Prognostic value of pretreatment immune inflammation indices in patients with immune-related tumors

Curr Med Res Opin. 2023 Mar;39(3):425-431. doi: 10.1080/03007995.2023.2167440. Epub 2023 Feb 3.

Abstract

Background: Pretreatment high levels of lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), modified Glasgow prognostic scores (mGPS), prognostic nutritional index (PNI), and other prognostic biomarkers have been associated with poor overall survival (OS) in immune-related tumor types. Therefore, we explored a simple, inexpensive and effective method for cancer prognosis.

Methods: Between March 2017 and June 2022, 111 individuals who had immunotherapy were retrospectively examined. Oncologic outcomes of patients with immune-related tumor types, include OS and progression-free survival (PFS), and response rates (RR).

Results: Pretreatment ECOG (Eastern Cooperative Oncology Group) performance quality was independently linked with poor OS ECOG ≥2 (HR 4.80, 95% CI 2.57-8.96, p < .001) and inferior PFS (HR 3.31, 95% CI 2.023-5.445, p < .001). Additionally, a high LDH status prior to therapy was independently linked to an inferior OS (HR 1.004, 95% CI 1.001-1.007, p = .003) and inferior PFS (HR 1.004, 95% CI 1.002-1.006, p < .001). Higher MLR at baseline was a prognostic factor for both shorter PFS (HR = 3.691, 95% CI 1.582-8.610, p = .003) and OS (HR = 2.876, 95% CI 1.127-7.342, p = .027).

Conclusions: In our cohort, elevated pre-treatment MLR, LDH and ECOG ≥2 were associated with poor OS and PFS. Prospective studies need to determine the utility of them.

Keywords: ECOG (Eastern Cooperative Oncology Group) performance; Prognostic biomarkers; lactate dehydrogenase levels (LDH); monocyte-lymphocyte ratio (MLR).

MeSH terms

  • Carcinoma, Non-Small-Cell Lung*
  • Humans
  • Inflammation
  • Lung Neoplasms*
  • Neutrophils
  • Prognosis
  • Prospective Studies
  • Retrospective Studies