Clinical calculator summary
Original 2018 Mezquita Lung Immune Prognostic Index
Clinical calculator summary
Original 2018 Mezquita Lung Immune Prognostic Index
A two-factor pretreatment prognostic grouping using calculated dNLR and LDH relative to the local laboratory ULN.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original good, intermediate, and poor LIPI groups without implying individualized immunotherapy benefit.
- Population:
- Adults with advanced NSCLC receiving PD-1/PD-L1 inhibitors in the original cohorts.
- Factors:
- Raw dNLR >3, LDH above local laboratory ULN
- Reference:
- Mezquita et al. JAMA Oncol. 2018;4(3):351-357.
LIPI Score (Lung Immune)
Clinical Context & Background
dNLR = absolute neutrophils / (white blood cells - absolute neutrophils). Original 2018 LIPI = 1 point for raw dNLR >3 plus 1 point for LDH > the local laboratory ULN.Reference Data
| Score | Original group | Definition |
|---|---|---|
| 0 | Good group | Neither adverse factor |
| 1 | Intermediate group | One adverse factor |
| 2 | Poor group | Both adverse factors |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use pretreatment laboratory values in adults with advanced NSCLC resembling the original PD-1/PD-L1 inhibitor cohorts.
- Use WBC and absolute neutrophils in the same units, and LDH and its local ULN in the same units.
How To Interpret
- Score 0 is the original Good group, 1 the Intermediate group, and 2 the Poor group.
- Equality at dNLR 3 or LDH equal to ULN scores zero; values are never rounded before classification.
What To Do Next
- Integrate the result with disease status, performance status, molecular findings, treatment context, comorbidity, patient goals, and specialist assessment.
- Do not withhold or select immunotherapy because of LIPI alone.
Limitations
- Not validated for screening, diagnosis, early-stage disease, surveillance, post-treatment reassessment, or non-NSCLC use.
- Infection, corticosteroids, marrow suppression, and other causes of abnormal counts may confound interpretation.
- Later pooled evidence supports a prognostic association across treatment classes, not a proven immunotherapy-specific predictive biomarker.
- No unsupported upper limits are imposed on the four laboratory inputs.
Validated Population
Pretreatment adults with advanced NSCLC in the original immune-checkpoint-inhibitor cohorts.
Equality example
WBC 10 and neutrophils 7.5 gives dNLR exactly 3; LDH equal to its ULN also scores zero, so the total is 0.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed LIPI cases passed through visible production controls at scores 0, 1, and 2 across exact dNLR and LDH transitions.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/lipi-lung-immune-prognostic-index-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/lipi-lung-immune-prognostic-index.json.
: Browser input adapter corrected and reverified
- Accepted finite number values already normalized by the shared calculator form while retaining strict malformed-input rejection.
- No equation, cutoff, unit, classification, or applicability rule changed; calculator-specific verification and the calculator-wide browser-input audit passed.
: Full validation test
- 320/320 independent numerical, exact-boundary, denominator, malformed-input, trace, wording, UI, reset, immutability, card, download, and integration checks passed.
- No registered master panel calculates LIPI; no panel receives inherited LIPI verification.
: Calculation and input-contract correction
- Replaced favorable pre-scored defaults with required raw WBC, absolute neutrophils, LDH, and local LDH ULN; missing, extra, coercive, nonfinite, nonpositive, and invalid-denominator values are rejected.
- Added the full-precision dNLR calculation, strict >3 and >ULN equality handling, complete contribution trace, and wording that does not present LIPI as individualized prognosis, immunotherapy-benefit prediction, treatment selection, or medical advice.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
Does dNLR exactly 3 score a point?
No. The original adverse criterion is strictly greater than 3.
Does LDH exactly at the local ULN score a point?
No. Only LDH strictly above the local laboratory ULN scores a point.
Does LIPI predict immunotherapy benefit?
No. LIPI is presented as a prognostic grouping and must not be used as a stand-alone immunotherapy-benefit prediction or treatment-selection rule.
Evidence-based oncology decision support. Verify with clinical guidelines.