Prognostic value of inflammatory-nutritional indexes and HALP score in advanced stage NSCLC treated with first-line TKI.

In metastatic Non-small cell lung cancer (NSCLC) with driver mutations, resistance mechanisms may limit treatment benefit, and their detection is expensive. The aim of this retrospective study was to investigate the usability of inflammatory-nutritional indices and hemoglobin, albumin, lymphocyte and platelet (HALP) scores for predicting survival in patients with metastatic NSCLCs with driver mutations undergoing first-line treatment with tyrosine kinase inhibitors (TKIs). Ninety-two patients using TKIs for metastatic disease with driver mutations were followed up in our center from December 2018 to May 2024. We retrospectively investigated the effects on progression-free survival (PFS) and overall survival (OS) by calculating inflammatory-nutritional indices and HALP scores using pre-treatment laboratory values. Higher plate-let-to-lymphocyte ratios (PLRs) were associated with shorter PFS, whereas a higher prognostic nutritional index (PNI) predicted longer PFS. Similarly, high HALP and PNI scores were significantly associated with longer OS, while lower platelet-to-lymphocyte ratio (PLR), systemic immune inflammatory index (SII) and systemic inflammation response index (SIRI) were linked to improved OS. Multivariate analysis identified only SII as an independent OS prognostic factor (OR = 7.182, p = 0.003). HALP score, PLR, SII, PNI and SIRI may serve as potential prognostic biomarkers in NSCLC patients with driver mutations treated with first-line TKIs.