The prognostic value of baseline and early variations of peripheral blood inflammatory ratios and their cellular components in patients with metastatic renal cell carcinoma treated with nivolumab: The Δ-Meet-URO analysis

Rebuzzi, Sara Elena; Signori, Alessio; Stellato, Marco; Santini, Daniele; Maruzzo, Marco; Giorgi, Ugo De; Pedrazzoli, Paolo; Galli, Luca; Zucali, Paolo Andrea; Fantinel, Emanuela; Carella, Claudia; Procopio, Giuseppe; Milella, Michèle; Boccardo, Francesco; Fratino, Lucia; Sabbatini, Roberto; Ricotta, Riccardo; Panni, Stefano; Massari, Francesco; Sorarú, Mariella; Santoni, Matteo; Cortellini, Alessio; Prati, Veronica; Parra, Hector J. Soto; Atzori, Francesco; Napoli, Marilena Di; Caffo, Orazio; Messina, Marco; Morelli, Franco; Prati, Giuseppe; Nolè, Franco; Vignani, Francesca; Cavo, Alessia; Roviello, Giandomenico; Obispo, Miguel Angel Llaja; Porta, Camillo; Buti, Sebastiano; Fornarini, Giuseppe; Banna, Giuseppe Luigi

doi:10.3389/fonc.2022.955501

Cited by 9 publications

(10 citation statements)

References 51 publications

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“…There are limited studies on the effect of PLR and response to immunotherapy compared to NLR. Most of the literature focuses on PLR as a prognostic indicator (33, 34,40,41,[52][53][54]. One of the studies included in this meta-analysis investigated blood markers before treatment that could be used as predictors of best clinical response (13).…”

Section: Discussionmentioning

confidence: 99%

“…A total of 40 studies were included in this systematic review, but only 17 studies (13,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) qualified for meta-analysis. Regionwise, almost half of the included studies came from Asian countries (Japan, China, and Korea).…”

Section: Research Characteristicsmentioning

confidence: 99%

“…Rebuzzi et al (34) reported mean values of NLR and PLR among patients who achieved clinical response and those with progressive disease at baseline and after four doses of treatment (longitudinal variation). The mean value of NLR and PLR at baseline and after four doses of treatment was lower as compared with the group with progressive disease (NLR, 3.18 vs. 4.12, p = 0.012; PLR, 184 vs. 237, p = 0.003).…”

Section: Urothelial Carcinoma (Renal [Rcc] and Bladder [Uc])mentioning

confidence: 99%

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Neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as potential predictive markers of treatment response in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Rugambwa,

Abdihamid,

Zhang

et al. 2023

Front. Oncol.

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BackgroundThe role of platelet–lymphocyte ratio (PLR) and neutrophil–lymphocyte ratio (NLR) as independent prognostic markers in different tumors is well established. However, there is a limited review of the potential of NLR and PLR as predictors of treatment outcomes from immune checkpoint inhibitors (ICIs).ObjectiveTo establish a correlation between NLR and PLR and the potential of clinical benefit from ICIs.MethodsThe literature search was performed for studies that reported the association between NLR, PLR, and treatment outcomes among cancer patients treated with ICIs. The outcomes of interest were objective response rate (ORR), disease control rate (DCR), and progressive disease (PD). ORR was the summation of patients who achieved complete response and partial response. DCR included patients who achieved stable disease. PD was the proportion of patients who progressed, relapsed, or discontinued the treatment. Statistical analysis was performed using the STATA 12.0 package. Heterogeneity was determined by the I2 value. Quality assessment was performed using the Newcastle–Ottawa Scale. Egger’s test was used to establish publication bias and sensitivity analysis.ResultsA total of 40 papers that met the inclusion criteria were included in the systematic review. However, only 17 studies were used in the meta-analysis to determine the correlation between NLR, PLR, and treatment response. We found that treatment with ICIs and monitoring of outcomes and adverse events using PLR and NLR parameters have been studied in different tumors. Our analysis showed that low NLR correlated with higher ORR (OR = 0.62 (95% CI 0.47–0.81, p = 0.001) and higher DCR (OR = 0.23, 95% CI 0.14–0.36, p < 0.001). Higher NLR predicted a higher probability of PD (OR = 3.12, 95% CI 1.44, 6.77, p = 0.004). Similarly, low PLR correlated with higher ORR (OR = 0.69, 95% CI 0.5, 0.95, p = 0.025). Generally, patients with low NLR and PLR were more likely to achieve clinical benefit and better response (p-value < 0.001). Meanwhile, patients with high ratios were more likely to progress (p-value < 0.005), although there was significant heterogeneity among studies. There was no significant publication bias observed.ConclusionThe study showed that high NLR and PLR either at baseline or during treatment is associated with poorer treatment outcome. Therefore, these ratios can be utilized in clinical practice with other markers to determine treatment efficacy from immunotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Research Characteristicsmentioning

confidence: 99%

Section: Urothelial Carcinoma (Renal [Rcc] and Bladder [Uc])mentioning

confidence: 99%

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Neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as potential predictive markers of treatment response in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Rugambwa,

Abdihamid,

Zhang

et al. 2023

Front. Oncol.

