{"paper_id":"32c666b7-2ef5-46e7-bd77-3e435f17493d","body_text":"Predictive value of peripheral blood inflammatory biomarkers in immunotherapy for extensive-stage small-cell lung cancer | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Predictive value of peripheral blood inflammatory biomarkers in immunotherapy for extensive-stage small-cell lung cancer meiyi you, Chunchu kong, MU Mei, Wenjun Pei This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7744188/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The clinical management of extensive-stage small-cell lung cancer (ES-SCLC) is challenged by the lack of reliable biomarkers to identify patients resistant to first-line immunotherapy. Peripheral blood inflammatory biomarkers are emerging as promising prognostic tools in oncology, but their predictive role in ES-SCLC remains unclear. Methods We conducted a multicenter retrospective study of patients with ES-SCLC treated between January 2020 and January 2024 in two hospitals. Baseline clinical data and peripheral blood inflammatory indices—including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), modified Glasgow Prognostic Score (mGPS), and Lung Immune Prognostic Index (LIPI)—were collected before treatment and after four cycles of immunochemotherapy. Optimal cut-off values were determined using X-tile software, and dynamic changes (Δ) were calculated. Survival analyses were performed with Kaplan–Meier and Cox proportional hazards models. Prognostic nomograms were developed and validated with calibration curves and receiver operating characteristic (ROC) analysis. Results A total of 212 patients were included, with a median follow-up of 16.2 months. The objective response rate (ORR) and disease control rate (DCR) were 46.7% and 72.2%, respectively. The median progression-free survival (PFS) and overall survival (OS) were 8.4 and 15.3 months. High pre-treatment NLR, high pre-treatment MPV, increased ΔNLR, pre-mGPS score of 2, and elevated ΔmGPS or ΔLIPI were independent predictors of shorter PFS. For OS, high pre-treatment NLR, pre-mGPS score of 2, pre-LIPI score of 2, and increased ΔNLR, ΔmGPS, or ΔLIPI were independent risk factors. The nomograms demonstrated good predictive accuracy for both PFS and OS, with area under the curve (AUC) values ranging from 0.728 to 0.946. Conclusion Peripheral blood inflammatory biomarkers, particularly pre-NLR, ΔNLR, pre-mGPS, and ΔLIPI, are independent predictors of outcomes in ES-SCLC patients receiving first-line immunotherapy. The proposed nomograms provide effective tools for individualized risk stratification and treatment optimization. extensive-stage small-cell lung cancer immunotherapy peripheral blood inflammatory biomarkers neutrophil-to-lymphocyte ratio prognostic model Full Text Additional Declarations No competing interests reported. Supplementary Files file.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-7744188\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":558510512,\"identity\":\"e3170429-279d-4f97-a40d-bafa066d09eb\",\"order_by\":0,\"name\":\"meiyi you\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"The First People's Hospital of Changde\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"meiyi\",\"middleName\":\"\",\"lastName\":\"you\",\"suffix\":\"\"},{\"id\":558510517,\"identity\":\"ab7ff31a-e1b3-489e-a89d-d1e668717b19\",\"order_by\":1,\"name\":\"Chunchu 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biomarkers in immunotherapy for extensive-stage small-cell lung cancer\",\"fulltext\":[],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":false,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":true,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":true,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"extensive-stage small-cell lung cancer, immunotherapy, peripheral blood inflammatory biomarkers, neutrophil-to-lymphocyte ratio, prognostic model\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-7744188/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-7744188/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground\\u003c/h2\\u003e \\u003cp\\u003eThe clinical management of extensive-stage small-cell lung cancer (ES-SCLC) is challenged by the lack of reliable biomarkers to identify patients resistant to first-line immunotherapy. Peripheral blood inflammatory biomarkers are emerging as promising prognostic tools in oncology, but their predictive role in ES-SCLC remains unclear.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e \\u003cp\\u003eWe conducted a multicenter retrospective study of patients with ES-SCLC treated between January 2020 and January 2024 in two hospitals. Baseline clinical data and peripheral blood inflammatory indices\\u0026mdash;including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), modified Glasgow Prognostic Score (mGPS), and Lung Immune Prognostic Index (LIPI)\\u0026mdash;were collected before treatment and after four cycles of immunochemotherapy. Optimal cut-off values were determined using X-tile software, and dynamic changes (Δ) were calculated. Survival analyses were performed with Kaplan\\u0026ndash;Meier and Cox proportional hazards models. Prognostic nomograms were developed and validated with calibration curves and receiver operating characteristic (ROC) analysis.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e \\u003cp\\u003eA total of 212 patients were included, with a median follow-up of 16.2 months. The objective response rate (ORR) and disease control rate (DCR) were 46.7% and 72.2%, respectively. The median progression-free survival (PFS) and overall survival (OS) were 8.4 and 15.3 months. High pre-treatment NLR, high pre-treatment MPV, increased ΔNLR, pre-mGPS score of 2, and elevated ΔmGPS or ΔLIPI were independent predictors of shorter PFS. For OS, high pre-treatment NLR, pre-mGPS score of 2, pre-LIPI score of 2, and increased ΔNLR, ΔmGPS, or ΔLIPI were independent risk factors. The nomograms demonstrated good predictive accuracy for both PFS and OS, with area under the curve (AUC) values ranging from 0.728 to 0.946.\\u003c/p\\u003e\\u003ch2\\u003eConclusion\\u003c/h2\\u003e \\u003cp\\u003ePeripheral blood inflammatory biomarkers, particularly pre-NLR, ΔNLR, pre-mGPS, and ΔLIPI, are independent predictors of outcomes in ES-SCLC patients receiving first-line immunotherapy. 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