Prognostic Value of the Lung Immune Prognostic Index in Metastatic Renal Cell Carcinoma Treated With Second-Line Immunotherapy.

Authors

Uğur Özberk, Perihan Perkin, Berkay Yeşilyurt, Efnan Algın, Hilal Karakaş, Bülent Akıncı, Gökhan Uçar

Published in

International journal of urology : official journal of the Japanese Urological Association. Volume 33. Issue 9. Pages e70619.

Abstract

Prognostic stratification remains challenging in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors. The Lung Immune Prognostic Index (LIPI) may better reflect immunotherapy-related outcomes in this setting.
This retrospective study included 120 patients with mRCC who received second-line nivolumab after progression on prior tyrosine kinase inhibitor therapy. LIPI was calculated using lactate dehydrogenase (LDH) and derived neutrophil-to-lymphocyte ratio (dNLR), and patients were categorized into good, intermediate, and poor risk groups. Overall survival (OS) was estimated using the Kaplan-Meier method and compared with the log-rank test. Prognostic performance was assessed using log-rank Chi-squared statistics and the concordance index (C-index). Cox regression analyses were performed to identify independent prognostic factors for OS.
Kaplan-Meier analyses demonstrated the most distinct survival separation for LIPI compared with MSKCC and IMDC risk models. Log-rank Chi-squared values were approximately 24 for LIPI, 16 for MSKCC, and 6.6 for IMDC. Concordance analysis confirmed superior prognostic discrimination with LIPI (C-index 0.639) compared with MSKCC (0.618) and IMDC (0.555). In multivariate analysis, ECOG performance status 2 (HR 4.18, 95% CI 1.62-10.79; p = 0.003), absence of diabetes mellitus (HR 0.45, 95% CI 0.25-0.79; p = 0.005), absence of prior nephrectomy (HR 1.93, 95% CI 1.10-3.37; p = 0.021), and absence of brain metastases (HR 0.47, 95% CI 0.23-0.95; p = 0.036) were independently associated with OS.
In mRCC patients treated with second-line nivolumab, LIPI provided superior discrimination for OS compared with established risk models, supporting its clinical utility.

PMID:
42655932
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.

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