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Cheng LY, Su PJ, Kuo MC, Lin CT, Luo HL, Chou CC, Huang SY, Wu CC, Chen CH, Huang CC, Tsai KL, Yu-Li Su H. Combining serum inflammatory markers and clinical factors to predict survival in metastatic urothelial carcinoma patients treated with immune checkpoint inhibitors. Ther Adv Med Oncol 2024; 16:17588359241305091. [PMID: 39687055 PMCID: PMC11648016 DOI: 10.1177/17588359241305091] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Accepted: 11/19/2024] [Indexed: 12/18/2024] Open
Abstract
Background Despite the revolutionary impact of immune checkpoint inhibitors (ICIs) on the treatment of metastatic urothelial carcinoma (mUC), the clinical utility of reliable prognostic biomarkers to foresee survival outcomes remains underexplored. Objectives The purpose of this study was to ascertain the prognostic significance of serum inflammatory markers in mUC patients undergoing ICI therapy. Design This is a retrospective, multicenter study. Methods Data were collected from two independent medical centers in Taiwan, encompassing a validation and a training cohort (TC). Patients with histopathologically confirmed urothelial carcinoma who received at least one cycle of ICI monotherapy were included. Serum inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated prior to ICI therapy. Statistical analyses involved the use of receiver operating characteristic (ROC) curves to determine optimal biomarker cutoffs and Cox proportional hazards models to evaluate the independent predictive capability of these markers. Results A total of 192 patients were enrolled. In the univariate analysis, serum markers such as NLR, PLR, SII, and Hb were significantly associated with overall survival (OS) in both the training and validation cohorts (VC). White blood cells, NLR, and SII demonstrated a robust correlation with progression-free survival across both cohorts. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status ⩾2 (p < 0.001), visceral metastasis (p < 0.001), leukocytosis (p < 0.001), Hb levels ⩾10 mg/dL (p = 0.008), and NLR ⩾5 (p = 0.032) as independent predictors of OS. A prognostic nomogram integrating these independent factors yielded a C-index for a 3-year OS of 0.769 in the TC and 0.657 in the VC. Conclusion Serum inflammatory markers, combined with clinicopathologic factors, provide a practical prognostic tool in mUC treatment with ICIs.
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Affiliation(s)
- Liang-Yun Cheng
- Division of Hematology–Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Po-Jung Su
- Division of Hematology–Oncology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ming-Chun Kuo
- Division of Hematology–Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chang-Ting Lin
- Division of Hematology–Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hao-Lun Luo
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Chi Chou
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih-Yu Huang
- Division of Hematology–Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chia-Che Wu
- Division of Hematology–Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Hsu Chen
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chun-Chieh Huang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kai-Lung Tsai
- Department of Colorectal Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Harvey Yu-Li Su
- Division of Hematology–Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Dapi Road, Niaosong District, Kaohsiung City 833, Taiwan
- Genomic and Proteomic Core Laboratory, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
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Firatligil FB, Sucu ST, Tuncdemir S, Saglam E, Dereli ML, Ozkan S, Reis YA, Yucel KY, Celen S, Caglar AT. Evaluation of systemic immune-inflammation index for predicting late-onset fetal growth restriction. Arch Gynecol Obstet 2024; 310:433-439. [PMID: 38536449 DOI: 10.1007/s00404-024-07453-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/29/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION To determine a cut-off value for systemic immune-inflammation index (SII) (neutrophil × platelet/lymphocyte) in the prediction of fetal growth restriction (FGR). MATERIALS AND METHODS This case-control study was conducted retrospectively at the Obstetrics-Gynecology and Perinatology Clinics of Etlik Zubeyde Hanim Women's Health Education and Training Hospital. Singleton pregnant women with late-onset FGR who were followed up in outpatient clinics or hospitalized and whose pregnancy resulted at our hospital were included in the study group (group I). Healthy early and full-term singleton pregnant women with spontaneous labor who were followed up in the same hospital and whose pregnancy resulted at the same hospital were included in the control group (group II). Receiver-operating characteristic curves were used to assess the performance of SII value in predicting FGR. RESULTS We recruited 79 cases (pregnant with late-onset fetal growth restriction) and 79 controls (healthy pregnant), matched for age, body mass index, and parity. ΔSII was statistically significantly higher in the pregnant with late-onset FGR compared with healthy pregnant (123 vs - 65; p = 0.039). The values in ROC curves with the best balance of sensitivity/specificity were > 152 109/L (49% sensitivity, 70% specificity) and > 586 109/L (27% sensitivity, 90% specificity) for late-onset FGR. DISCUSSION Higher ΔSII levels in maternal blood indicate an inflammatory process causing FGR. The cut-off value for ΔSII (> 586 109/L) at 90% specificity can be used as a screening test. In the presence of ΔSII levels > 586 109/L (27% sensitivity and 90% specificity), the physicians should be more cautious about risk for FGR. Therefore, pregnant women at risk for FGR should be checked more frequently and monitored closely. However, further studies are needed to confirm our findings.
