Prognostic value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients with advanced solid tumors treated with PD-1 inhibitors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14132-e14132
Author(s):  
Miguel Gonzalez Velez ◽  
Giselle Alexandra Suero-Abreu ◽  
Marshall McKenna ◽  
Camille Michelle Johnson ◽  
Martin Gutierrez
Keyword(s):  
Solid Tumors ◽  
Real World ◽  
Prognostic Markers ◽  
Advanced Solid Tumors ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Longitudinal Response ◽  
Landmark Analyses ◽  
The Impact

e14132 Background: The use of PD-1 inhibitors (PD1) has been limited due to the lack of prognostic markers of response. Previous studies have suggested that indirect inflammatory markers such as neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) may correlate with response to treatment and improved survival. We sought to evaluate the impact NLR and PLR in a real world cohort of patients (pts) with advanced solid tumors treated with PD1. Methods: Records of all pts treated with PD1 between 2011-2017 at the John Theurer Cancer Center were reviewed. NLR and PLR were registered at baseline and longitudinally. We dichotomized as low (lNLR/lPLR), and high (hNLR ≥5/hPLR ≥160). Univariate logistic regression and Cox proportional hazards were used for progression free survival (PFS), and overall survival (OS). Landmark analyses were performed at cycles 2 (C2), and 5 (C5). Results: 178 pts received 1131 cycles of PD1. Median age was 65 (range 24-93); 43% were female. ECOG was ≥1 for 85%. 142 pts (80%), and 89 (50%) received ≥2C and ≥5C respectively. In univariate analyses, baseline hNLR and hPLR were independently associated with inferior OS (median 7.8 vs 18.3 months; HR 1.77, 95% CI 1.21-2.43; p = 0.004), ) and (median 6.4 vs 15.6 months; HR 1.42, 95% CI 1.09-2; p = 0.04) respectively. On landmark analyses, lNLR and lPLR were associated with longer PFS and OS at 2C, and 5C. Longitudinally, lNLR and lPLR correlated with response rate; NLR decreased by 0.08 (95% CI: -0.19 to -0.04; p = 0.03) and PLR by 17 (95% CI: -29 to -14; p = 0.07) per month in responders compared with non-responders. hNLR or hPLR did not correlate with increase in autoimmune toxicities. Conclusions: hNLR, hPLR are adversely prognostic markers in pts receiving PD1 inhibitors in a “real world cohort”. These markers correlate with a longitudinal response and may help predict response. Further prospective studies are needed to determine their utility in decision making during treatment.

An evaluation of administrative data linkage for measurement of real-world outcomes of large clinical panel sequencing for advanced solid tumors.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 283-283
Author(s):  
Ramy Saleh ◽  
Philippe L. Bedard ◽  
Paul Nguyen ◽  
Eoghan Ruadh Malone ◽  
Celeste Yu ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Administrative Data ◽  
Real World ◽  
Short Interval ◽  
Common Disease ◽  
Advanced Solid Tumors ◽  
Vital Status ◽  
Treatment Matching ◽  
The Impact ◽  
Panel Sequencing

283 Background: There is limited real-world evidence of impact of large clinical panel sequencing on treatment-matching for patients with advanced solid tumors. The province of Ontario has a single payer, publicly funded health care system. We linked genomic testing results from a prospective province-wide trial, OCTANE (Ontario-Wide Cancer TArgeted Nucleic Acid Evaluation), to administrative data to determine the feasibility of this approach for evaluating survival and the impact of sequencing on treatment matching. Methods: We linked all Ontario patients from Princess Margaret (PM) with panel testing results (tumor-only 555-gene panel) to province-wide administrative data on treatments and outcomes. Patients were recruited from August 2016 to August 2018. Only clinically actionable variants based upon OncoKB annotation (Level 1 and 2) were assessed for genotype-informed treatment matching. Results: All 888 eligible patients were successfully linked to administrative data. Mean age was 58 (±13) years, 635 (71.5%) were female. Most common disease sites were ovary (26.4%), uterus (14.0%), colorectal (11.8%) and breast (9.5%). Administrative data vital status was more complete than trial collected data with 262 of 476 deaths only recorded in administrative data. Median survival was 1.70 years (95% confidence interval 1.50-1.91). 247 (27.8%) had actionable mutations, most commonly PIK3CA (54.7%), BRCA1 (15.8%), BRCA2 (15.0%) and BRAF (8.9%). 37 (15.0%) and 42 (17.0%) patients with actionable mutations received targeted therapy within 6 and 12 months of test report date, respectively. Conclusions: This is the first known feasibility study of linked administrative data to measure outcomes of large clinical panel sequencing for patients with advanced solid tumors. Vital status was more complete with administrative data compared to trial-collected data, and treatment data was successfully linked. About one in twenty-one enrolled patients received genome-informed treatments within 12 months, or about one in six of all patients with actionable mutations. This may be due to short interval follow up, trial and drug access, successful standard of care treatments, early patient deterioration or limited alterations covered by the panel, among other causes.

