Caner ACAR, Haydar Çağatay YÜKSEL, Gökhan ŞAHİN, Fatma Pınar AÇAR, Erdem GÖKER
Journal of Oncological Sciences - 2026;12(1):32-40
Objective: The Scottish Inflammatory Prognostic Score (SIPS)-based on serum albumin and neutrophil count-has prognostic value in programmed death-ligand 1 (PD-L1)-high non-small-cell lung cancer (NSCLC), but its performance in broader real-world populations is uncertain. Material and Methods: We conducted a single-centre, retrospective study of patients with metastatic NSCLC who were treated with immune-checkpoint inhibitors between June 2016 and January 2025. SIPS was calculated pre-treatment (albumin 3.5 g/dL=1; neutrophils >7,500/µL=1). Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Cox regression was performed to estimate hazard ratios (HRs) and account for potential confounding. Results: Among 178 patients, the median age was 64.9 years, 80.3% were male, and 55 (30.9%) were classified as SIPS high-risk. High-risk was associated with shorter PFS (median 3.13 months, 95% confidence interval (CI) 2.27-3.70 vs. 4.27 months, 95% CI: 3.63-6.47; p<0.001) and shorter OS (median 4.73 months, 95% CI: 3.23-7.07 vs. 15.23 months, 95% CI: 12.23-23.90; p<0.001). In multivariable analyses, SIPS high-risk predicted inferior PFS (HR: 1.72, 95% CI: 1.18-2.52; p=0.005) and OS (HR: 2.21, 95% CI: 1.48-3.31; p<0.001). Effects were consistent across PD-L1 strata, treatment regimens, and lines of therapy; no significant interactions were detected. Conclusion: In a real-world NSCLC cohort, SIPS independently stratified PFS and OS, and may complement routine clinical variables in baseline risk discussions. Prospective multi-centre studies should validate SIPS, assess longitudinal applications, and determine whether SIPS-guided strategies improve patient-centred outcomes.