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Affiliation(s)
- Fahri Burcin Firatligil
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey.
| | - Serap Topkara Sucu
- Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Sitare Tuncdemir
- Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Erkan Saglam
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Murat Levent Dereli
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Sadullah Ozkan
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Yildiz Akdas Reis
- Department of Obstetrics and Gynecology, Ankara Etlik Zubeyde Hanim Women's Health Education and Research Hospital, Ankara, Turkey
| | - Kadriye Yakut Yucel
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Sevki Celen
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Ali Turhan Caglar
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey
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Guo C, Cai Q, Li Y, Li F, Liu K. A cross-sectional National Health and Nutrition Examination survey-based study of the association between systemic immune-inflammation index and blood urea nitrogen levels in United States adolescents. Sci Rep 2024; 14:13248. [PMID: 38858433 PMCID: PMC11164917 DOI: 10.1038/s41598-024-64073-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024] Open
Abstract
Blood urea nitrogen (BUN) level is one of the commonly used indicators to assess renal function and systemic immune-inflammatory status. In the adolescent population, changes in BUN levels may be associated with a variety of factors, including physiologic dehydration, lifestyle influences such as nutritional intake, physical activity, and possible endocrine or metabolic disorders. In recent years, more and more studies have shown that BUN levels are not only a reflection of kidney function, but it may also be related to the inflammatory state of the body. The Systemic Immune Inflammatory Index (SII) is a comprehensive index that takes into account platelet counts, neutrophil and lymphocyte counts, and is thought to be effective in reflecting the body's immune status and inflammatory response. However, research on the relationship between the two, SII and BUN, remains understudied in the adolescent population. The purpose of this study was to examine the relationship between SII and BUN levels in a population of American adolescents and to further analyze the factors that influence it. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) database. Using descriptive statistics, correlation analysis, and regression analysis, we explored the relationship between SII and BUN levels. We found a significant negative correlation between SII and BUN levels, with BUN levels decreasing when SII levels increased (BUN as the dependent variable and SII as the outcome variable). We performed a multiple regression analysis of this relationship, controlling for possible confounders such as gender, age, race, and BMI, and found that this negative correlation remained significant. Our findings reveal an important relationship between SII and BUN levels and provide new perspectives for understanding adolescent health.
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Affiliation(s)
- Cheng Guo
- Comprehensive Pediatrics & Pulmonary and Critical Care Medicine, Kunming Children's Hospital, No.28, Shulin Street, Kunming, 650103, Yunnan Province, China
| | - Qinhui Cai
- Pediatric Department, Qionghai People's Hospital, No.33, Fuhai Road, Qionghai, 571400, Hainan Province, China
| | - Yang Li
- Comprehensive Pediatrics & Pulmonary and Critical Care Medicine, Kunming Children's Hospital, No.28, Shulin Street, Kunming, 650103, Yunnan Province, China
| | - Feng Li
- Comprehensive Pediatrics & Pulmonary and Critical Care Medicine, Kunming Children's Hospital, No.28, Shulin Street, Kunming, 650103, Yunnan Province, China
| | - Kai Liu
- Comprehensive Pediatrics & Pulmonary and Critical Care Medicine, Kunming Children's Hospital, No.28, Shulin Street, Kunming, 650103, Yunnan Province, China.
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Qiu Q, Wu C, Tang W, Ji L, Dai G, Gao Y, Chen E, Jiang H, Xie X, Zhang J. Development and validation of a risk-prediction model for immune-related adverse events in patients with non-small-cell lung cancer receiving PD-1/PD-L1 inhibitors. J Zhejiang Univ Sci B 2023; 24:935-942. [PMID: 37752094 PMCID: PMC10522565 DOI: 10.1631/jzus.b2200631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/20/2023] [Indexed: 09/28/2023]
Abstract
Lung cancer remains the leading cause of cancer deaths worldwide and is the most common cancer in males. Immune-checkpoint inhibitors (ICIs) that target programmed cell death protein-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) have achieved impressive efficacy in the treatment of non-small-cell lung cancer (NSCLC) (Pardoll, 2012; Champiat et al., 2016; Gao et al., 2022). Although ICIs are usually well tolerated, they are often accompanied by immune-related adverse events (irAEs) (Doroshow et al., 2019). Non-specific activation of the immune system produces off-target immune and inflammatory responses that can affect virtually any organ or system (O'Kane et al., 2017; Puzanov et al., 2017). Compared with adverse events caused by chemotherapy, irAEs are often characterized by delayed onset and prolonged duration and can occur in any organ at any stage of treatment, including after cessation of treatment (Puzanov et al., 2017; von Itzstein et al., 2020). They range from rash, pneumonitis, hypothyroidism, enterocolitis, and autoimmune hepatitis to cardiovascular, hematological, renal, neurological, and ophthalmic irAEs (Nishino et al., 2016; Kumar et al., 2017; Song et al., 2020). Hence, we conducted a retrospective study to identify validated factors that could predict the magnitude of the risk of irAEs in patients receiving PD-1/PD-L1 inhibitors; our approach was to analyze the correlation between the clinical characteristics of patients at the start of treatment and relevant indicators such as hematological indices and the risk of developing irAEs. Then, we developed an economical, practical, rapid, and simple model to assess the risk of irAEs in patients receiving ICI treatment, as early as possible.
