ORIGINAL RESEARCH article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1616302
This article is part of the Research TopicReal-World Data and Real-World Evidence in Lung Cancer Volume IIView all 4 articles
Association of the Triglyceride-Glucose Index With Immunotherapy Efficacy and Long-Term Prognosis in Advanced Non-Small Cell Lung Cancer
Provisionally accepted
- 1Xuzhou Medical University, Xuzhou, China
- 2Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, Zhejiang Province, China
- 3The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 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: Non-small cell lung cancer (NSCLC), the most common subtype of primary lung cancer, represents a major component of the global cancer burden. Despite the availability of several immunotherapeutic and immune-combination treatment modalities, its prognosis remains poor. Therefore, it is particularly important to predict the prognosis of these patients. Aim: To investigate whether a marker of insulin resistance [the triglyceride-glucose (TyG) index] could predict clinical outcomes in patients with advanced non-small cell lung cancer receiving pembrolizumab and chemotherapy. Methods: We retrospectively analysed data of 243 patients with advanced non-small cell lung cancer treated with pembrolizumab and chemotherapy, dividing them into high and low TyG index groups based on an optimal cut-off value of 1.61, determined using the X-tile software. Cox proportional hazards regression analysis identified independent prognostic factors for overall survival (OS), and a prediction nomogram model was developed based on them. Results: The study cohort included 132 patients with a high TyG index and 111 with a low TyG index. The median progression-free survival and OS in the low TyG index group were significantly longer than in the high TyG index group. The objective response rate was 45.05% in the low TyG index group and 25.76% in the high TyG index group, while the respective disease control rates were 85.59% and 53.03%. Multifactorial regression analysis identified pre-treatment maximum tumour diameter, PD-L1 TPS (Tumor Proportion Score), BMI(Body Mass Index), and TyG index as independent prognostic predictors of OS. The nomogram model emphasised the importance of the TYG index as a major prognostic predictor, followed by the PD-L1 TPS score, pre-treatment tumour diameter, and BMI. Conclusion: The TyG index is a long-term predictor of the efficacy of combined immunotherapy and chemotherapy in patients with advanced NSCLC. Patients with a low TyG index have a better prognosis.
Keywords: Non-small cell lung cancer, TyG index, pembrolizumab monoclonal antibody, efficacy, Safety
Received: 22 Apr 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Ma, Zhu, Wang, Zhao, Wei, Xiong and Ji. 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: Guijuan Ji, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
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.