIPI 1 = 36.5%, LIPI 2 = 4.9% (p < 0.001)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians may consider measuring pretreatment LIPI in advanced NSCLC patients initiating nivolumab to refine prognostic stratification and counseling, particularly to identify high-risk LIPI 2 patients with markedly reduced survival. However, prospective external validation is needed before incorporation into routine clinical practice or trial design.
Real-world retrospective single-center analysis showing LIPI independently predicts survival in nivolumab-treated advanced NSCLC with statistically significant stratification and improved model discrimination, but limited by retrospective design, single center, and lack of external validation.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians may consider measuring pretreatment LIPI in advanced NSCLC patients initiating nivolumab to refine prognostic stratification and counseling, particularly to identify high-risk LIPI 2 patients with markedly reduced survival. However, prospective external validation is needed before incorporation into routine clinical practice or trial design.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background: The Lung Immune Prognostic Index (LIPI), based on the derived neutrophil-to-lymphocyte ratio and lactate dehydrogenase, may reflect systemic inflammation and tumor-related metabolic burden. This study evaluated the prognostic value of pretreatment LIPI and its relationship with programmed death-ligand 1 (PD-L1) expression in patients with advanced non-small cell lung cancer (NSCLC) receiving nivolumab after first-line therapy. Methods: A total of 158 patients were included in this retrospective, single-center study. Patients were classified into LIPI 0, LIPI 1, or LIPI 2 groups according to their pretreatment LIPI scores. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan–Meier analysis and multivariable Cox regression. The prognostic value of LIPI was also evaluated within PD-L1-negative and PD-L1-positive subgroups, and LIPI × PD-L1 interactions were explored. Harrell’s concordance index was used to examine whether adding LIPI improved model discrimination beyond clinical variables and PD-L1 expression. PD-L1 data were available for 145 patients. Results: Median PFS was 566, 340, and 109 days for the LIPI 0, LIPI 1, and LIPI 2 groups, respectively, while median OS was 841, 760, and 201 days, respectively; the differences were statistically significant for both outcomes (both p < 0.001). The objective response rate (ORR) was 55.6%, 36.5%, and 4.9%, whereas the disease control rate (DCR) was 75.9%, 65.1%, and 14.6% in the LIPI 0, LIPI 1, and LIPI 2 groups, respectively (both p < 0.001). In multivariable analyses, higher LIPI remained independently associated with shorter PFS and OS, with the strongest association observed in the LIPI 2 group. LIPI also differentiated survival outcomes within both PD-L1-negative and PD-L1-positive subgroups, although no significant LIPI × PD-L1 interaction was identified for PFS or OS. The addition of LIPI increased the C-index from 0.583 to 0.698 for PFS (ΔC-index, 0.115; p < 0.001) and from 0.588 to 0.697 for OS (ΔC-index, 0.109; p = 0.003). Conclusions: Pretreatment LIPI was independently associated with PFS and OS in patients with advanced NSCLC receiving nivolumab after first-line therapy. Its association remained after adjustment for available PD-L1 expression data, and its addition improved model discrimination. These findings suggest that LIPI may provide prognostic information complementary to PD-L1 expression and routinely available clinical factors.
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