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Affiliation(s)
- Qing Qiu
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou 310016, China
| | - Chenghao Wu
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou 310016, China
| | - Wenxiao Tang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
- Department of Clinical Laboratory, Zhejiang Rongjun Hospital, Jiaxing 314000, China
| | - Longfei Ji
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
- Department of Clinical Laboratory, Huzhou First People Hospital, Huzhou 313000, China
| | - Guangwei Dai
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou 310016, China
| | - Yuzhen Gao
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou 310016, China
| | - Enguo Chen
- Department of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Hanliang Jiang
- Department of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Xinyou Xie
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou 310016, China.
| | - Jun Zhang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou 310016, China.
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Li M, Cai G, Gao Z, Meng X, Han X. Inflammatory biomarkers as predictors of immune activation to different irradiated sites and short-term efficacy in advanced squamous cell esophageal carcinoma received radioimmunotherapy. Front Oncol 2023; 13:1117648. [PMID: 37234974 PMCID: PMC10206221 DOI: 10.3389/fonc.2023.1117648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Purpose The present study aimed to compare immune activation among different irradiated sites and identify potential short-term efficacy prognostic factors in patients with advanced squamous cell esophageal carcinoma (ESCC) who received radiotherapy (RT) and immunotherapy. Patients and methods We recorded the clinical characteristics, blood cell counts, and derived blood index ratios, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), at three time points (before, during, and after RT) in 121 patients with advanced ESCC who had received RT and immunotherapy. Chi-square test and univariate and multivariate logistic regression analyses were used to calculate the relationships among inflammatory biomarkers (IBs), irradiated sites, and short-term efficacy. Results Delta-IBs were calculated as (medio-IBs - pre-IBs) ÷ pre-IBs. The medians of delta-LMR, and delta-ALC were the highest, whereas the median of delta-SII was the lowest in patients with brain radiation. Treatment responses were observed within 3 months after RT or until the beginning of the next line therapy, and the disease control rate (DCR) was 75.2%. The areas under the receiver operating characteristic curve (AUCs) for delta-NLR and delta-SII were 0.723 (p = 0.001) and 0.725 (p < 0.001), respectively. Multivariate logistic regression analysis showed that the treatment lines of immunotherapy (odds ratio [OR], 4.852; 95% confidence interval [CI], 1.595-14.759; p = 0.005) and delta-SII (OR, 5.252; 95% CI, 1.048-26.320; p = 0.044) were independent indicators of short-term efficacy. Conclusion In this study, we found that RT to the brain had a stronger immune activation effect than RT to extracranial organs. We also found that earlier-line immunotherapy plus RT and a decrease in SII during RT may generate better short-term efficacy in advanced ESCC.
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Affiliation(s)
- Mengying Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Guoxin Cai
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Radiation Oncology, School of Medicine, Shandong University, Jinan, China
| | - Zhenhua Gao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xue Meng
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiao Han
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
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Fan R, Chen Y, Xu G, Pan W, Lv Y, Zhang Z. Combined systemic immune-inflammatory index and prognostic nutritional index predict outcomes in advanced non-small cell lung cancer patients receiving platinum-doublet chemotherapy. Front Oncol 2023; 13:996312. [PMID: 37077828 PMCID: PMC10106714 DOI: 10.3389/fonc.2023.996312] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
Background Systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) could evaluate the therapeutic efficacy and prognosis in different tumors. However, no studies investigated the SII-PNI score to predict outcomes in non-small cell lung cancer (NSCLC) patients treated with platinum-doublet chemotherapy. The aim of this study was to investigate the SII-PNI score in predicting outcomes in non-small cell lung cancer (NSCLC) patients treated with platinum-doublet chemotherapy. Materials and methods Our study retrospectively analyzed clinical data from 124 patients with advanced NSCLC receiving platinum-doublet chemotherapy. The SII and PNI were calculated based on peripheral blood cell counts and serum albumin, and the optimal cut-off values were determined using receiver operating characteristic (ROC). All patients were divided into three groups according to the SII-PNI score. The association between the SII-PNI score and the clinicopathological characteristics of the patients was examined. The Kaplan-Meier and Cox regression models were used to assess progression-free survival (PFS)and overall survival (OS). Results There was no significant correlation between SII, PNI at baseline and chemotherapy response in patients with advanced NSCLC (p>0.05). However, after receiving 4 cycles of platinum-doublet chemotherapy, the SII of the SD group (p=0.0369) and PD group (p=0.0286) was significantly higher than that of the PR group. At the same time, the PNI of the SD group (p=0.0112) and the PD group (p=0.0007) was significantly lower than that of the PR group. The PFS of patients with SII-PNI scores of 0, 1, and 2 were 12.0, 7.0, and 5.0 months, and the OS of patients with SII-PNI scores of 0, 1, and 2 were 34.0, 17.0, and 10.5 months, respectively. There was statistical significance among the three groups (all p <0.001). Multivariate analyses showed that the chemotherapy response of progressive disease (PD) (HR, 3.508; 95% CI, 1.546-7.960; p=0.003) and SII-PNI score of 2 (HR, 4.732; 95% CI, 2.561-8.743; p < 0.001) were independently associated with a shorter OS. The uses of targeted drugs (HR, 0.543; 95% CI, 0.329-0.898; p=0.017) and immune checkpoint inhibitors (HR, 0.218; 95% CI, 0.081-0.584; p=0.002) were protective factors for OS in patients with NSCLC. Conclusion Compared with baseline parameters, the correlation between SII, PNI after 4 cycles of chemotherapy and the chemotherapy effect was more significant. The SII-PNI score after 4 cycles of chemotherapy is an effective prognostic biomarker for advanced NSCLC patients treated with platinum-doublet chemotherapy. Patients with a higher SII-PNI score had a worse prognosis.
