Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

Zeng, Xiaojiao; Liu, Guo-Hong; Pan, Yunbao; Li, Yirong

doi:10.3389/fonc.2020.00146

“…In the last few years, PNI has been extensively investigated as predictor of poor outcome in several types of cancer [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], including HNC [ 31 , 32 , 33 , 34 ]. Although a number of studies have evaluated PNI in relation to treatment toxicity [ 35 , 36 , 37 , 38 ], only few ones focused on HNC [ 39 , 40 , 41 , 42 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Nutritional Index Predicts Toxicity in Head and Neck Cancer Patients Treated with Definitive Radiotherapy in Association with Chemotherapy

Fanetti

¹

,

Polesel

²

,

Fratta

³

et al. 2021

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Background: The Prognostic Nutritional Index (PNI) is a parameter of nutritional and inflammation status related to toxicity in cancer treatment. Since data for head and neck cancer are scanty, this study aims to investigate the association between PNI and acute and late toxicity for this malignancy. Methods: A retrospective cohort of 179 head and neck cancer patients treated with definitive radiotherapy with induction/concurrent chemotherapy was followed-up (median follow-up: 38 months) for toxicity and vital status between 2010 and 2017. PNI was calculated according to Onodera formula and low/high PNI levels were defined according to median value. Odds ratio (OR) for acute toxicity were calculated through logistic regression model; hazard ratios (HR) for late toxicity and survival were calculated through the Cox proportional hazards model. Results: median PNI was 50.0 (interquartile range: 45.5–53.5). Low PNI was associated with higher risk of weight loss > 10% during treatment (OR = 4.84, 95% CI: 1.73–13.53 for PNI < 50 versus PNI ≥ 50), which was in turn significantly associated with worse overall survival, and higher risk of late mucositis (HR = 1.84; 95% CI:1.09–3.12). PNI predicts acute weight loss >10% and late mucositis. Conclusions: PNI could help clinicians to identify patients undergoing radiotherapy who are at high risk of acute and late toxicity.

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“…However, results from these emerging findings are inconsistent. For instance, some of them evinced that elevated AAPR was associated with poor survival outcomes [ 9 , 10 , 12 – 21 , 23 – 26 ], but others evinced that elevated AAPR was not correlated with survival outcomes [ 11 , 22 ]. Additionally, qualities of the above mentioned studies are variable, especially in terms of cancer types and methodology.…”

Section: Introductionmentioning

confidence: 99%

Albumin-to-alkaline phosphatase ratio as a promising indicator of prognosis in human cancers: is it possible?

An

¹

,

Wang

²

,

Sun

³

2021

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Background The impact of albumin-to-alkaline phosphatase ratio (AAPR) on prognosis in cancer patients remains uncertain, despite having multiple relevant studies in publication. Methods We systemically compiled literatures from 3 databases (Cochrane Library, PubMed, and Web of Science) updated to May 24th, 2020. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed and synthesized using STATA 14, values were then pooled and utilized in order to assess the overall impact of AAPR on patient’s prognosis. Results In total, 18 studies involving 25 cohorts with 7019 cases were incorporated. Pooled results originated from both univariate and multivariate analyses (HR = 2.14, 95%CI:1.83–2.51, random-effects model; HR = 1.93, 95%CI:1.75–2.12, fixed-effects model; respectively) suggested that decreased AAPR had adverse effect on overall survival (OS). Similarly, pooled results from both univariate and multivariate analysis of fixed-effects model, evinced that decreased AAPR also had adverse effect on disease-free survival (DFS) (HR = 1.81, 95%CI:1.60–2.04, I2 = 29.5%, P = 0.174; HR = 1.69, 95%CI:1.45–1.97, I2 = 13.0%, P = 0.330; respectively), progression-free survival (PFS) (HR = 1.71, 95%CI:1.31–2.22, I2 = 0.0%, P = 0.754; HR = 1.90, 95%CI:1.16–3.12, I2 = 0.0%, P = 0.339; respectively), and cancer-specific survival (CSS) (HR = 2.22, 95%CI:1.67–2.95, I2 = 5.6%, P = 0.347; HR = 1.88, 95%CI:1.38–2.57, I2 = 26.4%, P = 0.244; respectively). Admittedly, heterogeneity and publication bias existed, but stratification of univariate meta-analytic results, as well as adjusted meta-analytic results via trim and fill method, all showed that AAPR still significantly correlated with poor OS despite of confounding factors. Conclusions In summary, decreased AAPR had adverse effect on prognosis in cancer patients. As an inexpensive and convenient ratio derived from liver function test, AAPR might become a promising indicator of prognosis in human cancers.

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“…PNI is a biomarker based on serum albumin level and total lymphocyte count. Several evidences reported that PNI reflected the systemic immunonutritional status and was a prognostic indicator in various cancers, including gastric cancer [ 13 , 18 ], nasopharyngeal carcinoma [ 19 ], and lung cancer [ 20 , 21 ]. It was easily calculated in daily routine.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Nutritional Index Predicts Outcome of PD-L1 Negative and MSS Advanced Cancer Treated with PD-1 Inhibitors

Zhang

¹

,

Jin

²

,

Tang

³

et al. 2022

BioMed Research International

3

0

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Purpose. Tumor mutational burden (TMB), microsatellite instability-high (MSI-H), and expression of programmed death ligand-1 (PD-L1) have emerged as predictive biomarkers for responsiveness to immune checkpoint inhibitors (ICIs) in several cancer types. However, for patients with negative PD-L1 expression, or microsatellite stability (MSS), some cases may experience favorable response to immunotherapy, and there is currently a lack of good relevant predictors. We tried to introduce several peripheral blood markers for predicting treatment outcome and immune-related adverse events (irAEs) in PD-L1 negative and MSS patients. Methods. A retrospective study of 142 PD-L1 negative and MSS patients was carried out. The association of peripheral blood markers including lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), albumin-to-globulin ratio (AGR), prognostic nutrition index (PNI), and other factors with clinicopathological characters and prognosis were assessed by Cox regression and Kaplan-Meier methods. Results. Lower level of PNI and poor performance status (ECOG score of 2) was correlated with significantly shorter overall survival (OS) and worse outcome of ICIs. The multivariate analysis revealed that PNI (for OS HR = 0.465 , 95% CI: 0.236–0.916, p = 0.027 ; for PFS HR = 0.493 , 95% CI: 0.251–0.936, p = 0.031 ) and ECOG score (for OS HR = 4.601 , 95% CI: 2.676–7.910, p < 0.001 ; for PFS HR = 2.830 , 95% CI: 1.707–4.691, p < 0.001 ) were independent prognostic factors for OS and PFS. NLR was related to the onset of irAEs. Conclusions. Pretreatment level of PNI and NLR, beyond PD-L1 expression and MSS, can improve the predictive accuracy for immunotherapy outcomes and has the potential to expand the candidate pool of patients for treatment with ICIs.

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Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma

Cited by 29 publications

References 38 publications

Prognostic Nutritional Index Predicts Toxicity in Head and Neck Cancer Patients Treated with Definitive Radiotherapy in Association with Chemotherapy

Prognostic Nutritional Index Predicts Toxicity in Head and Neck Cancer Patients Treated with Definitive Radiotherapy in Association with Chemotherapy

Albumin-to-alkaline phosphatase ratio as a promising indicator of prognosis in human cancers: is it possible?

Prognostic Nutritional Index Predicts Outcome of PD-L1 Negative and MSS Advanced Cancer Treated with PD-1 Inhibitors

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