Prognostic Significance of C-PLAN Index in Patients Treated with Immunotherapy for Non-Small-Cell Lung Cancer

<b>Background/Objectives:</b> Non-small-cell lung cancer (NSCLC) is a common disease with a high mortality rate and is often treated with immunotherapies; however, prognostic markers are required to identify patients who are most likely to benefit from these treatments. Therefore, we designed this study to assess the prognostic significance of the C-PLAN index, which includes performance status (PS) and C-reactive protein (CRP). <b>Methods:</b> A total of 560 patients were included in this multicenter study. Patients had been diagnosed with NSCLC and had received nivolumab therapy. The C-PLAN index, defined in 2022, is a score derived from the combination of PS, CRP, lactate dehydrogenase (LDH), albumin, and neutrophil-lymphocyte ratio (NLR). Patients were classified into good-, moderate-, and poor-prognosis groups according to the C-PLAN score. <b>Results:</b> The median metastatic overall survival was 25 months in the group with a C-PLAN score < 2 and 6 months in the group with a C-PLAN score ≥ 2 (<i>p</i> < 0.001). The median metastatic progression-free survival was 11 months in the group with a C-PLAN score < 2 and 3 months in the group with a C-PLAN score ≥ 2. <b>Conclusion:</b> This is the first comprehensive study demonstrating that the C-PLAN index can be used for prognostic purposes in immunotherapy. This score, which can be easily, economically, and practically calculated in outpatient clinics, can predict patient prognosis and determine who should receive longer durations of immunotherapy.

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Journal
Journal of Clinical Medicine
Published
2026-01-13
DOI
https://doi.org/10.3390/jcm15020642
Primary Topic
Inflammatory Biomarkers in Disease Prognosis
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article
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article

Prognostic Significance of C-PLAN Index in Patients Treated with Immunotherapy for Non-Small-Cell Lung Cancer

M. Erman, M. Özcan Ersoy, Saadettin Kılıçkap, Teoman Şakalar et al.
Journal of Clinical Medicine
Inflammatory Biomarkers in Disease Prognosis
article

Prognostic Significance of C-PLAN Index in Patients Treated with Immunotherapy for Non-Small-Cell Lung Cancer

M. Erman, M. Özcan Ersoy, Saadettin Kılıçkap, Teoman Şakalar, T. Koseci, Latif Karahan, Berrak Mermit Erçek, muslih urun, Elif Şahin, Cengiz Akosman, Hayati Arvas, Gözde Ağdaş, Sedat Biter, Erkam Kocaaslan, Muhammet Cengiz, Duygu Bayir, Metin Özkan, Aslihan Ezgi Apaydin Rollas, Erdem Kolemen, Sedat Yildirim, Nargiz Majidova, Emel Mutlu Ozkan, Ayse Nuransoy Cengiz, Devrim Cabuk, Anıl Karakayali, Mevlude Inanc, Havva Yesil Cinkir, Umut Kefeli, Ezgi Turkoğlu, Mehmet Mutlu Kidi, Canan Yildiz, Pervin Can Sanci
article en

Abstract

<b>Background/Objectives:</b> Non-small-cell lung cancer (NSCLC) is a common disease with a high mortality rate and is often treated with immunotherapies; however, prognostic markers are required to identify patients who are most likely to benefit from these treatments. Therefore, we designed this study to assess the prognostic significance of the C-PLAN index, which includes performance status (PS) and C-reactive protein (CRP). <b>Methods:</b> A total of 560 patients were included in this multicenter study. Patients had been diagnosed with NSCLC and had received nivolumab therapy. The C-PLAN index, defined in 2022, is a score derived from the combination of PS, CRP, lactate dehydrogenase (LDH), albumin, and neutrophil-lymphocyte ratio (NLR). Patients were classified into good-, moderate-, and poor-prognosis groups according to the C-PLAN score. <b>Results:</b> The median metastatic overall survival was 25 months in the group with a C-PLAN score < 2 and 6 months in the group with a C-PLAN score ≥ 2 (<i>p</i> < 0.001). The median metastatic progression-free survival was 11 months in the group with a C-PLAN score < 2 and 3 months in the group with a C-PLAN score ≥ 2. <b>Conclusion:</b> This is the first comprehensive study demonstrating that the C-PLAN index can be used for prognostic purposes in immunotherapy. This score, which can be easily, economically, and practically calculated in outpatient clinics, can predict patient prognosis and determine who should receive longer durations of immunotherapy.

Journal of Clinical MedicineVol. 15(2)
Van Yüzüncü Yıl Üniversitesi (TR), Dicle University (TR), Heidelberg University (DE), Hitit Üniversitesi (TR), University Hospital Heidelberg (DE), Kütahya Dumlupınar Üniversitesi (TR), Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi (TR), Istinye University (TR), Şanlıurfa Mehmet Akif İnan Eğitim ve Araştırma Hastanesi (TR), Afyonkarahisar Sağlık Bilimleri Üniversitesi, Maltepe University (TR), Eskişehir Osmangazi University (TR), Kocaeli Üniversitesi (TR), Afyon Kocatepe University (TR), Cukurova University (TR), Gaziantep University (TR), Ordu University (TR), Hacettepe University (TR), Marmara University (TR), Erciyes University (TR)
Erciyes Üniversitesi
Good health and well-being
Openalex Percentile: Top 88%
Inflammatory Biomarkers in Disease Prognosis
DOIOpen Access PDFOpenAlex
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