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Affiliation(s)
| | | | | | | | | | - Zhongwei Zhang
- Department of Pulmonary and Critical Care, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
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Xiang S, Yang YX, Pan WJ, Li Y, Zhang JH, Gao Y, Liu S. Prognostic value of systemic immune inflammation index and geriatric nutrition risk index in early-onset colorectal cancer. Front Nutr 2023; 10:1134300. [PMID: 37143476 PMCID: PMC10151795 DOI: 10.3389/fnut.2023.1134300] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/16/2023] [Indexed: 05/06/2023] Open
Abstract
Background Systemic nutritional and inflammatory markers, which are easy to measure are associated with the progression and prognosis of many cancers. Nevertheless, among the various available indicators, optimal prognostic indicators for patients with early-onset colorectal cancer have not been identified. Therefore, the aim of this study was to identify optimal nutritional and inflammatory markers for early-onset colorectal cancer and examine the relationship between systemic nutritional and inflammatory markers before treatment and survival in patients with early-onset colorectal cancer. Methods We retrospectively collected data from 236 eligible patients with early-onset colorectal cancer. Area under the prognostic curve (AUC) and concordance index (C-index) were used to compare seven systemic nutritional and inflammatory markers to identify the optimal inflammatory immune markers. Univariate and multivariate COX regression analyses were used to evaluate the prognostic value of indicators in the total study population and different subgroups. Results The AUC and C-index showed that the systemic immune inflammation index (SII) and geriatric nutrition risk index (GNRI) had higher prognostic values than other systemic nutritional and inflammatory indicators. Compared with patients in the low SII group, those in the high SII group had lower overall survival (HR, 4.42, 95% CI, 2.36-8.27, p = 0.000). Compared with patients in the high GNRI group, those in the low GNRI group had lower overall survival (HR, 0.33, 95% CI, 0.19-0.56, p = 0.000). SII was negatively associated with GNRI (R = -0.3, p < 0.001), and both were correlated with the tumor stage. Conclusion SII and GNRI are suitable nutritional and inflammatory factors for predicting OS in patients with early-onset colorectal cancer; high SII and low GNRI were correlated with worse prognoses. Identifying the high inflammatory state and low nutritional state of patients before surgery and conducting active and timely therapeutic interventions could improve patient prognosis.
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Affiliation(s)
- Shuai Xiang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu-Xiao Yang
- Department of Gastroenterology, China-Japan Friendship Hospital of Peking University, Beijing, China
| | - Wen-Jun Pan
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Li
- Department of Blood Transfusion, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun-Hao Zhang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuan Gao
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Yuan Gao,
| | - Shanglong Liu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
- Shanglong Liu,
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The Value of SII in Predicting the Mortality of Patients with Heart Failure. DISEASE MARKERS 2022; 2022:3455372. [PMID: 35634435 PMCID: PMC9135558 DOI: 10.1155/2022/3455372] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 03/15/2022] [Accepted: 04/12/2022] [Indexed: 01/11/2023]
Abstract
Background The main purpose of this study was to explore the predictive value of the systemic immune inflammation index (SII), a novel clinical marker, in heart failure (HF) patients. Methods Critically ill patients with HF were identified from the Medical Information Mart for Intensive Care III (MIMIC III) database. Patients were divided into three groups according to tertiles of SII (group 1, group 2, group 3). We used Kaplan-Meier curves and Cox proportional hazards regression models to evaluate the association between the SII and all-cause mortality in HF. Subgroup analysis was used to verify the predictive effect of the SII on mortality. Results This study included 9107 patients with a diagnosis of HF from the MIMIC III database. After 30, 60, 180, and 365 days of follow-up, 25.60%, 32.10%, 41.30%, and 47.50% of the patients in group 3 had died. Using the Kaplan-Meier curve, we observed that patients with higher SII values had a shorter survival time (log rank p < 0.001). The Cox proportional hazards regression model adjusted for all possible confounders and indicated that the higher SII group had a higher mortality (30-day: HR = 1.304, 95%CI = 1.161 − 1.465, 60-day: HR = 1.266, 95% CI = 1.120 − 1.418, 180-day: HR = 1.274, 95%CI = 1.163 − 1.395, and 365-day: HR = 1.255, 95%CI = 1.155 − 1.364). Conclusions SII values could be used as a predictor of prognosis in critically ill patients with HF.
