Impact of systemic inflammatory markers in patients with ALK-positive non-small cell lung cancer treated with crizotinib

ÖLMEZ Ö. F., BİLİCİ A., Gursoy P., ÇUBUKÇU E., Sakin A., KORKMAZ T., ...More

Pulmonology, vol.29, no.6, pp.478-485, 2023 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 29 Issue: 6
  • Publication Date: 2023
  • Doi Number: 10.1016/j.pulmoe.2022.11.006
  • Journal Name: Pulmonology
  • Journal Indexes: Scopus
  • Page Numbers: pp.478-485
  • Keywords: ALK-positive, Inflammation-based prognostic scores, NSCLC, Survival, Treatment response
  • Istanbul Medipol University Affiliated: Yes


Objectives: To evaluate the prognostic utility of inflammation-based prognostic scores in patients with ALK-positive metastatic or non-resectable non-small-cell lung cancer (NSCLC) treated with crizotinib. Patients and Methods: A total of 82 patients with ALK-positive metastatic or non-resectable NSCLC who received ALK TKI crizotinib were included. Pre-treatment modified Glasgow prognostic score (mGPS), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) were calculated. Multivariable logistic regression and Cox proportional hazards models were used to assess the impact of pretreatment mGPS, PNI, and SII on overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Results: The ORR was 77.2%, while 1-year OS and PFS rates were 95.0% and 93.5%, respectively. The univariate analysis revealed significantly higher 1-year PFS (89.4 vs. 64.4%, p=0.043) and OS (92.0 vs. 83.3%, p=0.01) rates in patients with low (<934.7) vs. high (≥934.7) SII scores. Multivariate analysis revealed that PNI ≥0.09 was a significant determinant of poorer 1-year OS rates (hazard ratio [HR]: 2.46, 95% confidence interval [CI] 0.88–4.85, p=0.035). No significant difference was observed in survival rates according to gender, age, smoking status, prior lines of therapy, or mGPS scores, while higher mGPS scores (odds ratio [OR]: 0.1, 95%CI 0.16–1.04; p=0.009) and higher PNI scores (OR: 0.16, 95% CI 0.02–0.55; p=0.035) were associated with poorer ORR. Conclusion: Our findings indicate the prognostic significance of PNI and SII in terms of survival outcome and the impact of mGPS and PNI on treatment response in patients with ALK-positive NSCLC treated with crizotinib.