TY  - EJOU
AU  - Cha, Hyungkeun 
AU  - Lee, Yong Seok 
AU  - Kwon, Gui Young 
AU  - Kim, Boran 
AU  - Moon, Yeonsook 
AU  - Kim, Lucia 
AU  - Nam, Hae-Seong 

TI  - Clinical Value of the Systemic Immune Inflammation Index and PD-L1 Expression in Advanced NSCLC Treated with Pembrolizumab: Real-World Preliminary Study
T2  - Oncology Research

PY  - 
VL  - 
IS  - 
SN  - 1555-3906

AB  - <b>Objective:</b> Studies on the comprehensive utility of complete blood count-derived inflammatory biomarkers (CBC-IBs) as biomarkers in pembrolizumab-treated advanced non-small-cell lung cancer (NSCLC) are scarce. This study aimed to investigate the clinical relevance of a panel of CBC-IBs as potential predictive biomarkers and assess whether integrating the systemic immune-inflammation index (SII) with programmed death-ligand 1 (PD-L1) expression could overcome the limitations of PD-L1 as a standalone predictive biomarker. <b>Methods:</b> Our real-world preliminary study was conducted on a cohort of patients with advanced NSCLC. Patients who had undergone PD-L1 immunohistochemistry testing at the time of diagnosis, and had completed at least three cycles of pembrolizumab were included. The CBC-IBs analyzed in this study were calculated using absolute cell counts of neutrophils, lymphocytes, monocytes, and platelets. <b>Results:</b> A total of 102 patients were included. Low baseline SII was significantly associated with superior progression-free survival (PFS) (<i>p</i> = 0.031) and overall survival (OS) (<i>p</i> = 0.004). In multivariate analysis, SII emerged as the strongest independent predictor for OS among all evaluated CBC-IBs. Furthermore, patients with a combination of low SII and high PD-L1 expression demonstrated the most favorable survival outcomes. <b>Conclusion:</b> Although further prospective and multicenter studies are needed to validate the generalizability of our findings, the clinical implication is that the use of pretreatment SII and/or PD-L1 expression values may predict therapeutic outcomes and assist in optimizing individualized treatment strategies for patients with advanced NSCLC.
KW  - Systemic immune inflammation index (SII); programmed death-ligand 1 (PD-L1) expression; pembrolizumab; non-small-cell lung cancer (NSCLC); biomarkers

DO  - 10.32604/or.2026.077514