Akademik Veri Yönetim Sistemi
CURRENT ONCOLOGY, cilt.32, sa.10, 2025 (SCI-Expanded, Scopus)
Simple Summary Despite the success of immunotherapy with nivolumab in advanced non-small cell lung cancer, many patients still experience poor outcomes. Reliable tools are needed to better predict which patients are most likely to benefit from treatment. This study introduces SUVmax-IPI, a novel and practical biomarker that combines two routinely assessed parameters: tumor metabolic activity and systemic inflammation. It aimed to predict survival outcomes in patients with metastatic non-small cell lung cancer receiving nivolumab. By integrating positron emission tomography imaging and standard laboratory tests, this score provides a simple and cost-effective tool for clinicians to better identify patients at higher risk of poor outcomes. SUVmax-IPI can help guide treatment decisions, improve patient counseling, and enhance personalized care in the immunotherapy setting.Abstract Background/Objectives: Nivolumab has significantly improved outcomes in patients with metastatic non-small cell lung cancer (NSCLC); however, reliable prognostic biomarkers remain an unmet need. To address this gap, we developed the SUVmax-IPI, a novel prognostic index combining maximum standardized uptake value (SUVmax) from 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) with systemic inflammatory markers. This study aimed to evaluate the prognostic value of SUVmax-IPI in patients with NSCLC receiving nivolumab therapy. Methods: This multicenter retrospective analysis included 187 patients with metastatic NSCLC receiving nivolumab across 5 tertiary institutions. The SUVmax-IPI incorporated pretreatment SUVmax and laboratory-based inflammatory prognostic index (IPI) parameters. Survival outcomes were evaluated using Kaplan-Meier analysis with log-rank testing and multivariate cox regression. Results: Receiver operating characteristic (ROC) analysis established an optimal SUVmax-IPI cut-off of 241.9. Patients with SUVmax-IPI <= 241.9 had significantly better survival outcomes: median overall survival (OS) was 35 versus 15 months (p = 0.002). For progression-free survival (PFS), although a numerical difference favored patients with SUVmax-IPI <= 241.9 (median: 15 vs. 8 months), this did not reach statistical significance (log-rank p = 0.175). Multivariate analysis confirmed SUVmax-IPI as an independent predictor of survival (p = 0.002). Conclusions: The SUVmax-IPI represents a promising prognostic tool for patients with metastatic NSCLC who received at least 3 months of nivolumab, integrating metabolic and inflammatory parameters to predict survival outcomes.