Nutritional Indexes and Their Variations as Predictors of Atezolizumab Plus Chemotherapy Efficacy in Extensive-Stage Small Cell Lung Cancer: A Turkish Oncology Group Study

Nutritional status has been associated with prognosis in several cancers. We investigated whether baseline prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) as well as their variations during treatment predicted response and survival in extensive-stage small cell lung cancer (ES-SCLC) patients treated with atezolizumab plus chemotherapy. In this multicenter study, records of ES-SCLC patients who received first-line atezolizumab plus platinum-etoposide combination were reviewed retrospectively. Baseline PNI P =0.02). In patients with a low baseline PNI, median PFS was significantly shorter (6.1 vs. 8.7 mo, P =0.04) and it significantly predicted PFS (hazard ratio=1.52, P =0.03). Median OS was significantly shorter in patients with ΔPNI ≤−10% (11.1 vs. 14.9 mo, P =0.01), which independently predicted OS (hazard ratio=2.10, P =0.001). Baseline GNRI and ΔGNRI were not associated with efficacy. However, in patients 65 years of age or older, median PFS was significantly shorter in cases with a low baseline GNRI (7.1 vs. 10.7 mo, P =0.04). PNI and its variations as convenient and cost-effective markers can help predict response and prognosis in ES-SCLC patients receiving first-line atezolizumab plus chemotherapy. GNRI might emerge as an additional prognostic tool in patients 65 years of age or older.