Pan-Immune-Inflammation Values in Cancer Prognosis

The Pan-Immune-Inflammation Value (PIV) is a composite blood-based biomarker that integrates neutrophil, platelet, monocyte and lymphocyte counts into a single index reflecting systemic immune and inflammatory status. Originally proposed as an evolution of simpler ratios, PIV has attracted attention for its ability to capture the complex interplay between pro-tumour inflammation and antitumour immunity. Across a range of solid tumours, elevated PIV at baseline or after initial treatment correlates with adverse clinicopathological features, diminished response to therapy and shortened survival. Its non-invasive nature, ease of calculation from routine blood tests and consistency across disease settings have fuelled interest in its incorporation into prognostic models and treatment stratification algorithms. Clinically, PIV may help identify patients at higher risk of progression or relapse, guide the intensity of surveillance and inform decisions on the utility of systemic therapies such as chemotherapy and immunotherapy. Emerging evidence also suggests that dynamic changes in PIV during treatment provide additional prognostic information beyond a single pretreatment measurement.

Research from Nature Portfolio

Recent studies have demonstrated that pre-treatment PIV can predict pathological complete response and survival outcomes in the neoadjuvant setting of breast cancer. In a large retrospective cohort of patients receiving taxane-based chemotherapy before surgery, those with lower PIV values achieved higher rates of complete pathological remission and enjoyed longer disease-free and overall survival. Notably, PIV outperformed traditional blood-cell ratios in multivariable models, underscoring its potential as a superior biomarker for tailoring neoadjuvant treatment strategies.

Pan-Immune-Inflammation Values in Cancer Prognosis publication trend

The graph below shows the total number of articles in pan-immune-inflammation values in cancer prognosis across all publications each year (not limited to Nature Index journals).

Technical terms

Pan-Immune-Inflammation Value (PIV): A prognostic biomarker calculated as (neutrophil count × platelet count × monocyte count) ÷ lymphocyte count, reflecting systemic immune–inflammatory balance.

Immune checkpoint inhibitors (ICIs): Anticancer agents that block regulatory pathways in T cells (for example PD-1/PD-L1), thereby enhancing the immune response against tumour cells.

Overall survival (OS): The interval from diagnosis or treatment initiation until death from any cause, used as a primary endpoint in oncology studies.

Progression-free survival (PFS): The duration from the start of therapy until objective tumour progression or death, serving as a measure of treatment efficacy.

Pathological complete response (pCR): The absence of residual invasive cancer in the surgical specimen following neoadjuvant therapy, often correlating with improved long-term outcomes.

References

1. Pan-immune inflammation value as a prognostic biomarker for cancer patients treated with immune checkpoint inhibitors. Frontiers in Immunology (2024).
2. Prognostic significance of the pretreatment pan-immune-inflammation value in cancer patients: an updated meta-analysis of 30 studies. Frontiers in Nutrition (2023).
3. Low pan-immune-inflammation-value predicts better chemotherapy response and survival in breast cancer patients treated with neoadjuvant chemotherapy. Scientific Reports (2021).