Prognostic significance of baseline T cells, B cells and neutrophil-lymphocyte ratio (NLR) in recurrent ovarian cancer treated with chemotherapy

Abstract

Purpose: Biomarkers are needed to guide treatment decisions in recurrent ovarian cancer, as a high proportion of patients do not benefit from treatments. Data on immune subsets in patients receiving chemotherapy are scarce. We investigated the impact of T cells, B cells, neutrophils and the neutrophil-lymphocyte ratio (NLR) in ovarian cancer patients receiving palliative chemotherapy. Methods: Blood samples were collected prospectively at baseline in recurrent ovarian cancer (N = 72) receiving chemotherapy. T cells, B cells, neutrophils, and NLR were analyzed. Primary and secondary endpoints were overall survival (OS) and treatment response, respectively. Cutoffs for T and B cells were predefined. Results: In patients with low vs. high T and B cells counts, OS was 6.1 months vs 12.0 months (P = 0.017) and 6.1 months vs 12.0 months (P = 0.011, respectively. Low T and B cells analyzed as continuous variables were also associated with unfavorable OS, P = 0.011 and P = 0.007, respectively. Neutrophils had no significant prognostic impact. Median NLR was 4.1. High vs. low NLR was associated with poor survival, 7.4 months vs. 15.9 months (P = 0.012). In multivariate analysis including platinum sensitivity, number of prior lines of chemotherapy, and performance status, high NLR remained an independent poor prognostic factor HR: 2.17 (95% CI 1.21-3.88) (P = 0.009). High NLR was also significantly associated with lack of response, OR 0.15 (95% CI: 0.04-0.51) (P = 0.002). Conclusion: In recurrent ovarian cancer patients undergoing palliative chemotherapy, low T and B lymphocyte counts had an unfavorable prognostic impact. High NLR was associated with lack of response and a poor prognosis, and the parameter may be used in patient counselling and treatment decisions.

Nlr & Brca Mutational Status In Patients With High Grade Serous Advanced Ovarian Cancer: A Large Population Study

“…We also found that high NLR in patients with primary advanced OC is predictive of larger tumor burden (expressed as LPS-PIV score) and those with higher NLR have higher chances of receiving NACT instead of PDS, compared with those with lower NLR. These observations are in line with the negative prognostic value of high NLR reported in other retrospective series of different OC settings [45,46]. Finally, our data con rm that NLR at baseline has an independent prognostic impact for both PFS and OS.…”

COVID-19 and cytokine storm syndrome: can what we know about interleukin-6 in ovarian cancer be applied?

“…Patients who did not survive also had progressive neutrophilia with concomitant lymphocytopenia, in more severe cases. These parameters define the neutrophil/lymphocyte ratio (NLR), which provides a consolidated prognostic parameter for other diseases [12,13], including ovarian cancer [14][15][16][17]. Noteworthy, during hospitalization evaluation, fibrinogen and antithrombin levels were significantly low in non-survivors [18].…”

Genomic, Immunological, and Clinical Characterization of Pyroptosis in Ovarian Cancer

“…A recent prospective study revealed that patients with high infiltration of T and B cells have significantly prolonged overall survival. 26 In our study, the relative abundance of B cells in subtype B and high-risk score groups with worse OS was lower than that in subtype A and low-risk score groups, suggesting that B cell infiltration inhibits the development of OV. Collectively, our results demonstrated a quantitative and qualitative difference in the landscape of immune infiltration between the distinct pyroptosis subtypes and risk subgroups.…”