Characterization of Age-Associated, Neutrophil-to-Lymphocyte Ratio (NLR) and Systemic Immune-Inflammatory Index (SII) as Biomarkers of Inflammation in Geriatric Patients with Cancer Treated with Immune Checkpoint Inhibitors: Impact on Efficacy and Survival.

biomarkers circulating inflammatory markers geriatric oncology immune checkpoint inhibitors systemic immune-inflammatory index

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
19 Oct 2023
Historique:
received: 18 09 2023
revised: 10 10 2023
accepted: 16 10 2023
medline: 28 10 2023
pubmed: 28 10 2023
entrez: 28 10 2023
Statut: epublish

Résumé

Geriatric patients (≥80 years) are underrepresented in immune checkpoint inhibitor (ICIs) clinical trials. However, their unique biology may affect their response to ICIs. There are currently no established biomarkers of the response to ICIs in adult patients with cancer that can help with patient selection. We built a multicenter, international retrospective study of 885 patients (<80 years: n = 417, 47.12%; ≥80 years: n = 468, 52.88%) with different tumor types treated with ICIs between 2011 and 2021 from 11 academic centers in the U.S. and Europe. The main outcome measures were objective response rates (ORR), progression-free survival (PFS) and overall survival (OS) stratified by age and circulating inflammatory levels (neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammatory index (SII)). Patients ≥80 years with low NLR (NLR-L) and SII (SII-L) had significantly higher ORR (vs. high NLR [NLR-H], Lower inflammation pre-ICI initiation may predict an improved response and survival in geriatric patients with cancer.

Sections du résumé

BACKGROUND BACKGROUND
Geriatric patients (≥80 years) are underrepresented in immune checkpoint inhibitor (ICIs) clinical trials. However, their unique biology may affect their response to ICIs. There are currently no established biomarkers of the response to ICIs in adult patients with cancer that can help with patient selection.
METHODS METHODS
We built a multicenter, international retrospective study of 885 patients (<80 years: n = 417, 47.12%; ≥80 years: n = 468, 52.88%) with different tumor types treated with ICIs between 2011 and 2021 from 11 academic centers in the U.S. and Europe. The main outcome measures were objective response rates (ORR), progression-free survival (PFS) and overall survival (OS) stratified by age and circulating inflammatory levels (neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammatory index (SII)).
RESULTS RESULTS
Patients ≥80 years with low NLR (NLR-L) and SII (SII-L) had significantly higher ORR (vs. high NLR [NLR-H],
CONCLUSION CONCLUSIONS
Lower inflammation pre-ICI initiation may predict an improved response and survival in geriatric patients with cancer.

