The Predictive Value of Systemic Inflammatory Factors in Advanced, Metastatic Esophageal Squamous Cell Carcinoma Patients Treated with Camrelizumab

Liu, Jiang; Gao, Deyu; Zhang, Yingbo; Hu, Guangyin; Liu, Jianhua; Liu, Degan

doi:10.2147/ott.s382967

Cited by 11 publications

(11 citation statements)

References 30 publications

(36 reference statements)

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“…Previous researches revealed that high NLR level has been consistently linked to a worse prognosis in EC when patients were treated with either topical therapies or systemic chemotherapy ( 34 , 35 ). Our results, consistent with these researches ( 29 , 30 ), showed that a high baseline NLR was in line with inferior survival in ESCC receiving immunotherapy. Multivariate cox analysis indicated that baseline NLR was an independent prognostic indicator for both PFS and OS.…”

Section: Discussionsupporting

confidence: 93%

“…As a novel inflammatory marker based on neutrophils, platelets, and lymphocytes, SII could objectively reflect the balance between inflammation and immunity ( 36 ), and thus has an important prognostic value in many types of cancer ( 37 ). Our finding confirmed that high SII was a worse prognostic indicator for OS in ESCC patients receiving immunotherapy ( 29 , 38 ). Notably, based on multivariate Cox regression analysis, both dNLR and PLR, which were positive predictors of short-term outcomes, failed to demonstrate statistical significance for survival.…”

Section: Discussionsupporting

confidence: 86%

“…Similar studies were also performed in EC patients treated with immunotherapy. For example, Liu et al revealed that PLR, NLR, and SII at baseline were significantly linked to PFS and OS (29). Previous researches suggested that pretreatment high NLR was correlated with inferior PFS and OS (30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of inflammatory markers and clinical features for survival in advanced or metastatic esophageal squamous cell carcinoma patients receiving anti-programmed death 1 treatment

Zhang

et al. 2023

Front. Oncol.

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PurposeThis study aims to assess the prognostic value of inflammatory markers and clinical features in advanced or metastatic esophageal squamous cell carcinoma (ESCC) patients receiving anti-programmed death 1 (PD-1) treatment.MethodsBased on receiver operating characteristic curve (ROC) analysis, Youden’s indexes were applied to determine the cut-off values for inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocye ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Wilcoxon test was conducted to evaluate the changes in above inflammatory markers. Kaplan-Meier method was utilized to estimate progression-free survival (PFS) and overall survival (OS), and the Log-rank test was used to compare the different survival between groups. Univariate and multivariate Cox regression analyses were performed to assess the prognostic value of inflammatory markers and clinical features.Results162 advanced or metastatic ESCC patients receiving anti-PD-1 treatment were enrolled in this retrospective study. The cut-off values of NLR, dNLR, MLR, PLR, and SII were 4.748, 2.214, 0.309, 250.505, and 887.895, respectively. NLR, dNLR, PLR, and SII declined significantly among the partial response (PR) (P<0.001, P<0.001, P=0.036, P<0.001), objective response rate (ORR) (P<0.001, P<0.001, P=0.036, P<0.001), and disease control rate (DCR) (P<0.001, P<0.001, P=0.038, P<0.001) groups, respectively. Significant increases were found in NLR (P<0.001), dNLR (P<0.001), MLR (P=0.001), and SII (P=0.024) when anti-PD-1 treatment failed. Multivariate Cox regression analysis indicated that NLR (P<0.001, P=0.002), lymph node metastasis (P=0.013, P=0.001), Eastern Cooperative Oncology Group Performance Status (ECOG PS) (P=0.008, P=0.002), and treatment lines (P=0.037, P=0.048) were significant prognostic indicators of PFS and OS. Additionally, SII (P=0.016) was also significantly related to OS in ESCC patients. The risk score model showed that low risk patients prolonged PFS and OS than those with middle or high risk (P<0.001, P<0.001).ConclusionInflammatory markers can reflect short-term outcomes of anti-PD-1 treatment for ESCC patients. NLR, lymph node metastases, ECOG PS, and treatment lines are significant prognostic indicators for PFS and OS. And the risk score model constructed based on the above factors has favourable prognostic predictive value.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 86%

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Prognostic value of inflammatory markers and clinical features for survival in advanced or metastatic esophageal squamous cell carcinoma patients receiving anti-programmed death 1 treatment

Zhang

et al. 2023

Front. Oncol.

