Work

Evaluation of six clinical prognostic scores in NSCLC patients undergoing first line chemoimmunotherapy

Year: 2026

Type: article

Abstract: Background: The study aimed to evaluate the effectiveness of six prognostic scores for predicting the outcomes to first-line chemoimmunotherapy (CIT) in non-small cell lung cancer (NSCLC) patients. Materials and methods: NSCLC patients receiving first-line CIT were included. The prognostic scores evaluated were RMH, MDACC, MDACC+NLR, MDA-ICI, LIPI, and GRIm. Survival curves were generated using the Kaplan-Meier method, and univariate and multivariate analyses were conducted via the Cox proportional hazards regression model. The C-index and time-dependent AUC were calculated to comprehensively quantify and compare the predictive performance of each system. The Log-rank test and False Discovery Rate (FDR) correction was employed to compare survival outcomes across different risk groups defined by the six prognostic scoring systems. Results: = 0.031) as independent predictors of poor OS. In quantitative performance comparison, RMH achieved the highest C-indices for both OS (0.672, 95%CI: 0.531-0.813) and PFS (0.652, 0.564-0.737); MDACC also performed well, with C-indices for OS (0.651, 0.564-0.737) and PFS (0.615, 0.554-0.738). Time-dependent AUC analysis showed that MDA-ICI attained the highest 1-year OS and PFS AUC (0.630 and 0.592), followed by the MDACC+NLR (0.600 and 0.571). Based on log-rank testing and following FDR correction, only the MDACC maintained a statistically significant association with OS (high-risk 14.0 vs. intermediate-risk 34.6 vs. low-risk NR months; P = 0.003, Q = 0.036). For PFS, the MDACC+NLR score showed a marginal significance after FDR correction (Q = 0.054). Conclusions: The RMH, MDACC, and MDACC+NLR scoring systems all demonstrate prognostic utility in the NSCLC patients treated with first-line CIT, and the optimal choice among them may depend on the specific clinical context and the outcome metric of primary interest.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1695859