Immunological inflammatory biomarkers as prognostic predictors for advanced hepatocellular carcinoma
| Autor: | Takuji Torimura, Yu Noda, Ryoko Kuromatsu, Hideki Iwamoto, Tomotake Shirono, Hironori Koga, Shigeo Shimose, Syusuke Okamura, Naoki Kamachi, Masahito Nakano, Takashi Niizeki |
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| Rok vydání: | 2021 |
| Předmět: |
Sorafenib
Cancer Research medicine.medical_specialty Carcinoma Hepatocellular medicine.medical_treatment Gastroenterology chemistry.chemical_compound neutrophil-to-lymphocyte ratio Internal medicine Biomarkers Tumor Humans Medicine Lymphocytes Neutrophil to lymphocyte ratio Original Research Receiver operating characteristic business.industry Liver Neoplasms Therapeutic effect Immunotherapy medicine.disease platelet-to-lymphocyte ratio Oncology chemistry Hepatocellular carcinoma advanced hepatocellular carcinoma prognosis Liver function business Lenvatinib medicine.drug |
| Zdroj: | ESMO Open |
| ISSN: | 2059-7029 |
| DOI: | 10.1016/j.esmoop.2020.100020 |
| Popis: | Background The immunological inflammatory biomarkers for advanced hepatocellular carcinoma are unclear. We aimed to investigate the association of immunity and inflammatory status with treatment outcomes in patients with advanced hepatocellular carcinoma who received molecular-targeted agents as primary treatment. Patients and methods We enrolled 728 consecutive patients with advanced hepatocellular carcinoma who received sorafenib (n = 554) or lenvatinib (n = 174) as primary treatment in Japan between May 2009 and June 2020. Changes in the neutrophil-to-lymphocyte ratio before and 1 month after treatment and their impact on survival were evaluated. The cut-off values of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for predicting overall and progression-free survival were calculated using receiver operating characteristic curves. Results The neutrophil-to-lymphocyte ratio, but not the platelet-to-lymphocyte ratio, was an independent prognostic factor. Patients with decreased neutrophil-to-lymphocyte ratio survived significantly longer than patients with increased neutrophil-to-lymphocyte ratio (median overall survival: 14.7 versus 10.4 months, P = 0.0110). Among patients with a low pre-treatment neutrophil-to-lymphocyte ratio, the overall survival did not differ significantly between those with decreased and those with increased neutrophil-to-lymphocyte ratio after 1 month (median: 19.0 versus 14.8 months, P = 0.1498). However, among patients with high pre-treatment neutrophil-to-lymphocyte ratio, those whose neutrophil-to-lymphocyte ratio decreased after 1 month showed significantly longer survival than those whose neutrophil-to-lymphocyte ratio increased (median: 12.7 versus 5.5 months, P < 0.0001). The therapeutic effect was not correlated with pre-treatment neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio. Conclusions The neutrophil-to-lymphocyte ratio is a prognostic factor, along with liver function and tumor markers, in patients with advanced hepatocellular carcinoma who received molecular-targeted agents as primary treatment. Thus, the neutrophil-to-lymphocyte ratio could be a prognostic biomarker for advanced hepatocellular carcinoma primarily treated with immunotherapy. Highlights • NLR was an independent prognostic factor with advanced HCC, along with liver function and tumor markers. • Patients with decreased NLR 1 month after treatment survived significantly longer than patients with increased NLR. • The therapeutic effect was not correlated with pre-treatment NLR or PLR. • NLR is a prognostic factor in patients with advanced HCC who received molecular-targeted agents as primary treatment. • Thus, NLR could be a prognostic biomarker for advanced HCC treated with immunotherapy. |
| Databáze: | OpenAIRE |
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