World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website http://www.wjon.org

Original Article

Volume 11, Number 3, June 2020, pages 98-105


Gustave Roussy Immune Score and Royal Marsden Hospital Prognostic Score Are Prognostic Markers for Extensive Disease of Small Cell Lung Cancer

Figures

Figure 1.
Figure 1. Kaplan-Meier curves of overall survival according to GRIm-score (a) and RMH score (b). GRIm-score: Gustave Roussy immune score; RMH score: Royal Marsden Hospital prognostic score.
Figure 2.
Figure 2. Kaplan-Meier curves of progression-free survival according to GRIm-score (a) and RMH score (b). GRIm-score: Gustave Roussy immune score; RMH score: Royal Marsden Hospital prognostic score.

Tables

Table 1. Distribution of GRIm-Score and RMH Score
 
GRIm-scoreRMH score
0123Total
GRIm-score: Gustave Roussy immune score; RMH score: Royal Marsden Hospital prognostic score.
01760023
103026056
200221537
3004812
Total17365223128

 

Table 2. Baseline Characteristics, Treatment and Laboratory Data According to GRIm-Score
 
GRIm-scoreP
LowHigh
aFisher exact test. bMann-Whitney U test. BMI: body mass index; CI: confidence interval; CR: complete response; CS: current smoker; DCR: disease control rate; ECOG-PS: Eastern Cooperative Oncology Group performance status; Ex: ex-smoker; GRIm-score: Gustave Roussy immune score; IQR: interquartile range; LDH: lactate dehydrogenase; NE: not evaluated; NLR: neutrophil-to-lymphocyte ratio; NS: non-smoker; ORR: overall response rate; PD: progressive disease; SD: stable disease; ULN: upper limit of normal.
N7949
Backgrounds
  Sex (N)
    Male/female65/1436/130.27a
  Age (years)
    Median (IQR)71 (64 - 76)72 (66 - 81)0.17b
    < 75/≥ 75 years49/3030/191.00a
  Smoking status (N)
    NS/Ex/CS/unknown1/24/53/12/17/30/00.69a
  BMI
    Median (IQR)23.1 (20.3 - 26.2)21.1 (19.0 - 23.8)< 0.01b
    ≥ 18.5/< 18.5 (N)72/740/90.17a
  ECOG-PS (N)
    0 - 1/2/357/18/420/13/16< 0.01a
  Metastatic sites (N)
    < 3/≥ 346/3319/330.045a
Treatment
  Regimen (N)
    Platinum-based
      Cisplatin/carboplatin20/5911/380.83a
    Partner drugs
      Etoposide/irinotecan67/1246/30.16a
  Efficacy
    CR/PR/SD/PD/NE2/51/11/11/40/25/6/10/80.14a
    ORR (%) (95% CI)67.1 (55.6 - 77.3)51.0 (36.3 - 65.6)0.09a
    DCR (%) (95% CI)81.0 (70.6 - 89.0)63.3 (48.3 - 76.6)0.04a
  Second or later line (N)5118< 0.01a
    Amrubicin (N)3811< 0.01a
    Topotecan (N)1030.37a
    Irinotecan (N)610.25a
  Radiotherapy
    Brain2260.048a
    Thoracic641.00a
Laboratory data
  NLR
    Median (IQR)2.7 (2.0 - 4.1)4.7 (3.3 - 8.7)< 0.01b
    > 6 (N)120< 0.01a
  LDH (U/L)
    Median (IQR)233 (196.5 - 350)398 (280 - 493)< 0.01b
    > ULN (N)4348< 0.01a
  Albumin (g/dL)
    Median (IQR)3.9 (3.6 - 4.1)3.1 (2.7 - 3.4)< 0.01b
    < 3.5 g/dL (N)1242< 0.01a

 

Table 3. Baseline Characteristics, Treatment and Laboratory Data According to RMH Score
 
