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ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026

Exploring the prognostic value of the magnesium-immune prognostic score (MIPS) in metastatic non-small cell lung cancer receiving Nivolumab.

Sait Kitapli, Melih Akpunar, Ali Alkan, Ozgur Tanriverdi

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Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Sait KitapliDepartment of Medical Oncology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla Universitesi Egitim ve Arastirma Hastanesi, Oncology Poliklinigi, 48000, Mugla, Türkiye.
Melih AkpunarDepartment of Medical Oncology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla Universitesi Egitim ve Arastirma Hastanesi, Oncology Poliklinigi, 48000, Mugla, Türkiye.
Ali AlkanDepartment of Medical Oncology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla Universitesi Egitim ve Arastirma Hastanesi, Oncology Poliklinigi, 48000, Mugla, Türkiye.
Ozgur TanriverdiDepartment of Medical Oncology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla Universitesi Egitim ve Arastirma Hastanesi, Oncology Poliklinigi, 48000, Mugla, Türkiye. dr.ozgur.tanriverdi@gmail.com.ORCID http://orcid.org/0000-0002-0598-7284

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6 · The paper itself

Abstract

backgroundAlthough immune checkpoint inhibitors have transformed the treatment landscape in advanced non-small cell lung cancer (NSCLC), reliable and accessible biomarkers to predict survival and treatment response remain limited. This study aimed to evaluate the prognostic and predictive utility of the Magnesium-Immune Prognostic Score (MIPS), a composite index based on neutrophil-to-lymphocyte ratio and serum levels of C-reactive protein, magnesium, albumin, calcium, phosphorus, lactate dehydrogenase, and uric acid, in metastatic NSCLC patients receiving second-line nivolumab.

methodsThis retrospective study included 95 patients with advanced NSCLC treated with nivolumab. The MIPS was constructed by integrating three predefined component indices: the Inflammation-Mediated Immunity Index (IMI), the Mineral and Nutritional Index (MINI), and the Aggressive Tumor Index (ATI). Survival outcomes were analyzed using ROC curves, Kaplan-Meier methods, and Cox regression models.

resultsAmong 95 patients, those with high MIPS had significantly shorter progression-free survival and overall survival than those with low MIPS (p < 0.001). In multivariable Cox analysis, high MIPS remained an independent predictor of poor OS (HR: 2.694, p < 0.001). Among all indices, MIPS showed the strongest discriminative ability (AUC = 0.696). All four composite indices-IMI, MINI, ATI, and MIPS-were significantly associated with treatment response, with high-score groups demonstrating higher rates of good response (CR + PR), and MIPS showing the strongest association (p < 0.001).

conclusionThe MIPS represents a simple, accessible, and clinically applicable prognostic and predictive tool for stratifying metastatic NSCLC patients receiving nivolumab. By integrating inflammatory, nutritional, and metabolic components, the score offers a holistic assessment of patient biology. Prospective validation studies are warranted.

Indexed as

Antineoplastic Agents, ImmunologicalCarcinoma, Non-Small-Cell LungImmune Checkpoint InhibitorsLung NeoplasmsMagnesiumNivolumabAdultAgedAged, 80 and overBiomarkers, TumorC-Reactive ProteinFemaleHumansLymphocytesMaleMiddle AgedAntineoplastic Agents, ImmunologicalBiomarkers, TumorC-Reactive ProteinImmune Checkpoint InhibitorsMagnesiumNivolumabImmune checkpoint inhibitorInflammationLung cancerMagnesiumNivolumabPrognostic biomarkerSurvival prediction

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.