Systemic Immune-Inflammation Index as a Predictor of Survival in Non-Small Cell Lung Cancer Patients Undergoing Immune Checkpoint Inhibition: A Systematic Review and Meta-Analysis
Abstract
BACKGROUND
This meta-analysis aims to evaluate the association between pretreatment systemic immune-inflammation index (SII) levels and progression-free survival (PFS) and overall survival (OS) in NSCLC patients receiving immune checkpoint inhibitors (ICIs).
METHODS
A systematic search was conducted across PubMed, Embase, and Web of Science. Hazard ratios (HRs) with 95% confidence intervals (CIs) for PFS and OS were extracted or calculated. Random-effects models were employed to pool the results and subgroup analyses were performed based on study characteristics, treatment regimens, and analytical methods.
RESULTS
Two prospective and 11 retrospective studies involving 2,342 NSCLC patients treated with ICIs were included. A high pretreatment SII was significantly associated with poor PFS (HR: 2.05, 95% CI: 1.59-2.64, p 0.05). Interestingly, the subgroup analyses indicated a stronger association in patients receiving ICIs alone versus those receiving concurrent chemotherapy (p for subgroup difference = 0.04).
CONCLUSIONS
High pretreatment SII is associated with worse PFS and OS in NSCLC patients treated with ICIs, particularly for the patients receiving ICIs alone without concurrent chemotherapy.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,342 participants or records.
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