Dynamical Inflammatory Factors: More Promising Markers in Advanced Tumors
Ziwei Guo and Jun Liang*
Peking University International Hospital, Beijing, China
*Corresponding Author: Jun Liang, Peking University International Hospital, Beijing, China.
July 12, 2022; Published: July 29, 2022
Introduction: Many biomarkers to predict clinical response and prognosis are available but there are still many issues to be further solved. We showed the correlation between dynamical inflammatory factors and clinical response.
Methods: We collected inflammatory factors from patients diagnosed advanced solid tumors. The endpoints were the agreement of therapeutic response, disease control rate, progress-free survival and overall survival.
Results: 41 patients enrolled. AUC was 0.927, 0.957 and 0.160 in dynamic biomarkers (p < 0.001) compared with imaging assessment. The disease control rate was 45.2% (p < 0.05). Only shorter median progress-free survival can be observed in higher increased neutrophil-to-lymphocyte significantly. The median overall survival was 7 months (95% CI: 4.27-9.73), but no significance.
Conclusion: Dynamical decreased platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio or increased lymphocyte-to monocyte ratio are positively associated with the radiograph assessment, and that lower neutrophil-to-lymphocyte ratio leads to shorter progress-free survival statistically and a trend of shorter overall survival.
Keywords: Dynamic Biomarkers; Immunotherapy; Clinical Benefit; Prognosis
- Herbst RS., et al. “Predictive correlates of response to the anti-PD-L1 antibody MPDL3280A in cancer patients”. Nature7528 (2014): 563-567.
- Brahmer JR., et al. “Safety and activity of anti-PD-L1 antibody in patients with advanced cancer”. The New England Journal of Medicine28 (2012): 2455-2465.
- Amanda JO., et al. “Tissue-speciﬁc tumor microenvironments inﬂuence responses to immunotherapies”. Clinical and Translational Immunology11 (2019): 1094.
- William CD., et al. “Dual targeting of RANKL and PD-1 with a bispeciﬁc antibody improves anti-tumor immunity”. Clinical and Translational Immunology10 (2019): 1081.
- David GW., et al. “Impact of pre-therapy glioblastoma multiforme microenvironment on clinical response to autologous CMV-speciﬁc T-cell therapy”. Clinical and Translational Immunology11 (2019): 01088.
- Shavedian N., et al. “Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer: a secondary analysis of the KEYNOTE-001 phase 1 trial”. Lancet Oncology11 (2017): 865-903.
- Antonia SJ., et al. “Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer (CheckMate 032): A multicentre, open-label, phase1/2 trail”. Lancet Oncology7 (2016): 883-895.
- Hellmann MD., et al. “Nivolumab plus ipilimumab as first-line treatment for advanced non-small-cell lung cancer (CheckMate 012): Results of an open-label, phase 1, multicohort study”. Lancet Oncology 2017;18 (1): 31-41.
- Gandara DR., et al. “Blood-based tumor mutational burden as a predictor of clinical benefit in non-small-cell lung cancer patients treated with atezolizumab”. Nature Medicine9 (2018): 1441-1448.
- Hellamnn MD., et al. “Nivolumab plus Ipimumab in Lung Cancer with a High tumor Mutational Burden”. The New England Journal of Medicine22 (2018): 2093-2104.
- Le DT., et al. “PD-1 Blockade in Tumors with Mismatch-Repair Deficiency”. The New England Journal of Medicine26 (2015): 2509-2520.
- Lopes G., et al. “Pembrolizumab vs Platinum-Based Chemotherapy as First-Line Therapy for advanced/Metastastic NSCLC with a PD-L1 TPS≥1%: Open-Label, Phase 3 KEYNOTE-042 Study”. Lancet 10183 (2019): 1819-1830.
- Horn L., et al. “Nivolumab versus docetaxel in previously treated patients with advanced non-small-cell lung cancer: Two-year outcomes from two randomized, open-label, phase III trials (CheckMate017 and CheckMate 057)”. Journal of Clinical Oncology35 (2017): 3924-3933.
- Diakos Cl., et al. “Cancer-related inflammation and treatment effectiveness”. Lancet Oncology11 (2014): 493-503.
- RL Stone., et al. “Paraneoplastic thrombocytosis in ovarian cancer”. The New England Journal of Medicine7 (2012): 610-618.
- Templeton AJ., et al. “Prognostic role of platelet to lymphocyte radio in solid tumors: a systematic review and meta-analysis”. Cancer Epidemiology, Biomarkers and Prevention 7 (2014): 1204-1212.