Identifiants

pubmed: 37894419
pii: cancers15205052
doi: 10.3390/cancers15205052
pmc: PMC10605297
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Cancer Treat Rev. 2016 Apr;45:30-7
pubmed: 26946217
Clin Cancer Res. 2018 Nov 1;24(21):5347-5356
pubmed: 29898988
Nat Commun. 2020 Jul 30;11(1):3801
pubmed: 32732879
Clin Cancer Res. 2019 Jul 1;25(13):3839-3846
pubmed: 30967420
Cancers (Basel). 2022 Oct 27;14(21):
pubmed: 36358716
Vaccine. 2000 Feb 25;18(16):1717-20
pubmed: 10689155
J Immunother Cancer. 2018 Jan 22;6(1):5
pubmed: 29353553
Ann Transl Med. 2019 Sep;7(18):433
pubmed: 31700869
J Gerontol A Biol Sci Med Sci. 2014 Jun;69 Suppl 1:S4-9
pubmed: 24833586
Cancer Res Treat. 2021 Jul;53(3):671-677
pubmed: 33285051
Curr Opin Immunol. 2014 Aug;29:105-11
pubmed: 24934647
Melanoma Res. 2013 Apr;23(2):132-7
pubmed: 23344159
Cancer Immunol Immunother. 2015 Dec;64(12):1531-9
pubmed: 26392296
J Cell Mol Med. 2020 Mar;24(5):2993-3021
pubmed: 31989747
Arch Immunol Ther Exp (Warsz). 2016 Jun;64(3):249-54
pubmed: 26283530
Cancer Discov. 2015 Jan;5(1):43-51
pubmed: 25358689
JAMA Oncol. 2018 Dec 1;4(12):1721-1728
pubmed: 30242316
Nat Rev Clin Oncol. 2019 Sep;16(9):563-580
pubmed: 31092901
J Cancer. 2018 Sep 7;9(18):3295-3302
pubmed: 30271489
Cancers (Basel). 2021 Dec 31;14(1):
pubmed: 35008350
Nat Immunol. 2018 Jan;19(1):10-19
pubmed: 29242543
World J Gastroenterol. 2017 Sep 14;23(34):6261-6272
pubmed: 28974892
Nat Rev Cancer. 2012 Mar 22;12(4):252-64
pubmed: 22437870
Nat Rev Endocrinol. 2018 Oct;14(10):576-590
pubmed: 30046148
JAMA Oncol. 2021 Dec 01;7(12):1856-1861
pubmed: 34734989
Annu Rev Pathol. 2021 Jan 24;16:223-249
pubmed: 33197221
Ann N Y Acad Sci. 2000 Jun;908:244-54
pubmed: 10911963
Cancer. 2022 Aug 15;128(16):3067-3079
pubmed: 35727053
J Clin Lab Anal. 2019 Oct;33(8):e22964
pubmed: 31282096
Chin J Cancer. 2017 Sep 12;36(1):75
pubmed: 28899420

Auteurs

Khalil Choucair (K)

Barbara Ann Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA.

Caroline Nebhan (C)

Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA.

Alessio Cortellini (A)

Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London SW7 2BX, UK.
Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.

Stijn Hentzen (S)

Department of Medicine, Kansas University Medical Center, Kansas City, KS 66211, USA.

Yinghong Wang (Y)

The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Cynthia Liu (C)

Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.

Raffaele Giusti (R)

Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, 00189 Rome, Italy.

Marco Filetti (M)

Phase 1 Unit, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 71013 Rome, Italy.

Paolo Antonio Ascierto (PA)

Istituto Nazionale Tumori IRCCS Fondazione Pascale, 80131 Napoli, Italy.

Vito Vanella (V)

Istituto Nazionale Tumori IRCCS Fondazione Pascale, 80131 Napoli, Italy.

Domenico Galetta (D)

Medical Thoracic Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy.

Annamaria Catino (A)

Medical Thoracic Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy.

Nour Al-Bzour (N)

UPMC Hillman Cancer Center, Department of Medicine, Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, PA 15232, USA.

Azhar Saeed (A)

Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT 05401, USA.

Ludimila Cavalcante (L)

Novant Health Cancer Institute, Charlotte, NC 28204, USA.

Pamela Pizzutilo (P)

Medical Thoracic Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy.

Carlo Genova (C)

UOC Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, 16126 Genova, Italy.

Melissa Bersanelli (M)

Medical Oncology Unit, University Hospital of Parma, 43125 Parma, Italy.

Sebastiano Buti (S)

Medicine and Surgery Department, University of Parma, 43121 Parma, Italy.

Douglas B Johnson (DB)

Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA.

Claudia Angela Maria Fulgenzi (CAM)

Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London SW7 2BX, UK.
Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.

David J Pinato (DJ)

Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London SW7 2BX, UK.

Maluki Radford (M)

Department of Medicine, Kansas University Medical Center, Kansas City, KS 66211, USA.

Chul Kim (C)

Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA.

Abdul Rafeh Naqash (AR)

Medical Oncology/Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK 73019, USA.

Anwaar Saeed (A)

UPMC Hillman Cancer Center, Department of Medicine, Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, PA 15232, USA.

Classifications MeSH