SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1640066
This article is part of the Research TopicPredictive Biomarkers to Immune Checkpoint Inhibitors in Lung CancerView all 6 articles
Prognostic value of baseline LIPI, LDH and dNLR in ES-SCLC patients receiving immune checkpoint inhibitors: A systematic review and meta-analysis
Provisionally accepted
- 1The First Affiliated Hospital of Zhengzhou University Department of Oncology, Zhengzhou, China
- 2Zhengzhou University College of Public Health, Zhengzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background:Existing research presents conflicting findings on how baseline lung immune prognostic index (LIPI), lactate dehydrogenase (LDH), and derived neutrophil-to-lymphocyte ratio (dNLR) levels influence the prognosis of patients with extensive-stage small cell lung cancer (ES-SCLC) undergoing treatment with immune checkpoint inhibitors (ICIs). This meta-analysis aims to clarify their impact. Methods:A comprehensive search of published literature up to January 1, 2025 was conducted in PubMed, Web of Science, Cochrane Library, and Embase. The study evaluated the association between baseline LIPI, LDH, and dNLR levels and overall survival (OS) and progression-free survival (PFS) in ES-SCLC patients receiving ICIs . Subgroup analyses were performed based on relevant factors, and the study adhered to PRISMA 2020 guidelines. Results: This meta-analysis included 23 studies (LIPI: 10 studies/1,291 patients; LDH: 17 studies/1,768 patients; dNLR: 5 studies/324 patients). Elevated LIPI was significantly associated with poorer PFS (hazard ratio (HR) = 1.57, 95% confidence interval (95% CI) 1.20 - 2.06; I² = 59.0%, P = 0.013) and OS (HR = 1.76, 95% CI 1.26 - 2.45; I² = 64.2%, P < 0.001). Baseline LDH correlated with poorer OS (HR = 1.70, 95% CI 1.29 - 2.24; I² = 78.7%, P < 0.001), while elevated dNLR affected OS (HR = 2.05, 95% CI 1.02 - 4.12; I² = 86.31%, P < 0.001). Subgroup analysis showed that LIPI-PFS heterogeneity came from univariate and multivariate groupings. And LDH-OS heterogeneity was driven by country grouping. Conclusion:In ES-SCLC patients treated with ICIs, elevated baseline LIPI indicates reduced PFS and OS, while higher LDH and dNLR levels correlate with poorer OS. Monitoring these biomarkers can inform clinical decisions and enhance patient counseling.
Keywords: lung immune prognostic index, Lactate dehydrogenase, derived neutrophil-to-lymphocyte ratio, Extensive-stage small cell lung cancer, immune checkpoint inhibitors, prognostic
Received: 03 Jun 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Zhou, Hu, Song, Wang, Kong, Zhao, Wu, Chen and Jia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shuaiyin Chen, sychen@zzu.edu.cn
Bin Jia, fccjiab@zzu.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.