Dynamic changes in liver-to-spleen ratio: can it be a prognostic biomarker for chemo-immunotherapy in small cell lung cancer?

The liver-to-spleen ratio (LSR) is a non-invasive imaging biomarker used to assess non-alcoholic fatty liver disease (NAFLD). Given the potential link between the NAFLD-associated immune microenvironment and systemic anti-tumor immunity, we hypothesized that NAFLD—as defined by LSR—might predict clinical outcomes in small cell lung cancer (SCLC) patients treated with chemo-immunotherapy. This study aimed to evaluate the association between LSR-defined NAFLD, dynamic LSR changes, and treatment efficacy in SCLC patients receiving chemotherapy or chemo-immunotherapy.