WCLC 2025 - Posters & ePosters-P2.15 .03 Predictive Value of LIPI Score in the Response to Immunotherapy in Very Elderly Patients With Advanced Non-Small Cell Cancer

P2.15 .03 Predictive Value of LIPI Score in the Response to Immunotherapy in Very Elderly Patients With Advanced Non-Small Cell Cancer

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This study evaluates the predictive value of the Lung Immune Prognostic Index (LIPI) score for immunotherapy response in very elderly patients (aged 80 and above) with advanced non-small-cell lung cancer (NSCLC). Given the rising incidence of NSCLC among the very elderly—a population increasingly treated with immunotherapy—the research addresses an important clinical gap regarding personalized treatment in this age group.<br /><br />Conducted prospectively, the study included 30 patients (median age 83, range 80-95; 80% male) with advanced NSCLC receiving immunotherapy. The LIPI score was calculated using lactate dehydrogenase (LDH) and derived neutrophil-to-lymphocyte ratio (dNLR) values obtained 30 days before therapy initiation. Molecular profiling and PD-L1 expression were also assessed, with KRAS mutations being the most common genetic alteration.<br /><br />Patients were stratified into three prognostic groups based on LIPI: good, intermediate, and poor. Median overall survival (OS) varied markedly across these groups: 14 months in the good, 6 months in the intermediate, and 1 month in the poor prognosis group (p=0.062). Progression-free survival (PFS) showed significant differences, with the good prognosis group’s median PFS not reached, compared to 5 months and 1 month in the intermediate and poor groups, respectively (p=0.035). These survival differences were consistent regardless of whether patients received immunotherapy alone or combined with chemotherapy, and irrespective of first-line treatment status.<br /><br />In conclusion, the LIPI score is a valid prognostic tool that correlates with immunotherapy efficacy in very elderly NSCLC patients. Its use may enable more personalized and individualized treatment, addressing the specific needs of this growing patient population. The study underscores the importance of incorporating prognostic indices like LIPI in clinical decision-making for elderly oncology patients.

Asset Subtitle

Alejandro Olivares Hernández

Meta Tag

Speaker Alejandro Olivares Hernández

Topic Multidisciplinary Care: Nursing, Allied Health and Palliative Care

Keywords

Lung Immune Prognostic Index

LIPI score

immunotherapy response

very elderly patients

advanced non-small-cell lung cancer

NSCLC

overall survival

progression-free survival

KRAS mutations

prognostic groups