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Cantero-Cid R, Montalbán-Hernández KM, Guevara J, Pascual-Iglesias A, Pulido E, Casalvilla JC, Marcano C, Serrano CB, Valentín J, Bonel-Pérez GC, Avendaño-Ortiz J, Terrón V, Lozano-Rodríguez R, Martín-Quirós A, Marín E, Pena E, Guerra-Pastrián L, López-Collazo E, Aguirre LA. Intertwined leukocyte balances in tumours and peripheral blood as robust predictors of right and left colorectal cancer survival. World J Gastrointest Oncol 2022; 14:295-318. [PMID: 35116118 PMCID: PMC8790415 DOI: 10.4251/wjgo.v14.i1.295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/07/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) accounts for 9.4% of overall cancer deaths, ranking second after lung cancer. Despite the large number of factors tested to predict their outcome, most patients with similar variables show big differences in survival. Moreover, right-sided CRC (RCRC) and left-sided CRC (LCRC) patients exhibit large differences in outcome after surgical intervention as assessed by preoperative blood leukocyte status. We hypothesised that stronger indexes than circulating (blood) leukocyte ratios to predict RCRC and LCRC patient outcomes will result from combining both circulating and infiltrated (tumour/peritumour fixed tissues) concentrations of leukocytes. AIM To seek variables involving leukocyte balances in peripheral blood and tumour tissues and to predict the outcome of CRC patients. METHODS Sixty-five patients diagnosed with colon adenocarcinoma by the Digestive Surgery Service of the La Paz University Hospital (Madrid, Spain) were enrolled in this study: 43 with RCRC and 22 with LCRC. Patients were followed-up from January 2017 to March 2021 to record overall survival (OS) and recurrence-free survival (RFS) after surgical interventions. Leukocyte concentrations in peripheral blood were determined by routine laboratory protocols. Paraffin-fixed samples of tumour and peritumoural tissues were assessed for leukocyte concentrations by immunohistochemical detection of CD4, CD8, and CD14 marker expression. Ratios of leukocyte concentration in blood and tissues were calculated and evaluated for their predictor values for OS and RFS with Spearman correlations and Cox univariate and multivariate proportional hazards regression, followed by the calculation of the receiver-operating characteristic and area under the curve (AUC) and the determination of Youden's optimal cutoff values for those variables that significantly correlated with either RCRC or LCRC patient outcomes. RCRC patients from the cohort were randomly assigned to modelling and validation sets, and clinician-friendly nomograms were developed to predict OS and RFS from the respective significant indexes. The accuracy of the model was evaluated using calibration and validation plots. RESULTS The relationship of leukocyte ratios in blood and peritumour resulted in six robust predictors of worse OS in RCRC: CD8+ lymphocyte content in peritumour (CD8pt, AUC = 0.585, cutoff < 8.250, P = 0.0077); total lymphocyte content in peritumour (CD4CD8pt, AUC = 0.550, cutoff < 10.160, P = 0.0188); lymphocyte-to-monocyte ratio in peritumour (LMRpt, AUC = 0.807, cutoff < 3.185, P = 0.0028); CD8+ LMR in peritumour (CD8MRpt, AUC = 0.757, cutoff < 1.650, P = 0.0007); the ratio of blood LMR to LMR in peritumour (LMRb/LMRpt, AUC = 0.672, cutoff > 0.985, P = 0.0244); and the ratio of blood LMR to CD8+ LMR in peritumour (LMRb/CD8MRpt, AUC = 0.601, cutoff > 1.485, P = 0.0101). In addition, three robust predictors of worse RFS in RCRC were found: LMRpt (AUC = 0.737, cutoff < 3.185, P = 0.0046); LMRb/LMRpt (AUC = 0.678, cutoff > 0.985, P = 0.0155) and LMRb/CD8MRpt (AUC = 0.615, cutoff > 1.485, P = 0.0141). Furthermore, the ratio of blood LMR to CD4+ LMR in peritumour (LMRb/CD4MRpt, AUC = 0.786, cutoff > 10.570, P = 0.0416) was found to robustly predict poorer OS in LCRC patients. The nomograms showed moderate accuracy in predicting OS and RFS in RCRC patients, with concordance index of 0.600 and 0.605, respectively. CONCLUSION Easily obtainable variables at preoperative consultation, defining the status of leukocyte balances between peripheral blood and peritumoural tissues, are robust predictors for OS and RFS of both RCRC and LCRC patients.