scholarly journals Prognostic value of the postoperative neutrophil-lymphocyte ratio in solid tumors: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250091
Author(s):  
Meilong Wu ◽  
Shizhong Yang ◽  
Xiaobin Feng ◽  
Chengquan Li ◽  
Fei Yu ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Relevant Literature ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Tumor Type ◽  
Long Term Outcomes ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Impact

Purpose Numerous studies have demonstrated that a variety of systemic inflammatory markers were associated with the survival of different tumors. However, the association between elevated postoperative neutrophil-lymphocyte ratio (postNLR) and long-term outcomes, including overall survival (OS), disease-free survival (DFS), in patients with solid tumors remains controversial. A systematic review was conducted to explore the association between the postNLR and long-term outcomes in solid tumors. Materials and methods Relevant literature was identified using PubMed, Embase, Web of Science, and the Cochrane Library from the initiation of the databases to October 2020. Data were extracted from included studies reporting hazard ratio (HR) and 95% confidence intervals (CI), and were pooled using generic inverse-variance and random-effects modeling. 25 studies reporting on7539 patients were included in the analysis. Results Elevated postNLR was associated with poor OS (HR 1.87, 95% CI = 1.53–2.28; P < 0.00001), and worse DFS (HR 1.69, 95% CI = 1.28–2.22; P = 0.0002). Subgroup analyses showed that the trend of the pooled HR for most of the subgroups was not changed, and the heterogeneity of the same tumor type was not obvious. However, there was no correlation between high postNLR obtained within 7days and poor DFS (n = 3, HR 1.25, 95CI% = 0.54–2.88; P = 0.60). Conclusions Elevated postNLR might be a readily available and inexpensive biomarker for long-term outcomes in solid tumors. Multicenter and prospective studies are needed to explore the impact of the postNLR on the prognosis of solid tumors.

scholarly journals Comparison of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in patients with thyroiditis and papillary tumors

2019 ◽  
Vol 47 (5) ◽  
pp. 2077-2083 ◽  
Author(s):  
Aziz Ari ◽  
Feray Gunver
Keyword(s):  
Inflammatory Markers ◽  
Prognostic Markers ◽  
Healthy Controls ◽  
Blood Cell Count ◽  
Papillary Cancer ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Thyroid Papillary ◽  
Thyroid Papillary Cancer

Objective The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) have recently been introduced as prognostic markers of thyroid cancer and strong inflammatory markers. The study was performed to investigate the association of the PLR and NLR with thyroid inflammation and papillary cancer. Methods Patients with thyroiditis and patients with papillary carcinomas were compared with sex-, age-, and body mass index-matched healthy controls. The NLR and PLR were calculated and compared among the three groups. Results The NLR was significantly higher in patients with thyroiditis and non-significantly higher in patients with papillary cancer than in healthy controls. The PLR was significantly higher in both patients with thyroiditis and papillary cancer than in healthy controls. Like the NLR, the PLR was not different between patients with thyroiditis and papillary cancer. The NLR was significantly and positively associated with the PLR and white blood cell count. Conclusion The PLR and NLR showed similar results in both thyroid inflammation and cancer. It seems difficult to obtain clear results in separating cancer from inflammatory events using these parameters. We suggest using them as supportive parameters of thyroid papillary cancer or inflammation.

scholarly journals Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio as Diagnostic and Prognostic Markers for Hepatitis C Virus – Related Hepatocellular Carcinoma in Egyptian Patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E M Elgindy ◽  
I M F Montasser ◽  
W E Saad ◽  
M A Ghanem
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Markers ◽  
Best Supportive Care ◽  
University Hospitals ◽  
Female Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Group A ◽  
Group 2

Abstract Background hepatocellular carcinoma (HCC), a highly prevalent and lethal cancer, it is the sixth most common cancer and the third leading cause of cancer-related death worldwide. Aim of the work to evaluate the role of inflammatory markers Neutrophil lymphocyte ratio and Platelet lymphocyte ratio (NLR & PLR) as biomarkers for diagnosis of HCV related HCC. Patients and Methods this study was conducted in tropical medicine department, HCC clinic Ain-shams university hospitals. Our study included 174 candidates who were divided into three groups. Group A included 60 Patients with HCV-related HCC diagnosed according to American Association for the Study of Liver Diseases (AASLD) guidelines; HCC patients were subdivided into three subgroups According to BCLC Results group A included 114 Patients with HCV-related HCC, which was subdivided into three subgroups according to BCLC. Group 1 included 30 patients underwent Radio-frequency ablation (RF), 76.67% of them were males while 23.33% were females with mean age 57.433. Group 2 included 41 patients underwent Trans-arterial chemo-embolization (TACE), 80.49% were males while 19.51% were females with mean age 60.268. Group 3 included 43 Patients with BCLC stage C and D For best supportive care, 76.74% were males while 23.26% were females with mean age 60.372. Male to female ratio in HCC patients was 3.56:1. Conclusion AFP remains the gold standard marker for diagnosis of HCC. NLR and PLR has no role as early prognostic markers for HCC.

