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Comment & Response
November 27, 2019

Application of the Lung Immune Prognostic Index From Research to Clinical Practice—Reply

Author Affiliations
  • 1Oncology Center of Excellence and Office of Hematology and Oncology Products, US Food and Drug Administration, Silver Spring, Maryland
  • 2Multiple Myeloma Program, Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
JAMA Oncol. Published online November 27, 2019. doi:https://doi.org/10.1001/jamaoncol.2019.5157

In Reply We thank Long et al for critically evaluating our study1 on the prognostic value of the lung immune prognostic index (LIPI) for patients treated for non–small cell lung cancer and for proposing 3 future clinical practice points, which we will address below. First, Long et al propose that different treatments require varying cutoff values for the neutrophil to lymphocyte ratio. Although we agree that it is important to use the appropriate cutoff and that results might vary depending on that value, our study evaluated baseline values prior to treatment. We showed that a prespecified neutrophil to lymphocyte ratio and lactate dehydrogenase level composite score can identify patients who are likely to have longer survival independent of treatment type (eg, immunotherapy, targeted therapy, chemotherapy). Our analysis did not aim to define a new cutoff value; rather, its intent was to validate the findings by Mezquita et al.2 Furthermore, Sorich et al,3 while our article was in press, published their findings, which similarly show that LIPI (using the original cutoff values) is prognostic for patients irrespective of whether they received immune checkpoint inhibitors or cytotoxic chemotherapy.

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