- Duan J., et al. “Preoperative elevated neutrophil-to-lymphocyte ratio (NLR) and derived NLR are associated with poor prognosis in patients with breast cancer: A meta-analysis”. Medicine (Baltimore)49 (2018): 13340.
- Zhang H., et al. “Clinical significance of preoperative neutrophil-lymphocyte vs platelet-lymphocyte radio in primary operable patients with non-small cell lung cancer”. American Journal of Surgery3 (2015): 526-535.
- Deng Q., et al. “Prognostic value of pre-operative inflammatory response biomarkers in gastric cancer patients and the construction of a predictive model”. Journal of Translational Medicine 13 (2015): 66.
- Giakoustidis A., et al. “Identifying the role of neutrophil-to-lymphocyte radio and platelets-to-lymphocyte radio as prognostic markers in patients undergoing resection of pancreatic ductal adenocarcinoma”. Annals of Hepato-Biliary-Pancreatic Surgery 3 (2018): 197-207.
- Ferrucci PF., et al. “Baseline neutrophils and derived neutrophil-to-lymphocyte radio: prognostic relevance in metastatic melanoma patients receiving ipilimumab”. Annals of Oncology4 (2016): 732-738.
- Diem S., et al. “Neutrophil-to-Lymphocyte radio (NLR) and Platelet-to-Lymphocyte radio (PLR) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab”. Lung Cancer 111 (2017): 176-181.
- Rochet NM., et al. “The prognostic role of the preoperative absolute lymphocyte count and absolute monocyte count in patients with resected advanced melanoma”. American Journal of Clinical Oncology3 (2015): 252-258.
- Capone M., et al. “Baseline neutrophil-to-lymphocyte ratio and derived NLR could predict overall survival in patients with advanced melanoma treated with nivolumab”. Journal of Immunotherapy Cancer1 (2018): 74.
- Ettinger DS., et al. “NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 1. 2020”. Journal of the National Comprehensive Cancer Network12 (2019): 1464-1472.
- Kalemkerian GP., et al. “NCCN Guidelines Insights: Small Cell Lung Cancer, Version 2. 2018”. Journal of the National Comprehensive Cancer Network10 (2018): 1171-1182.
- von Mehren M., et al. “NCCN Guidelines Insights: Soft Tissue Sarcoma, Version 1.2021”. National Comprehensive Cancer Network 12 (2020): 1604-1612.
- Qiu H and Zhou Z. “Updates and interpretation on NCCN clinical practice guidelines for gastric cancer 2017 version 5”. Zhonghua Wei Chang Wai Ke Za Zhi 2 (2018): 160-164.
- Provenzale D., et al. “NCCN Guidelines Insights: Colorectal Cancer Screening, Version 2.2020”. National Comprehensive Cancer Network10 (2020): 1312-1320.
- Covey AM. “Hepatocellular Carcinoma: Updates to Screening and Diagnosis”. National Comprehensive Cancer Network 5S (2018): 663-665.
- Gettinger SN., et al. “Overall Survival and Long-term safety of nivolumab (Anti-Programmed Death 1 Antibody, BMS-936558, ONO-4538 ) in patients with Previously Treated Advanced non-small cell lung cancer”. Journal of Clinical Oncology18 (2015): 2004-2012.
- Wolchok JD., et al. “Guidelines for the evaluation of immune therapy activity in solid tumors: immune-related response criteria”. Clinical Cancer Res23 (2009): 7412-7420.
- Eisenhauer EA., et al. “New response evaluation criteria in solid tumours: revised RECIST guideline (version 1. 1)”. European Journal of Caner2 (2009): 228-247.
- Cummings M., et al. “Preoperative neutrophil:lymphocyte and platelet:lymphocyte radios predict endometrial cancer survival”. British Journal of Caner2 (2015): 311-320.
- Que Y., et al. “Preoperative platelet-lymphocyte ratio is superior to neutrophil-lymphocyte ratio as a prognostic factor for soft-tissue sarcoma”. BMC Cancer 15 (2015): 648.
- Yuan C., et al. “Elevated pretreatment neutrophil/white blood cell radio and monocyte/lymphocyte ratio predict poor survival in patients with curatively resected non-small cell lung cancer: Results from a large cohort”. Thoracic Cancer4 (2017): 350-358.
- Nishijima TF., et al. “Inflammatory markers and overall survival in older adults with cancer”. Journal of Geriatric Oncology 2 (2019): 279-284.
- Song SB., et al. “Derived neutrophil to lymphocyte radio and monocyte to lymphocyte radio may be better biomarkers for predicting overall survival of patients with advanced gastric cancer”. OncoTargets and Therapy 10 (2017): 3145-3154.