An evaluation of administrative data linkage for measurement of real-world outcomes of large clinical panel sequencing for advanced solid tumors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19303-e19303
Author(s):  
Ramy Saleh ◽  
Philippe L. Bedard ◽  
Paul Nguyen ◽  
Eoghan Ruadh Malone ◽  
Celeste Yu ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Administrative Data ◽  
Real World ◽  
Short Interval ◽  
Common Disease ◽  
Advanced Solid Tumors ◽  
Vital Status ◽  
Treatment Matching ◽  
The Impact ◽  
Panel Sequencing

e19303 Background: There is limited real-world evidence of impact of large clinical panel sequencing on treatment-matching for patients with advanced solid tumors. The province of Ontario has a single payer, publicly funded health care system. We linked genomic testing results from a prospective province-wide trial, OCTANE (Ontario-Wide Cancer TArgeted Nucleic Acid Evaluation), to administrative data to determine the feasibility of this approach for evaluating survival and the impact of sequencing on treatment matching. Methods: We linked all Ontario patients from Princess Margaret (PM) with panel testing results (tumor-only 555-gene panel) to province-wide administrative data on treatments and outcomes. Patients were recruited from August 2016 to August 2018. Only clinically actionable variants based upon OncoKB annotation (Level 1 and 2) were assessed for genotype-informed treatment matching. Results: All 888 eligible patients were successfully linked to administrative data. Mean age was 58 (±13) years, 635 (71.5%) were female. Most common disease sites were ovary (26.4%), uterus (14.0%), colorectal (11.8%) and breast (9.5%). Administrative data vital status was more complete than trial collected data with 262 of 476 deaths only recorded in administrative data. Median survival was 1.70 years (95% confidence interval 1.50-1.91). 247 (27.8%) had actionable mutations, most commonly PIK3CA (54.7%), BRCA1 (15.8%), BRCA2 (15.0%) and BRAF (8.9%). 37 (15.0%) and 42 (17.0%) patients with actionable mutations received targeted therapy within 6 and 12 months of test report date, respectively. Conclusions: This is the first known feasibility study of linked administrative data to measure outcomes of large clinical panel sequencing for patients with advanced solid tumors. Vital status was more complete with administrative data compared to trial-collected data, and treatment data was successfully linked. About one in twenty-one enrolled patients received genome-informed treatments within 12 months, or about one in six of all patients with actionable mutations. This may be due to short interval follow up, trial and drug access, successful standard of care treatments, early patient deterioration or limited alterations covered by the panel, among other causes.

scholarly journals Comparison of Selected Immune and Hematological Parameters and Their Impact on Survival in Patients with HPV-Related and HPV-Unrelated Oropharyngeal Cancer

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3256
Author(s):  
Adam Brewczyński ◽  
Beata Jabłońska ◽  
Agnieszka Maria Mazurek ◽  
Jolanta Mrochem-Kwarciak ◽  
Sławomir Mrowiec ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Oropharyngeal Cancer ◽  
Hematological Parameters ◽  
White Blood Cells ◽  
Post Treatment ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Hpv Status ◽  
Pre Treatment ◽  
The Impact

Several immune and hematological parameters are associated with survival in patients with oropharyngeal cancer (OPC). The aim of the study was to analyze selected immune and hematological parameters of patients with HPV-related (HPV+) and HPV-unrelated (HPV-) OPC, before and after radiotherapy/chemoradiotherapy (RT/CRT) and to assess the impact of these parameters on survival. One hundred twenty seven patients with HPV+ and HPV− OPC, treated with RT alone or concurrent chemoradiotherapy (CRT), were included. Patients were divided according to HPV status. Confirmation of HPV etiology was obtained from FFPE (Formalin-Fixed, Paraffin-Embedded) tissue samples and/or extracellular circulating HPV DNA was determined. The pre-treatment and post-treatment laboratory blood parameters were compared in both groups. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and systemic immune inflammation (SII) index were calculated. The impact of these parameters on overall (OS) and disease-free (DFS) survival was analyzed. In HPV+ patients, a high pre-treatment white blood cells (WBC) count (>8.33 /mm3), NLR (>2.13), SII (>448.60) significantly correlated with reduced OS, whereas high NLR (>2.29), SII (>462.58) significantly correlated with reduced DFS. A higher pre-treatment NLR and SII were significant poor prognostic factors for both OS and DFS in the HPV+ group. These associations were not apparent in HPV− patients. There are different pre-treatment and post-treatment immune and hematological prognostic factors for OS and DFS in HPV+ and HPV− patients. The immune ratios could be considered valuable biomarkers for risk stratification and differentiation for HPV− and HPV+ OPC patients.

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