Baseline neutrophil-lymphocyte ratio and platelet-lymphocyte ratio appear predictive of immune treatment related toxicity in hepatocellular carcinoma  

作　　者：Sirish Dharmapuri UmutÖzbek Hiren Jethra Tomi Jun Thomas U Marron Anwaar Saeed Yi-Hsiang Huang Mahvish Muzaffar Matthias Pinter Lorenz Balcar Claudia Fulgenzi Suneetha Amara Arndt Weinmann Nicola Personeni Bernhard Scheiner Tiziana Pressiani Musharraf Navaid Bertram Bengsch Sonal Paul Uqba Khan Dominik Bettinger Naoshi Nishida Yehia Ibrahim Mohamed Arndt Vogel Anuhya Gampa James Korolewicz Antonella Cammarota Ahmed Kaseb Peter R Galle Anjana Pillai Ying-Hong Wan Alessio Cortellini Masatoshi Kudo Antonio D’Alessio Lorenza Rimassa David James Pinato Celina Ang 

机构地区：[1]Tisch Cancer Institute,Icahn School of Medicine at Mount Sinai,New York,NY 10029,United States [2]Department of Population Health Science and Policy,Icahn School of Medicine at Mount Sinai,New York,NY 10029,United States [3]Department of Data Analytics Harrisburg,Harrisburg University of Science and Technology,Harrisburd,PA 17101,United States [4]SEMA4,Stamford,CT 06902,United States [5]Division of Medical Oncology Kansas,University of Kansas Cancer Center,Kansas,MO 66160,United States [6]Division of Gastroenterology and Hepatology,Taipei Veterans General Hospital,Taipei 11217,Taiwan [7]Department of Internal Medicine,Brody School of Medicine,East Carolina University,Greenville,NC 27858,United States [8]Department of Internal Medicine III,Division of Gastroenterology and Hepatology,Medical University of Vienna,Vienna 1090,Austria [9]Department of Surgery and Cancer,Imperial College London,Hammersmith Hospital London,London W120HS,United Kingdom [10]Department of Hepatology,Johannes Gutenberg-University Medical Centre,Niedersachsen 30625,Germany [11]Medical Oncology Unit,ASST Garda,Via Lungomella Valsecchi,Brescia,Manerbio 25025,Italy [12]Medical Oncology and Hematology Unit,Humanitas Cancer Center,IRCCS Humanitas Research Hospital,Milan,Rozzano 20089,Italy [13]Department of Medicine II,Univ Med Ctr Freiburg,Hugstetter Str 55,University Hospital Freiburg,Freiburg D-79106,Germany [14]Department of Oncology Baltimore,LifeBridge Health,Baltimore,MD 21215,United States [15]Division of Hematology and Oncology,Weill Cornell Medical College,NY 10065,United States [16]Department of Gastroenterology and Hepatology,Kindai University Faculty of Medicine,Osaka 577-8502,Japan [17]Department of Gastrointestinal Medical Oncology,The University of Texas MD Anderson Cancer Center,Houston,TX 77030,United States [18]Department of Gastroenterology Hepatology and Endocrinology,HannoverArndt Vogel,Medical School Hannover,Carl-Neubergstr.,Hannover 30659,Germany [19]Department of Hepatology,Rush University Medical Group 1725 W Harriso

出　　处：《World Journal of Gastrointestinal Oncology》2023年第11期1900-1912,共13页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：BACKGROUND A well-recognized class effect of immune checkpoint inhibitors(ICI)is immune-related adverse events(IrAEs)ranging from low grade toxicities to life-threatening end organ damage requiring permanent discontinuation of ICI.Deaths are reported in<5%of patients treated with ICI.There are,however,no reliable markers to predict the onset and severity of IrAEs.We tested the association between neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)at baseline with development of clinically significant IrAEs(grade≥2)in hepatocellular carcinoma(HCC)patients treated with ICI.AIM To test the association between NLR and PLR at baseline with development of clinically significant IrAEs(grade≥2)in HCC patients treated with ICI.METHODS Data was extracted from an international database from a consortium of 11 tertiary-care referral centers.NLR=absolute neutrophil count/absolute lymphocyte count(ALC)and PLR=platelet count/ALC.Cutoff of 5 was used for NLR and 300 for PLR based on literature.We also tested the association between RESULTS Data was collected from 361 patients treated between 2016-2020 across the United States(67%),Asia(14%)and Europe(19%).Most patients received Nivolumab(n=255,71%).One hundred sixty-seven(46%)patients developed at least one IrAE,highest grade 1 in 80(48%),grade≥2 in 87(52%)patients.In a univariable regression model PLR>300 was significantly associated with a lower incidence of grade≥2 IrAEs(OR=0.40;P=0.044).Similarly,a trend was observed between NLR>5 and lower incidence of grade≥2 IrAEs(OR=0.58;P=0.097).Multivariate analyses confirmed PLR>300 as an independent predictive marker of grade≥2 IrAEs(OR=0.26;P=0.011),in addition to treatment with programmed cell death ligand 1(PD-1)/cytotoxic T lymphocyte-associated protein-4(OR=2.57;P=0.037)and PD-1/tyrosine kinase inhibitor(OR=3.39;P=0.01)combinations.Antibiotic use was not associated with IrAE incidence(OR=1.02;P=0.954).Patients treated with steroids had a>2-fold higher incidence of grade≥2 IrAEs(OR=2.74;P<0.001),altho

关 键 词：Neutrophil-lymphocyte ratio Platelet-lymphocyte ratio Inflammatory biomarkers Immunotherapy Immune toxicity 

分 类 号：R735.8[医药卫生—肿瘤]