Evidence map›Paper›PMID 41494746›Full record

ArticleJournal for immunotherapy of cancer2026

Dissecting the impact of Controlling Nutritional Status (CONUT) score on survival outcomes and immune-inflammatory profiles in patients with advanced NSCLC undergoing first-line immunotherapy.

Federica Pecci, Giulia Mazzaschi, Alessandra Dodi, Prisca Tamarozzi, Martina Manini, Marianna Peroni, Simona D'Agnelli, Lucas Moron Dalla Tor, Giulia Bruschi, Monica Pluchino and 9 more

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Article in Journal for immunotherapy of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Federica PecciMedicine and Surgery Department, University of Parma, Parma, Italy.
Giulia MazzaschiMedicine and Surgery Department, University of Parma, Parma, Italy.
Alessandra DodiMedicine and Surgery Department, University of Parma, Parma, Italy.
Prisca TamarozziMedicine and Surgery Department, University of Parma, Parma, Italy.
Martina ManiniMedicine and Surgery Department, University of Parma, Parma, Italy.
Marianna PeroniMedicine and Surgery Department, University of Parma, Parma, Italy.
Simona D'AgnelliMedicine and Surgery Department, University of Parma, Parma, Italy.
Lucas Moron Dalla TorMedicine and Surgery Department, University of Parma, Parma, Italy.ORCID http://orcid.org/0000-0002-6080-7864
Giulia BruschiDepartment of Information Engineering, Polytechnic University of Marche Faculty of Engineering, Ancona, Marche, Italy.
Monica PluchinoMedical Oncology Unit, University Hospital of Parma, Parma, Italy.
Michela VerzèMedical Oncology Unit, University Hospital of Parma, Parma, Italy.
Roberta MinariMedical Oncology Unit, University Hospital of Parma, Parma, Italy.
Fabiana PerroneMedical Oncology Unit, University Hospital of Parma, Parma, Italy.
Paola BordiMedical Oncology Unit, University Hospital of Parma, Parma, Italy.
Alessandro LeonettiMedical Oncology Unit, University Hospital of Parma, Parma, Italy.
Federico QuainiMedicine and Surgery Department, University of Parma, Parma, Italy.
Nicola SverzellatiInstitute of Radiologic Science, University of Parma, Parma, Italy.
Sebastiano ButiMedicine and Surgery Department, University of Parma, Parma, Italy.ORCID http://orcid.org/0000-0003-0876-0226
Marcello TiseoMedicine and Surgery Department, University of Parma, Parma, Italy marcello.tiseo@unipr.it.ORCID http://orcid.org/0000-0002-9553-8465

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe immunonutritional background has been deeply implicated in cancer behavior and clinical outcomes. In this study, we explored the prognostic impact of the Controlling Nutritional Status (CONUT) score through its correlation with blood immunophenotypes and cytokines to provide an easily available non-invasive tool to predict the survival benefit from first-line immune checkpoint inhibitors±chemotherapy (ICI±CHT) in patients affected by advanced non-small cell lung cancer (aNSCLC). MATERIAL AND

methodsFrom a prospective cohort of patients with aNSCLC treated with first-line ICI±CHT, clinicopathological data and baseline blood samples for the assessment of CONUT score (albumin, lymphocytes, total cholesterol), relevant immunophenotypes (flow cytometry) and cytokines (multiplex array) were collected. Correlations of CONUT score with survival outcomes (progression-free/overall survival [PFS/OS]) and circulating immune-inflammatory benchmarks were analyzed.

resultsAmong 178 patients enrolled in the AIRC (Italian Association for Cancer Research) project, 153 received ICI±CHT as first-line. Nutritional status tested by CONUT score was available in 137 cases and was <3, meaning good nutritional status, in 77 (56.2%), whereas scored ≥3 in 60 (43.8%), meaning an impaired nutritional status. At a median follow-up of 27.4 months (95% CI 22.9 to 32.0), patients with a CONUT score <3, compared to those with CONUT score ≥3, experienced significantly longer PFS (median PFS 8.03 vs 3.88 months, HR 0.58, 95% CI 0.40 to 0.84, p=0.004) and OS (median OS 22.24 vs 8.75 months, HR 0.61, 95% CI 0.40 to 0.94, p=0.03). The multivariable analysis, adjusting for age, histology, metastatic sites, sex, programmed death-ligand 1 (PD-L1), Eastern Cooperative Oncology Group Performance Status and treatment type, confirmed the prognostic impact of CONUT score in terms of PFS (HR 0.61, 95% CI 0.41 to 0.93, p=0.02) and OS (HR 0.60, 95% CI 0.38 to 0.96 p=0.03). Patients with CONUT score ≥3 displayed significantly higher blood levels of interleukin (IL)-1β, IL-12, IL-10, interferon-γ, IL-6, and soluble PD-L1 compared with those with CONUT score <3. A higher fraction of CD14+ cells (p=0.01) and CD8+Ki67+ (p<0.001) lymphocytes also characterized the blood of patients with CONUT score ≥3 compared with those with CONUT score <3.

conclusionA baseline good nutritional status (CONUT score <3) is associated with a distinct circulating immune-inflammatory profile and correlates with improved clinical outcomes in patients with aNSCLC treated with first-line ICI±CHT.

Indexed as

Carcinoma, Non-Small-Cell LungImmunotherapyLung NeoplasmsNutritional StatusAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPrognosisProspective StudiesCytokineImmune Checkpoint InhibitorImmunotherapyLung CancerNutrition

Identifiers

PMID41494746
PMCPMC12778215

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