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This study evaluates the prognostic value of the Controlling Nutritional Status (CONUT) score by relating it to blood immunophenotypes and cytokines to estimate survival benefit from first-line immune checkpoint inhibitors with or without chemotherapy in advanced non-small cell lung cancer. A prospective cohort provided CONUT variables (albumin, lymphocytes, total cholesterol), immune profiling, and multiplex cytokine measurements. In 137 evaluable patients, CONUT \u003C3 showed longer progression-free and overall survival and a distinct immune-inflammatory signature.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/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/449666/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/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/449666.png","ImageObject",300,407,{"name":92,"@type":93},"jayni","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What does the CONUT score reflect in this study?","Question",{"text":112,"@type":113},"The CONUT score is calculated from serum albumin, lymphocyte count, and total cholesterol to represent nutritional reserves and immune competence.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were immune-related measurements performed?",{"text":117,"@type":113},"Baseline blood samples were analyzed for immunophenotypes by flow cytometry and for cytokines using a multiplex array.",{"name":119,"@type":110,"acceptedAnswer":120},"What survival differences were observed between CONUT \u003C3 and CONUT ≥3?",{"text":121,"@type":113},"Patients with CONUT \u003C3 had significantly longer progression-free survival and overall survival, and multivariable analysis confirmed the prognostic impact of CONUT for both endpoints.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},449666,1791245398,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},3985747859343,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Open access Short report  \n Dissecting the impact of Controlling  \nNutritional Status (CONUT) score on survival outcomes and immuneinflammatory profiles in patients with advanced NSCLC undergoing firstline immunotherapy  \nFederica Pecci,1 Giulia Mazzaschi,1,2 Alessandra Dodi,1,2 Prisca Tamarozzi,1 Martina Manini,1 Marianna Peroni,1 Simona D’Agnelli,1 Lucas Moron Dalla Tor  ,1 Giulia Bruschi,3 Monica Pluchino,2 Michela Verzè,2 Roberta Minari,2  \nFabiana Perrone,2 Paola Bordi,2 Alessandro Leonetti,2 Federico Quaini,1  \nNicola Sverzellati,4 Sebastiano Buti  ,1,2 Marcello Tiseo  1,2  \nTo cite: Pecci F, Mazzaschi G, Dodi A, et al. Dissecting the impact of Controlling Nutritional Status (CONUT) score on survival outcomes and immune-inflammatory profilesin patients with advanced NSCLC undergoing first-line immunotherapy. Journal for ImmunoTherapy of Cancer 2026;14:e013045 . doi:10 . 1136/ jitc-2025-013045  \n► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[jitc-2025-013045](jitc-2025-013045)) .  \nFP and GM are joint first authors.  \nAccepted 15 December 2025  \n© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.  \nFor numbered affiliations see end of article.  \nCorrespondence to  \nProfessor Marcello Tiseo; [marcello.tiseo@unipr.it](marcello.tiseo@unipr.it)  \nABSTRACT  \nBackground The 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 immunophenotypesand 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 methods From 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 (progressionfree/overall survival [PFS/OS]) and circulating immuneinflammatory benchmarks were analyzed.  \nResults Among 178 patients enrolled in the AIRC (Italian Association for Cancer Research) project, 153 received ICI±CHT as first-line. Nutritional status tested by CONUTscore was available in 137 cases and was \u003C3, meaning good nutritional status, in 77 (56 .2%), whereas scored ≥3 in 60 (43 .8%), meaning an impaired nutritional status. Ata median follow-up of 27.4 months (95% CI 22.9 to 32 .0), patients with a CONUT score \u003C3, 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 CONUTscore ≥3 displayed significantly higher blood levels of  \ninterleukin (IL)-1β, IL-12, IL-10, interferon-γ, IL-6, and soluble PD-L1 compared with those with CONUT score \u003C3 . A higher fraction of CD14+ cells (p=0 .01) and CD8+Ki67+(p\u003C0 .001) lymphocytes also characterized the blood of patients with CONUT score ≥3 compared with those with CONUT score \u003C3 .  \nConclusion A baseline good nutritional status (CONUTscore \u003C3) is associated with a distinct circulating immuneinflammatory pr","cbCaipEIbA3W5iBX","https://ap.wps.com/l/cbCaipEIbA3W5iBX","pdf",1917237,"English","# Abstract\n## Background\n## Material and methods\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What does the CONUT score reflect in this study?\",\"answer\":\"The CONUT score is calculated from serum albumin, lymphocyte count, and total cholesterol to represent nutritional reserves and immune competence.\"},{\"question\":\"How were immune-related measurements performed?\",\"answer\":\"Baseline blood samples were analyzed for immunophenotypes by flow cytometry and for cytokines using a multiplex array.\"},{\"question\":\"What survival differences were observed between CONUT \\u003c3 and CONUT ≥3?\",\"answer\":\"Patients with CONUT \\u003c3 had significantly longer progression-free survival and overall survival, and multivariable analysis confirmed the prognostic impact of CONUT for both endpoints.\"}]","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 | PDF",1790730826,25]