Body mass index and serum markers associated with progression-free survival in lung cancer patients treated with immune checkpoint inhibitors

Background: ICIs have remarkably affected the treatment strategies for numerous malignancies, including lung cancer. However, only a fraction of patients experience durable responses to ICIs; thus, there is an urgent need to identify the parameters related to ICI therapeutic effects. In this study, we investigated nutritional status surrogates and several serum markers to estimate the efficacy of ICIs. Materials and methods: The records of 66 patients with stage III/IV lung cancer who received ICIs were retrospectively analyzed. Features of patients' clinical pathology, including age, sex, histology, line of treatment, BMI, serum albumin, serum creatinine, and serum inflammatory markers such as LMR and PLR, were examined. Progression-free survival was the primary endpoint. Relationships among categorical variables were assessed by the chi-squared test. Survival analysis was performed using the Kaplan-Meier method followed by the log-rank test. Cox multivariate analysis was performed to analyze the association between each variable and the survival time of patients. Results: The patients with BMI >= 25 (kg/m2), serum ALB >= 37 (g/dL), serum creatinine >= 61.8 (mu mol/L), LMR >= 2.12 had a significantly prolonged PFS in comparison with BMI<25 (kg/m2), ALB<37 (g/dL), creatinine<61.8 (mu mol/L), LMR<2.12 (p < 0.05). No statistically significant difference was detected between patients with PLR < 135 and PLR >= 135 (p = 0.612). Multivariate analysis revealed that ALB >= 37 (g/dL) and creatinine >= 61.8 (mu mol/L) were associated with prolonged PFS, while statistical significance was not achieved in the BMI groups. Conclusions: The current results indicated that high BMI is related to longer PFS in lung cancer patients treated with ICIs, which may be correlated with high levels of serum albumin and creatinine.