Exploring the metabolic-immune score in advanced NSCLC treated with immunotherapy

Abstract Identifying reliable prognostic markers in patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) is critical for clinical decision-making. This study introduces the Metabolic and Immune Score (MIS), a novel scoring system combining metabo...

Full description

Saved in:
Bibliographic Details
Main Authors: Beliz Bahar Karaoğlan, Ecenur Dursun, İrem Mesci, Mine Soylu Araz, Elif Berna Köksoy
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-16788-7
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849226459334311936
author Beliz Bahar Karaoğlan
Ecenur Dursun
İrem Mesci
Mine Soylu Araz
Elif Berna Köksoy
author_facet Beliz Bahar Karaoğlan
Ecenur Dursun
İrem Mesci
Mine Soylu Araz
Elif Berna Köksoy
author_sort Beliz Bahar Karaoğlan
collection DOAJ
description Abstract Identifying reliable prognostic markers in patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) is critical for clinical decision-making. This study introduces the Metabolic and Immune Score (MIS), a novel scoring system combining metabolic and inflammatory markers. A retrospective analysis was conducted on 56 patients with advanced NSCLC treated with ICIs between January 2018 and January 2024. Baseline metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were calculated using 18F-FDG PET-CT imaging. Systemic inflammatory status was assessed using the Lung Immune Prognostic Index (LIPI). Median values for MTV and TLG were used as cut-off points. Primary outcomes were progression-free survival (PFS) and overall survival (OS). Patients with a LIPI score of 0 demonstrated significantly longer PFS (25.1 vs. 4.1 months, P < 0.001). High TLG levels (> 250.20) were also associated with shorter PFS (4.0 vs. 12.5 months, P = 0.021). On baseline PET-CT, median MTV and TLG were determined as 57.29 cm³ and 250.20, respectively. The MIS, derived from the combination of these two parameters, stratified patients into good, intermediate, and poor prognostic groups. Significant differences in PFS were observed among MIS groups (25.1, 6.3, and 1.5 months; P < 0.001), whereas median OS was not yet reached in the favorable group, and was 13.1 and 5.0 months in the intermediate and poor groups, respectively (P = 0.029). The MIS combines LIPI and TLG, providing a useful tool for predicting outcomes in advanced NSCLC patients treated with immunotherapy. Further validation in larger cohorts is warranted.
format Article
id doaj-art-d8854d99347d42eeb5355c458d5e128a
institution Kabale University
issn 2045-2322
language English
publishDate 2025-08-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-d8854d99347d42eeb5355c458d5e128a2025-08-24T11:21:07ZengNature PortfolioScientific Reports2045-23222025-08-0115111010.1038/s41598-025-16788-7Exploring the metabolic-immune score in advanced NSCLC treated with immunotherapyBeliz Bahar Karaoğlan0Ecenur Dursun1İrem Mesci2Mine Soylu Araz3Elif Berna Köksoy4Faculty of Medicine, Department of Medical Oncology, Ankara UniversityFaculty of Medicine, Department of Nuclear Medicine, Ankara UniversityFaculty of Medicine, Department of Nuclear Medicine, Ankara UniversityFaculty of Medicine, Department of Nuclear Medicine, Ankara UniversityFaculty of Medicine, Department of Medical Oncology, Ankara UniversityAbstract Identifying reliable prognostic markers in patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) is critical for clinical decision-making. This study introduces the Metabolic and Immune Score (MIS), a novel scoring system combining metabolic and inflammatory markers. A retrospective analysis was conducted on 56 patients with advanced NSCLC treated with ICIs between January 2018 and January 2024. Baseline metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were calculated using 18F-FDG PET-CT imaging. Systemic inflammatory status was assessed using the Lung Immune Prognostic Index (LIPI). Median values for MTV and TLG were used as cut-off points. Primary outcomes were progression-free survival (PFS) and overall survival (OS). Patients with a LIPI score of 0 demonstrated significantly longer PFS (25.1 vs. 4.1 months, P < 0.001). High TLG levels (> 250.20) were also associated with shorter PFS (4.0 vs. 12.5 months, P = 0.021). On baseline PET-CT, median MTV and TLG were determined as 57.29 cm³ and 250.20, respectively. The MIS, derived from the combination of these two parameters, stratified patients into good, intermediate, and poor prognostic groups. Significant differences in PFS were observed among MIS groups (25.1, 6.3, and 1.5 months; P < 0.001), whereas median OS was not yet reached in the favorable group, and was 13.1 and 5.0 months in the intermediate and poor groups, respectively (P = 0.029). The MIS combines LIPI and TLG, providing a useful tool for predicting outcomes in advanced NSCLC patients treated with immunotherapy. Further validation in larger cohorts is warranted.https://doi.org/10.1038/s41598-025-16788-7ImmunotherapyLung immune prognostic indexMetabolic tumor volumeNon-small cell lung cancerTotal lesion glycolysis
spellingShingle Beliz Bahar Karaoğlan
Ecenur Dursun
İrem Mesci
Mine Soylu Araz
Elif Berna Köksoy
Exploring the metabolic-immune score in advanced NSCLC treated with immunotherapy
Scientific Reports
Immunotherapy
Lung immune prognostic index
Metabolic tumor volume
Non-small cell lung cancer
Total lesion glycolysis
title Exploring the metabolic-immune score in advanced NSCLC treated with immunotherapy
title_full Exploring the metabolic-immune score in advanced NSCLC treated with immunotherapy
title_fullStr Exploring the metabolic-immune score in advanced NSCLC treated with immunotherapy
title_full_unstemmed Exploring the metabolic-immune score in advanced NSCLC treated with immunotherapy
title_short Exploring the metabolic-immune score in advanced NSCLC treated with immunotherapy
title_sort exploring the metabolic immune score in advanced nsclc treated with immunotherapy
topic Immunotherapy
Lung immune prognostic index
Metabolic tumor volume
Non-small cell lung cancer
Total lesion glycolysis
url https://doi.org/10.1038/s41598-025-16788-7
work_keys_str_mv AT belizbaharkaraoglan exploringthemetabolicimmunescoreinadvancednsclctreatedwithimmunotherapy
AT ecenurdursun exploringthemetabolicimmunescoreinadvancednsclctreatedwithimmunotherapy
AT iremmesci exploringthemetabolicimmunescoreinadvancednsclctreatedwithimmunotherapy
AT minesoyluaraz exploringthemetabolicimmunescoreinadvancednsclctreatedwithimmunotherapy
AT elifbernakoksoy exploringthemetabolicimmunescoreinadvancednsclctreatedwithimmunotherapy