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Affiliation(s)
- Ramón Cantero-Cid
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Karla Marina Montalbán-Hernández
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Jenny Guevara
- Digestive Surgery Service, La Paz University Hospital, Madrid 28046, Spain
| | - Alejandro Pascual-Iglesias
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Elisa Pulido
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - José Carlos Casalvilla
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Cristóbal Marcano
- Digestive Surgery Service, La Paz University Hospital, Madrid 28046, Spain
| | | | - Jaime Valentín
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Gloria Cristina Bonel-Pérez
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - José Avendaño-Ortiz
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Verónica Terrón
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Roberto Lozano-Rodríguez
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Alejandro Martín-Quirós
- Emergency Department and Emergent Pathology Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Elvira Marín
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Eva Pena
- Pathologic Anatomy Service, Hospital La Paz, Madrid 28046, Spain
| | | | - Eduardo López-Collazo
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Luis Augusto Aguirre
- Tumor Immunology Laboratory, The Innate Immune Response Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
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Xiaowei M, Wei Z, Qiang W, Yiqian N, Yanjie N, Liyan J. Assessment of systemic immune-inflammation index in predicting postoperative pulmonary complications in patients undergoing lung cancer resection. Surgery 2022; 172:365-370. [DOI: 10.1016/j.surg.2021.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 12/14/2022]
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11
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Nardone V, Giannicola R, Giannarelli D, Saladino RE, Azzarello D, Romeo C, Bianco G, Rizzo MR, Di Meo I, Nesci A, Pastina P, Falzea AC, Caracciolo D, Reginelli A, Caraglia M, Luce A, Mutti L, Giordano A, Cappabianca S, Pirtoli L, Barbieri V, Tassone P, Tagliaferri P, Correale P. Distinctive Role of the Systemic Inflammatory Profile in Non-Small-Cell Lung Cancer Younger and Elderly Patients Treated with a PD-1 Immune Checkpoint Blockade: A Real-World Retrospective Multi-Institutional Analysis. Life (Basel) 2021; 11:life11111235. [PMID: 34833111 PMCID: PMC8621400 DOI: 10.3390/life11111235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/01/2021] [Accepted: 11/12/2021] [Indexed: 12/17/2022] Open
Abstract
An immune checkpoint blockade with mAbs to PD-1 and PD-L1 is an expanding therapeutic option for mNSCLC patients. This treatment strategy is based on the use of mAbs able to restore the anti-tumor activity of intratumoral T cells inhibited by PD-1 binding to PD-L1/2 on tumor and inflammatory cells. It has been speculated that a chronic status of systemic inflammation as well as the immunosenescence physiologically occurring in elderly patients may affect the efficacy of the treatment and the occurrence of irAEs. We performed a multi-institutional retrospective study aimed at evaluating the effects of these mAbs (nivolumab or atezolizumab) in 117 mNSCLC patients younger (90 cases) and older (27 cases) than 75 years in correlation with multiple inflammatory parameters (NLR, CRP, ESR, LDH and PCT). No differences were observed when the cohorts were compared in terms of the frequency of PFS, OS, inflammatory markers and immune-related adverse events (irAEs). Similarly, the occurrence of irAEs was strictly correlated with a prolonged OS survival in both groups. On the contrary, a negative correlation between the high baseline levels of inflammatory markers and OS could be demonstrated in the younger cohort only. Overall, PD-1/PD-L1-blocking mAbs were equally effective in young and elderly mNSCLC patients; however, the detrimental influence of a systemic inflammation at the baseline was only observed in young patients, suggesting different aging-related inflammation immunoregulative effects.
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Affiliation(s)
- Valerio Nardone
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (M.C.); (A.L.); (S.C.)
- Correspondence:
| | - Rocco Giannicola
- Medical Oncology Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy; (R.G.); (D.A.); (C.R.); (G.B.); (A.C.F.); (P.C.)
| | - Diana Giannarelli
- Biostatistical Unit, National Cancer Institute “Regina Elena”, IRCCS, 00161 Rome, Italy;
| | - Rita Emilena Saladino
- Tissue typing Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy;
| | - Domenico Azzarello
- Medical Oncology Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy; (R.G.); (D.A.); (C.R.); (G.B.); (A.C.F.); (P.C.)
| | - Caterina Romeo
- Medical Oncology Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy; (R.G.); (D.A.); (C.R.); (G.B.); (A.C.F.); (P.C.)
| | - Giovanna Bianco
- Medical Oncology Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy; (R.G.); (D.A.); (C.R.); (G.B.); (A.C.F.); (P.C.)
| | - Maria Rosaria Rizzo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.R.R.); (I.D.M.)
| | - Irene Di Meo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.R.R.); (I.D.M.)
| | - Antonio Nesci
- Unit of Pharmacy, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy;
| | - Pierpaolo Pastina
- Section of Radiation Oncology, Medical School, University of Siena, 53100 Siena, Italy;
| | - Antonia Consuelo Falzea
- Medical Oncology Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy; (R.G.); (D.A.); (C.R.); (G.B.); (A.C.F.); (P.C.)
| | - Daniele Caracciolo
- Medical and Translational Oncology Unit, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (D.C.); (V.B.); (P.T.); (P.T.)
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (M.C.); (A.L.); (S.C.)
| | - Michele Caraglia
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (M.C.); (A.L.); (S.C.)
- BiogemScarl, Institute of Genetic Research, Precision and Molecular Oncology Laboratory, Ariano Irpino, 83031 Avellino, Italy
| | - Amalia Luce
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (M.C.); (A.L.); (S.C.)
| | - Luciano Mutti
- Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA; (L.M.); (A.G.); (L.P.)