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“…The neutrophil-lymphocyte ratio is now a common composite inflammatory index, originally described by Goodman et al ( 45) in a 1995 study that evaluated its role in the diagnosis of appendicitis. Subsequently, as the relationship between tumors and inflammation was uncovered, more and more studies found that NLR was closely associated with the diagnosis and prognosis of urologic tumors such as prostate cancer (46), renal cell carcinoma (47), and adrenal cortical carcinoma (48). And similarly, NLR was strongly associated with predicting the occurrence of infection after minimally invasive treatment of urinary stones.…”

Section: Neutrophil-lymphocyte Ratiomentioning

confidence: 99%

Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy

Zhang

Jin

et al. 2023

Front. Immunol.

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Urolithiasis is a common and frequent disease in urology. Percutaneous nephrolithotomy (PCNL) is preferred for the treatment of upper urinary tract stones and complicated renal stones >2 cm in diameter, but it has a higher rate of postoperative complications, especially infection, compared with other minimally invasive treatments for urinary stones. Complications associated with infection after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome (SIRS), and sepsis, which is considered one of the most common causes of perioperative death after percutaneous nephrolithotomy. In contrast, SIRS serves as a sentinel for sepsis, so early intervention of SIRS by biomarker identification can reduce the incidence of postoperative sepsis, which in turn reduces the length of stay and hospital costs for patients. In this paper, we summarize traditional inflammatory indicators, novel inflammatory indicators, composite inflammatory indicators and other biomarkers for early identification of systemic inflammatory response syndrome after percutaneous nephrolithotomy.

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“…The NLR has been shown to be a useful prognostic indicator in patients with non-small-cell lung cancer (NSCLC) as well as a predictor of response to immunotherapy [ 9 , 10 , 11 ]. Moreover, in patients with renal cell cancers, variations in the NLR have been shown to influence overall survival (OS) and progression-free survival (PFS) [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Effects of GCSF Primary Prophylaxis on Survival Outcomes and Toxicity in Patients with Advanced Non-Small Cell Lung Cancer on First-Line Chemoimmunotherapy: A Sub-Analysis of the Spinnaker Study

Anpalakhan

Huddar

Behrouzi

et al. 2023

IJMS

Self Cite

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GCSF prophylaxis is recommended in patients on chemotherapy with a >20% risk of febrile neutropenia and is to be considered if there is an intermediate risk of 10–20%. GCSF has been suggested as a possible adjunct to immunotherapy due to increased peripheral neutrophil recruitment and PD-L1 expression on neutrophils with GCSF use and greater tumour volume decrease with higher tumour GCSF expression. However, its potential to increase neutrophil counts and, thus, NLR values, could subsequently confer poorer prognoses on patients with advanced NSCLC. This analysis follows on from the retrospective multicentre observational cohort Spinnaker study on advanced NSCLC patients. The primary endpoints were OS and PFS. The secondary endpoints were the frequency and severity of AEs and irAEs. Patient information, including GCSF use and NLR values, was collected. A secondary comparison with matched follow-up duration was also undertaken. Three hundred and eight patients were included. Median OS was 13.4 months in patients given GCSF and 12.6 months in those not (p = 0.948). Median PFS was 7.3 months in patients given GCSF and 8.4 months in those not (p = 0.369). A total of 56% of patients receiving GCSF had Grade 1–2 AEs compared to 35% who did not receive GCSF (p = 0.004). Following an assessment with matched follow-up, 41% of patients given GCSF experienced Grade 1–2 irAEs compared to 23% of those not given GCSF (p = 0.023). GCSF prophylaxis use did not significantly affect overall or progression-free survival. Patients given GCSF prophylaxis were more likely to experience Grade 1–2 adverse effects and Grade 1–2 immunotherapy-related adverse effects.

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The prognostic value of baseline and early variations of peripheral blood inflammatory ratios and their cellular components in patients with metastatic renal cell carcinoma treated with nivolumab: The Δ-Meet-URO analysis

Cited by 9 publications

References 51 publications

Neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as potential predictive markers of treatment response in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as potential predictive markers of treatment response in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy

The Effects of GCSF Primary Prophylaxis on Survival Outcomes and Toxicity in Patients with Advanced Non-Small Cell Lung Cancer on First-Line Chemoimmunotherapy: A Sub-Analysis of the Spinnaker Study

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