Gustave Roussy Immune Score (GRIm-Score) Predicts Prognosis in Non-Small Cell Lung Cancer Patients Undergoing Nivolumab: A Multicenter Retrospective Study from Turkiye

The Gustave Roussy Immune Score (GRIm-Score) is a prognostic marker used for predicting the survival outcomes of cancer patients who are undergoing immunotherapy. The purpose of this study is to evaluate the prognostic significance of the GRIm-Score in advanced NSCLC patients treated with nivolumab, and to explore its role in clinical decision-making and treatment optimization. This two-center retrospective study included 285 patients with metastatic NSCLC treated with nivolumab between 2021 and 2024. Clinico-pathologic characteristics, laboratory parameters and treatment responses were evaluated. GRIm-Score was calculated by neutrophil-to-lymphocyte ratio (NLR), baseline albumin and lactate dehydrogenase (LDH) levels. The median age of the patients was 64 years and men were 86.7% of all patients. Compared to those with a high GRIm-Score (2-3), those with a low GRIm-Score (0-1) had significantly better disease control rates (DCR) and objective response rates (ORR) (DCR: 79.7% vs. 32.8%, p= 0.0001; ORR: 56.5% vs. 18.5%; p= 0.0001). In multivariate analysis, serum albumin level, de novo metastatic disease and NLR outcome were predictive of overall survival. Low GRIm-score was associated with long-term survival. The GRIm-Score is an important prognostic factor in patients with advanced NSCLC treated with nivolumab. The GRIm-Score can guide clinicians in selecting patients for nivolumab therapy, optimizing treatment outcomes and resource allocation in clinical practice. Keywords: Non-small cell lung cancer, Gustave Roussy Immune Score, Peripheral blood inflammatory markers, Nivolumab, Immunotherapy