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA; (L.M.); (A.G.); (L.P.)
- Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (M.C.); (A.L.); (S.C.)
| | - Luigi Pirtoli
- Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA; (L.M.); (A.G.); (L.P.)
| | - Vito Barbieri
- Medical and Translational Oncology Unit, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (D.C.); (V.B.); (P.T.); (P.T.)
| | - Pierfrancesco Tassone
- Medical and Translational Oncology Unit, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (D.C.); (V.B.); (P.T.); (P.T.)
| | - Pierosandro Tagliaferri
- Medical and Translational Oncology Unit, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (D.C.); (V.B.); (P.T.); (P.T.)
| | - Pierpaolo Correale
- Medical Oncology Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89124 Reggio Calabria, Italy; (R.G.); (D.A.); (C.R.); (G.B.); (A.C.F.); (P.C.)
- Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA; (L.M.); (A.G.); (L.P.)
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12
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The Influence of Severe Radiation-Induced Lymphopenia on Overall Survival in Solid Tumors: A Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2021; 111:936-948. [PMID: 34329738 DOI: 10.1016/j.ijrobp.2021.07.1695] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/10/2021] [Accepted: 07/19/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Emerging evidence suggests a detrimental prognostic association between radiation-induced lymphopenia (RIL) and pathologic response, progression-free survival, and overall survival (OS) in patients who undergo radiation therapy for cancer. The aim of this study was to systematically review and meta-analyze the prognostic impact of RIL on OS in patients with solid tumors. METHODS AND MATERIALS PubMed/MEDLINE and Embase were systematically searched. The analysis included intervention and prognostic studies that reported on the prognostic relationship between RIL and survival in patients with solid tumors. An overall pooled adjusted hazard ratio (aHR) was calculated using a random-effects model. Subgroup analyses for different patient-, tumor-, treatment-, and study-related characteristics were performed using meta-regression. RESULTS Pooling of 21 cohorts within 20 eligible studies demonstrated a statistically significant association between OS and grade ≥3 versus grade 0-2 RIL (n = 16; pooled aHR, 1.65; 95% confidence interval [CI], 1.43-1.90) and grade 4 RIL versus grade 0-3 (n = 5; aHR, 1.53; 95% CI, 1.24-1.90). Moderate heterogeneity among aHRs was observed, mostly attributable to overestimated aHRs in 7 studies likely subject to model-overfitting. Subgroup analysis showed significant prognostic impact of grade ≥3 RIL in 4 brain tumor (aHR, 1.63; 95% CI, 1.06-2.51), 4 lung cancer (aHR, 1.52; 95% CI, 1.01-2.29), and 3 pancreatic cancer (aHR, 1.92; 95% CI, 1.10-3.36) cohorts. CONCLUSIONS This meta-analysis demonstrates a significant detrimental prognostic association between grade ≥3 lymphopenia and OS in patients receiving radiation therapy for solid tumors. This finding appears consistent for tumors of the brain, thorax, and upper abdomen and provides an imperative to further elucidate the potential survival benefit of lymphopenia-mitigating strategies.
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13
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The Role of the Immune Metabolic Prognostic Index in Patients with Non-Small Cell Lung Cancer (NSCLC) in Radiological Progression during Treatment with Nivolumab. Cancers (Basel) 2021; 13:cancers13133117. [PMID: 34206545 PMCID: PMC8268031 DOI: 10.3390/cancers13133117] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/08/2021] [Accepted: 06/20/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Identifying reliable prognostic biomarkers of progression in the early phases of treatment is crucial in patients undergoing immune checkpoints inhibitors (ICI) administration for advanced non-small cell lung cancer (NSCLC). With this aim, in this study we combined the prognostic power of the degree of systemic inflammation (depicted by peripheral inflammation indexes), the quantification of the metabolically active tumor burden (estimated using 18F-fluorodeoxyglucose positron emission tomography/computed tomography) as well as their combination in NSCLC patients receiving immune checkpoints inhibitors. This combined approach could be used to improve the risk stratification and the subsequent clinical management in NSCLC patients treated with immune checkpoints inhibitors. Abstract An emerging clinical need is represented by identifying reliable biomarkers able to discriminate between responders and non-responders among patients showing imaging progression during the administration of immune checkpoints inhibitors for advanced non-small cell lung cancer (NSCLC). In the present study, we analyzed the prognostic power of peripheral-blood systemic inflammation indexes and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in this clinical setting. In 45 patients showing radiological progression (defined as RECIST 1.1 progressive disease) during Nivolumab administration, the following lab and imaging parameters were collected: neutrophil-to-lymphocyte ratio (NLR), derived-NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelets-to-lymphocyte ratio (PLR), systemic inflammation index (SII), maximum standardized uptake value, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). MTV and SII independently predicted OS. Their combination in the immune metabolic prognostic index (IMPI) allowed the identification of patients who might benefit from immunotherapy continuation, despite radiological progression. The combination of FDG PET/CT volumetric data with SII also approximates the immune-metabolic response with respect to baseline, providing additional independent prognostic insights. In conclusion, the degree of systemic inflammation, the quantification of the metabolically active tumor burden, and their combination might disclose the radiological progression in NSCLC patients receiving Nivolumab.