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“…Our cutoff value of NLR was within the range for those of esophageal and other types of cancer. [11][12][13]18,[27][28][29] We found here that PLRs before, and on 14 and 28 days after treatment were not significant predictors of a clinical therapeutic effect and survival. However, others have shown that PLRs are important predictive markers of an ESCC tumor response to a PD-1 inhibitor and survival.…”

Section: Discussionmentioning

confidence: 47%

“…The reported cutoffs of pretreatment NLRs required to significantly stratify survival range from 3 to 7 in these studies, [11][12][13]18 and 3.84, 5.0 and 6.0 for unresectable advanced and recurrent esophageal cancer, although the reports [11][12][13] included patients with esophageal adenocarcinoma treated by some types of ICI or by combination chemotherapies. [27][28][29] The optimal cutoff for pretreatment NLRs required to significantly stratify the survival of patients with ESCC who underwent nivolumab monotherapy in the present study was 4.9. Our cutoff value of NLR was within the range for those of esophageal and other types of cancer.…”

Section: Discussionmentioning

confidence: 80%

Ability of Blood Cell Parameters to Predict Clinical Outcomes of Nivolumab Monotherapy in Advanced Esophageal Squamous Cell Carcinoma

Hamai¹,

Emi²,

Ibuki³

et al. 2023

OTT

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Various blood cell parameters have been identified as predictive markers of tumor responses and the survival of patients with cancer treated with immune checkpoint inhibitors. The purpose of this study is to assess the ability of various blood cell parameters to predict therapeutic effects and survival in patients with esophageal squamous cell carcinoma (ESCC) treated with nivolumab monotherapy. Patients and Methods: We evaluated neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR) and lymphocyte-to-monocyte (LMR) ratios as predictive markers of patients' survival and effects of nivolumab monotherapy after one or more prior chemotherapies for unresectable advanced or recurrent ESCC. Results: The objective response and disease control rates were 20.3% and 47.5%, respectively. The LMRs before, and 14 and 28 days after nivolumab initiation were significantly higher in patients with complete response (CR)/partial response (PR)/stable disease (SD) than those with progressive disease (PD). The NLRs at 14 and 28 days after nivolumab initiation were significantly lower in patients with CR/PR/SD than with PD. The optimal cutoffs for these parameters significantly discriminated patients with CR/PR/SD and PD. Univariate and multivariate analyses identified pretreatment NLRs as a significant independent factor for progression-free and overall survival (hazard ratio [HR]: 1.19, 95% confidence interval [CI]: 1.07-1.32, and HR 1.23, 95% CI: 1.11-1.37, respectively; p ≤ 0.001 for both). Conclusion:The pretreatment LMRs, and NLR and LMR at 14 and 28 days after starting nivolumab monotherapy were significantly associated with the clinical therapeutic effect. The pretreatment NLR was significantly associated with patients' survival. These blood cell parameters before and during the early days of nivolumab monotherapy can help to identify patients with ESCC who would most likely benefit from nivolumab monotherapy.

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The prognostic value of preoperative laboratory data indicators in patients with esophageal carcinoma: An observational study

Ma,

Liu,

et al. 2024

Medicine

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Preoperative laboratory data indicators significantly affect the prognosis of a variety of tumors. Nevertheless, the combined effect of systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) on overall survival (OS) in patients with esophageal carcinoma remains unclear. Thus, we examined these associations among patients with postoperative staged T3N0M0 esophageal carcinoma. The data of 246 patients with postoperative staged T3N0M0 esophageal carcinoma from January 1, 2010, to December 31, 2022, were retrospectively analyzed. OS was measured from the date of pathological diagnosis until either death or the last follow-up. The Kaplan–Meier method and multivariate Cox regression model were used to analyze the relationship between neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), Platelet-to-lymphocyte ratio (LMR), SII, PNI, and OS. The predictive value of SII and PNI as a combined index was analyzed by the receiver operating characteristic curve (ROC). A total of 246 patients aged 65.5 ± 7.4 years were included in this study and 181 (73.6%) were male. The univariate analysis revealed that differentiation, vessel involvement, postoperative treatment, NLR, SII, PLR, LMR, PNI were predictors of OS (P < .05). After adjusted for potential confounds, multivariate Cox regression analysis showed that the differentiation, SII, PNI, and postoperative treatment were independent prognostic factors correlated with OS in patients with postoperative staged T3N0M0 esophageal carcinoma (P < .05). SII and PNI, as a combined indicator, have a higher predictive value for OS. The NLR, SII, PLR, LMR, and PNI could all be used as independent predictors of OS in patients with postoperative staged T3N0M0 esophageal carcinoma. The combination of SII and PNI can significantly improve the accuracy of prediction.

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The Predictive Value of Systemic Inflammatory Factors in Advanced, Metastatic Esophageal Squamous Cell Carcinoma Patients Treated with Camrelizumab

Cited by 11 publications

References 30 publications

Prognostic value of inflammatory markers and clinical features for survival in advanced or metastatic esophageal squamous cell carcinoma patients receiving anti-programmed death 1 treatment

Prognostic value of inflammatory markers and clinical features for survival in advanced or metastatic esophageal squamous cell carcinoma patients receiving anti-programmed death 1 treatment

Ability of Blood Cell Parameters to Predict Clinical Outcomes of Nivolumab Monotherapy in Advanced Esophageal Squamous Cell Carcinoma

The prognostic value of preoperative laboratory data indicators in patients with esophageal carcinoma: An observational study

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