Pretreatment CALLY Index and Survival Outcomes in Metastatic Non-Small Cell Lung Cancer Treated with Nivolumab: A Multicenter Retrospective Study

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Günaltılı M., Guliyev M., Fidan M. C., Çerme E., Aliyev V., Bedir Ş., ...Daha Fazla

Eurasian Journal of Medical Investigation, cilt.10, sa.3, ss.1-10, 2026 (TRDizin)

Özet

Objectives: The C-reactive protein–albumin–lymphocyte (CALLY) index reflects systemic inflammation, nutritional status, and immune competence. We evaluated its prognostic value in patients with metastatic non-small cell lung cancer (NSCLC) treated with nivolumab in the second-line or later setting. Methods: This multicenter retrospective study included 181 patients receiving nivolumab monotherapy. The CALLY index was calculated from pretreatment albumin, absolute lymphocyte count, and C-reactive protein levels. Patients were divided into low and high CALLY groups using the cohort median. Progression-free survival (PFS) and overall survival (OS) were analyzed with Kaplan–Meier method, and independent prognostic factors were evaluated using Cox proportional hazards regression analyses. Results: Median follow-up was 27.6 months. Median PFS was shorter in the low CALLY group than in the high CALLY group (5.2 vs. 10.9 months; p=0.002), as was median OS (10.3 vs. 19.3 months; p<0.001). In multivariable analyses, a high CALLY index remained independently associated with longer PFS (HR 0.62, 95% CI 0.42–0.90; p=0.012) and OS (HR 0.47, 95% CI 0.31–0.72; p<0.001). Conclusion: The pretreatment CALLY index was independently associated with survival outcomes in patients with metastatic NSCLC treated with nivolumab and may be useful for prognostic risk stratification in this population. Keywords: CALLY Index, Non-Small Cell Lung Cancer, Nivolumab