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14
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Wang Y, Lyu J, Jia H, Liang L, Xiao L, Liu Y, Liu X, Li K, Chen T, Zhang R, Zhang H, Tang C, Li T. Clinical utility of the systemic immune-inflammation index for predicting survival in esophageal squamous cell carcinoma after radical radiotherapy. Future Oncol 2021; 17:2647-2657. [PMID: 34008415 DOI: 10.2217/fon-2021-0304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To explore the clinical utility of the systemic immune-inflammation index (SII) for predicting the prognosis of esophageal squamous cell carcinoma (ESCC). Patients & methods: After calculating the SII in 180 patients with ESCC, the relationship between SII values and the pre-/post-radiotherapy SII ratio and overall survival was determined. Results: The median overall survival was 649 days for the entire group and 909 and 466 days for the high and low pre-/post-radiotherapy SII ratio groups, respectively. Multivariate analysis identified Karnofsky performance status (p = 0.045), lymphatic metastasis (p = 0.032), mid-radiotherapy SII (p < 0.001) and pre-/post-radiotherapy SII ratio (p = 0.003) as independent prognostic factors. Conclusion: The pre-/post-radiotherapy SII ratio and mid-radiotherapy SII are potentially effective markers for predicting ESCC prognosis.
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Affiliation(s)
- Yuan Wang
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China
| | - Jiahua Lyu
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China.,Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610041, China
| | - Hongyuan Jia
- Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610041, China
| | - Long Liang
- Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610041, China
| | - Ling Xiao
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China
| | - Yudi Liu
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China
| | - Xiao Liu
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, 646000, China
| | - Ke Li
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, 646000, China
| | - Taiyu Chen
- School of Clinical Medical, Chengdu Medical College, Chengdu, 610599, China
| | - Rongke Zhang
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, 646000, China
| | - Hangyue Zhang
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, 646000, China
| | - Chunhan Tang
- School of Clinical Medical, Chengdu Medical College, Chengdu, 610599, China
| | - Tao Li
- School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610054, China.,Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu, 610041, China
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15
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Keit E, Coutu B, Zhen W, Zhang C, Lin C, Bennion N, Ganti AK, Ernani V, Baine M. Systemic inflammation is associated with inferior disease control and survival in stage III non-small cell lung cancer. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:227. [PMID: 33708854 PMCID: PMC7940875 DOI: 10.21037/atm-20-6710] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background The systemic immune-inflammation index (SII) correlates with patient survival in various types of solid malignancies, including non-small cell lung cancer (NSCLC). However, limited information is available on the prognostic implication and disease-specific survival of SII in patients undergoing definitive chemoradiation therapy (CRT) for stage III NSCLC. Methods We retrospectively reviewed 125 patients who underwent curative intent CRT for stage III NSCLC with sufficient laboratory assessment from 2010–2019. SII was calculated at the time of diagnosis as platelet count × neutrophil count/lymphocyte count. Chi-squared analysis was used to compare categorical variables. A Kaplan-Meier analysis was performed to estimate progression-free survival (PFS), disease specific survival (DSS), and overall survival (OS) rates, with Cox regression used to determine absolute hazards. Results At a median follow-up of 19.7 months, 5-year OS, DSS, and PFS rates were 22.6%, 30.9%, and 13.4%, respectively. A low SII (<1,266) at diagnosis was independently associated with an improved OS (HR: 0.399, 95%, CI: 0.247–0.644, P<0.001), DSS (HR: 0.383, 95%, CI: 0.228–0.645, P<0.001), and PFS (HR: 0.616, 95%, CI: 0.407–0.932, P=0.022). We did not detect an association between SII and freedom from recurrence (FFR), freedom from locoregional recurrence (FFLRR), or freedom from distant recurrence (FFDR). NSAID (1,483.4 vs. 2,302.9, P=0.038) and statin usage (1,443.9 vs. 2,201.7, P=0.046) were associated with a lower SII while COPD exacerbations (2,699.7 vs. 1,573.7, P=0.032) and antibiotic prescriptions (2,384.6 vs. 1,347.9, P=0.009) were associated with an elevated SII. These factors were not independently associated with improved survival outcomes. Conclusions Low SII scores were independently associated with improved OS, DSS, and PFS rates in patients with stage III NSCLC undergoing definitive CRT. NSAIDs and statin usage may be associated with lower SII at diagnosis of NSCLC. This study suggests that SII may be an effective prognostic indicator of patient mortality. Further investigation of the therapeutic potential of these agents in patients with an elevated SII in this setting may be warranted.
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Affiliation(s)
- Emily Keit
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Brendan Coutu
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Weining Zhen
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Chi Zhang
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Chi Lin
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Nathan Bennion
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Apar Kishor Ganti
- Division of Hematology/Oncology, Department of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.,Division of Hematology/Oncology, Department of Medicine, VA Nebraska Western Iowa Health Care System, Omaha, NE, USA
| | - Vinicius Ernani
- Division of Hematology/Oncology, Department of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael Baine
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
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