Pre-treatment pan-immune-inflammation value (PIV) and pile prognostic score in patients treated with immunotherapy

Abstract

Investigating predictive markers for inflammatory events in cancer, there was a trend observed in the diversity of prognostic scores obtained from blood counts. This study aimed to assess the pan-immune-inflammation value (PIV), encompassing lymphocyte, monocyte, neutrophil and platelet levels along with the PILE score (a composite profile obtained from PIV, Eastern Cooperative Oncology Group Performance Score (ECOG PS) and serum lactate dehydrogenase (LDH)) in patients with diverse tumour types undergoing treatment with immune checkpoint inhibitors (ICIs). A retrospective study was carried out on a cohort of 105 patients with assessed pre-treatment PIV and PILE scores. Only stage III–IV patients were recruited. PIV was determined using absolute values from peripheral blood cell counts (neutrophil x platelet xmonocyte/lymphocytes) integrated at the time of diagnosis. The PILE scoring system further integrated LDH levels (<245 vs. ≥245) and ECOG-PS (0-1 vs. ≥ 2) along with the incorporated PIV values. Elevated PIV levels were significantly associated with a high response rate (RR) compared to those with lower PIV levels (HR:2.63, 95% CI:1.06–6.54; p=0.037). In this study, a PILE score of 3 emerged as a potential surrogate marker for progression-free survival (PFS) (HR=3.393, 95% CI: [0.822–13.996]; p=0,091). Further, an ECOG PS ≥2 was related to an elevated risk of both progression (HR=1.862, 95% CI: [1.030–3.364]; p=0.040) and overall survival (OS) (HR=2.399, 95% CI: [1.286–4.474]; p=0.006), alongside a reduced RR (HR=3.352, 95% CI: [1.397–8.043]; p=0.007). The impact of monocyte levels on PFS was statistically significant (HR=2.291, 95% CI: [0.999–5.251]; p=0.050). The study demonstrated an association between PIV and PILE scores and RR, PFS and OS in ICI-treated patients.