Association of the prognostic model iSEND with PD-1/L1 monotherapy outcome in non-small-cell lung cancer

Wungki Park, Laura Mezquita, Naoyuki Okabe, Young Kwang Chae, Deukwoo Kwon, Diana Saravia, Edouard Auclin, David Planchard, Caroline Caramella, Roberto Ferrara, Sarita Agte, Michael Oh, Raja Mudad, Mohammad Jahanzeb, Hiroyuki Suzuki, Benjamin Besse, Gilberto Lopes*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Background: Accessible biomarkers are needed for immunotherapy in advanced non-small-cell lung cancer (NSCLC). We previously described a multivariate risk prediction model, the iSEND, which categorises advanced NSCLC patients treated with nivolumab into Good, Intermediate or Poor groups. This model was developed by using only clinical and analytical variables (sex, ECOG-performance status, neutrophil-to-lymphocyte ratio [NLR] and post-treatment delta NLR). Methods: An international database of 439 patients who received post-platinum PD-1/L1 monotherapies was collected for validation. Performance of the iSEND to different PD-L1 groups was compared by using time-dependent positive predictive value (PPV) for their mortality events. Results: Median follow-up was 18.2 months (95% CI: 15.9–19.6). The overall survival of the iSEND Good (HR = 0.31, 95% CI: 0.22–0.43, p < 0.0001) was superior to the iSEND Poor. Time-dependent PPV for mortality of iSEND Poor was superior to PD-L1 = 0% group at 12 (75 vs. 53%, p = 0.01) and 18 months (85 vs. 46%, p = 0.03). However, female gender did not independently associate with better outcome in the validation cohort. Conclusion: The iSEND model is associated with the outcome of post-platinum PD-1/L1 monotherapy in advanced NSCLC patients. The iSEND Poor demonstrated a superior performance to PD-L1 = 0% in negative prognostication. Prospective investigation and modelling with other significant parameters in a larger cohort are warranted.

Original languageEnglish (US)
Pages (from-to)340-347
Number of pages8
JournalBritish Journal of Cancer
Issue number3
StatePublished - Feb 4 2020

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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