RMH scoreP
LowHigh
aFisher exact test. bMann-Whitney U test. BMI: body mass index; CI: confidence interval; CR: complete response; CS: current smoker; DCR: disease control rate; ECOG-PS: Eastern Cooperative Oncology Group performance status; Ex: ex-smoker; IQR: interquartile range; LDH: lactate dehydrogenase; NE: not evaluated; NLR: neutrophil-to-lymphocyte ratio; NS: non-smoker; ORR: overall response rate; PD: progressive disease; RMH score: Royal Marsden Hospital prognostic score; SD: stable disease; ULN: upper limit of normal.
N5474
Backgrounds
  Sex (N)
    Male/female45/956/180.38a
  Age (years)
    Median (IQR)72 (66 - 76)71.5 (65.3 - 80)0.83b
    < 75/≥ 75 years33/2146/281.00a
  Smoking status (N)
    NS/Ex/CS/unknown1/19/34/02/22/49/10.93a
  BMI
    Median (IQR)22.8 (19.8 - 26.1)21.3 (19.4 - 24.3)0.22b
    ≥ 18.5/< 18.5 (N)49/563/110.42a
  ECOG-PS (N)
    0 - 1/2/339/13/238/18/18< 0.01a
  Metastatic sites (N)
    < 3/≥ 347/718/56< 0.01a
Treatment
  Regimen (N)
    Platinum-based
      Cisplatin/carboplatin12/4219/550.68a
    Partner drugs
      Etoposide/irinotecan46/867/70.41a
  Efficacy
    CR/PR/SD/PD/NE1/35/10/7/11/41/7/14/110.04a
    ORR (%) (95% CI)66.7 (52.5 - 78.9)56.8 (44.7 - 68.2)0.27a
    DCR (%) (95% CI)85.2 (72.9 - 93.4)66.2 (54.3 - 76.8)0.02a
  Second or later line (N)3930< 0.01a
    Amrubicin (N)2821< 0.01a
    Topotecan (N)490.56a
    Irinotecan (N)430.45a
  Radiotherapy
    Brain15130.20a
    Thoracic550.74a
Laboratory data
  NLR
    Median (IQR)2.6 (2.0 - 4.0)4.1 (2.7 - 5.8)< 0.01b
    > 6 (N)219< 0.01a
  LDH (U/L)
    Median (IQR)212 (186 - 314)332 (266 - 490)< 0.01b
    > ULN (N)2368< 0.01a
  Albumin (g/dL)
    Median (IQR)3.9 (3.7 - 4.1)3.3 (2.8 - 3.8)<0.01b
    < 3.5 g/dL (N)747<0.01a

 

Table 4. Multivariate Cox Hazard Proportional Analyses of Overall Survival of All Patients
 
VariableGRIm-scoreRMH score
HR (95% CI)PHR (95% CI)P
BMI: body mass index; CI: confidence interval; ECOG-PS: Eastern Cooperative Oncology Group performance status; GRIm-score: Gustave Roussy immune score; HR: hazard ratio; NLR: neutrophil-to-lymphocyte ratio; RMH score: Royal Marsden Hospital prognostic score.
Age (years)
  < 751 (Reference)1 (Reference)
  ≥ 751.34 (0.87 - 2.06)0.191.29 (0.82 - 2.02)0.27
BMI
  ≥ 18.51 (Reference)1 (Reference)
  < 18.51.39 (0.79 - 2.45)0.251.57 (0.89 - 2.77)0.12
Platinum-based
  Cisplatin1 (Reference)1 (Reference)
  Carboplatin0.94 (0.54 - 1.62)0.820.82 (0.48 - 1.41)0.48
ECOG-PS
  0 - 11 (Reference)1 (Reference)
  2 - 42.16 (1.41 - 3.31)< 0.012.12 (1.38 - 3.24)< 0.01
No. of metastases
  < 31 (Reference)
  ≥ 31.97 (1.29 - 3.02)< 0.01
GRIm-score
  Low (0 - 1)1 (Reference)
  High (2 - 3)1.80 (1.20 - 2.72)< 0.01
NLR
  < 61 (Reference)
  ≥ 61.17 (0.65 - 2.09)0.60
RMH score
  Low (0 - 1)1 (Reference)
  High (2 - 3)1.93 (1.27 - 2.92)< 0.01

 

Table 5. Multivariate Cox Hazard Proportional Analyses of Progression-Free Survival of First-Line Chemotherapy
 
VariablesGRIm-scoreRMH score
HR (95% CI)PHR (95% CI)P
BMI: body mass index; CI: confidence interval; ECOG-PS: Eastern Cooperative Oncology Group performance status; GRIm-score: Gustave Roussy immune score; HR: hazard ratio; NLR: neutrophil-to-lymphocyte ratio; RMH score: Royal Marsden Hospital prognostic score.
Age (years)
  < 751 (Reference)1 (Reference)
  ≥ 750.98 (0.65 - 1.47)0.911.00 (0.66 - 1.51)1.00
BMI
  ≥ 18.51 (Reference)1 (Reference)
  < 18.51.30 (0.76 - 2.22)0.341.21 (0.71 - 2.06)0.49
Platinum-based
  Cisplatin1 (Reference)1 (Reference)
  Carboplatin1.22 (0.73 - 2.01)0.451.08 (0.66 - 1.78)0.76
ECOG-PS
  0 - 11 (Reference)1 (Reference)
  2 - 41.27 (0.84 - 1.92)0.261.33 (0.88 - 2.02)0.18
No. of metastases
  < 31 (Reference)
  ≥ 31.60 (1.09 - 2.34)0.02
GRIm-Score
  Low (0 - 1)1 (Reference)
  High (2 - 3)1.13 (0.76 - 1.67)0.55
NLR
  < 61 (Reference)
  ≥ 60.87 (0.49 - 1.55)0.65
RMH score
  Low (0 - 1)1 (Reference)
  High (2 - 3)1.53 (1.04 - 2.25)0.03