SUVmax-IPI as a New Prognostic Index in Metastatic Non-Small Cell Lung Cancer Patients Receiving Nivolumab


Kolkıran N., ERDOĞAN A. P., ŞAHBAZLAR M., Taş S., Gököz Doğu G., CANASLAN K., ...More

Current Oncology, vol.32, no.10, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 10
  • Publication Date: 2025
  • Doi Number: 10.3390/curroncol32100566
  • Journal Name: Current Oncology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Keywords: inflammatory markers, nivolumab, non-small cell lung cancer, survival outcomes
  • Manisa Celal Bayar University Affiliated: Yes

Abstract

Background/Objectives: Nivolumab has significantly improved outcomes in patients with metastatic non-small cell lung cancer (NSCLC); however, reliable prognostic biomarkers remain an unmet need. To address this gap, we developed the SUVmax-IPI, a novel prognostic index combining maximum standardized uptake value (SUVmax) from 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) with systemic inflammatory markers. This study aimed to evaluate the prognostic value of SUVmax-IPI in patients with NSCLC receiving nivolumab therapy. Methods: This multicenter retrospective analysis included 187 patients with metastatic NSCLC receiving nivolumab across 5 tertiary institutions. The SUVmax-IPI incorporated pretreatment SUVmax and laboratory-based inflammatory prognostic index (IPI) parameters. Survival outcomes were evaluated using Kaplan–Meier analysis with log-rank testing and multivariate cox regression. Results: Receiver operating characteristic (ROC) analysis established an optimal SUVmax-IPI cut-off of 241.9. Patients with SUVmax-IPI ≤ 241.9 had significantly better survival outcomes: median overall survival (OS) was 35 versus 15 months (p = 0.002). For progression-free survival (PFS), although a numerical difference favored patients with SUVmax-IPI ≤ 241.9 (median: 15 vs. 8 months), this did not reach statistical significance (log-rank p = 0.175). Multivariate analysis confirmed SUVmax-IPI as an independent predictor of survival (p = 0.002). Conclusions: The SUVmax-IPI represents a promising prognostic tool for patients with metastatic NSCLC who received at least 3 months of nivolumab, integrating metabolic and inflammatory parameters to predict survival outcomes.