Baseline neutrophil-lymphocyte ratio and platelet-lymphocyte ratio appear predictive of immune treatment related toxicity in hepatocellular carcinoma.

BACKGROUND

A well-recognized class effect of immune checkpoint inhibitors (ICI) is immune-related adverse events (IrAEs) ranging from low grade toxicities to life-threatening end organ damage requiring permanent discontinuation of ICI. Deaths are reported in < 5% of patients treated with ICI. There are, however, no reliable markers to predict the onset and severity of IrAEs. We tested the association between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) at baseline with development of clinically significant IrAEs (grade ≥ 2) in hepatocellular carcinoma (HCC) patients treated with ICI.

AIM

To test the association between NLR and PLR at baseline with development of clinically significant IrAEs (grade ≥ 2) in HCC patients treated with ICI.

METHODS

Data was extracted from an international database from a consortium of 11 tertiary-care referral centers. NLR = absolute neutrophil count/absolute lymphocyte count (ALC) and PLR = platelet count/ALC. Cutoff of 5 was used for NLR and 300 for PLR based on literature. We also tested the association between antibiotic and steroid exposure to IrAEs.

RESULTS

Data was collected from 361 patients treated between 2016-2020 across the United States (67%), Asia (14%) and Europe (19%). Most patients received Nivolumab (

CONCLUSION

Given that high baseline NLR and PLR are associated with a decreased incidence of IrAEs, lower baseline NLR and PLR may be predictive biomarkers for the appearance of IrAEs in HCC treated with ICI. This finding is in keeping with several studies in solid tumors that have shown that baseline NLR and PLR appear predictive of IrAEs.

Informations de copyright

©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: Rimassa L report consulting fees from AstraZeneca, Basilea, Bayer, BMS, Eisai, Elevar Therapeutics, Exelixis, Genenta, Hengrui, Incyte, Ipsen, IQVIA, Jazz Pharmaceuticals, MSD, Nerviano Medical Sciences, Roche, Servier, Taiho Oncology, Zymeworks; lecture fees from AstraZeneca, Bayer, BMS, Eisai, Incyte, Ipsen, Merck Serono, Roche, Servier; travel expenses from AstraZeneca; research grants (to institution) from Agios, AstraZeneca, BeiGene, Eisai, Exelixis, Fibrogen, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche, Zymeworks. Pressiani T reports consulting fees from Bayer, Ipsen, AstraZeneca; travel expenses from Roche; research grants (to institution) from Roche, Bayer, Astra Zeneca. Personeni N reports consulting fees from Amgen, Merck KGaA, Boehringer Ingelheim, IQVIA, Servier, Sanofi Aventis; lecture fees from Janssens, Astra Zeneca, Incyte; research grants (to institution) from Servier, Basilea; travel expenses from Amgen, Servier. Pinter M is an investigator for Bayer, BMS, Lilly, and Roche, he received speaker honoraria from Bayer, BMS, Eisai, and MSD, he is a consultant for Bayer, BMS, Ipsen, Eisai, Lilly, Roche, and MSD, and he received travel support from Bayer, BMS, and Roche. Scheiner B received travel support from AbbVie, Ipsen and Gilead. Bettinger D received consulting fees from Bayer Healthcare, Boston Scientific, and Shionogi. Lectures: Falk Foundation. A.C. received consulting fees from MSD, BMS, AstraZeneca, and Roche; speakers’ fee from AstraZeneca, MSD, Novartis, and Astellas. Pinato DJ received lecture fees from ViiV Healthcare and Bayer Healthcare, and travel expenses from BMS and Bayer Healthcare; consulting fees for Mina Therapeutics, EISAI, Roche, and Astra Zeneca; and received research funding (to institution) from MSD and BMS. Saeed A receives consulting fee from AstraZeneca; Bristol-Myers Squibb; Daiichi Sankyo/Astra Zeneca; Exelixis; Five Prime Therapeutics; Pfize, speakers fee from Daiichi Sankyo/Astra Zeneca and research funding from Actuate Therapeutics (Inst); Astellas Pharma (Inst); AstraZeneca/MedImmune (Inst); Bristol-Myers Squibb (Inst); Clovis Oncology (Inst); Daiichi Sankyo/UCB Japan (Inst); Exelixis (Inst); Five Prime Therapeutics (Inst); KAHR Medical (Inst); Merck Sharp and Dohme (Inst); Seattle Genetics (Inst). Khan U receives honoraria from Cardinal Health, consulting fee from Bard Peripheral Vascular and travel expenses paid for by Bard Peripheral Vascular; Cardinal Health. Huang YH is a consultant for Bayer; Bristol-Myers Squibb; Eisai; Gilead Sciences; Lilly; MSD; Roche and received speaker honoraria from Bayer; Bristol-Myers Squibb; Eisai; Gilead Sciences; Lilly; MSD; Roche. Kesab AO receives honoraria from AstraZeneca; Bayer Health; Bristol-Myers Squibb; Eisai; Exelixis; Genentech/Roche; Merck and research funding from Adaptimmune (Inst); Bayer/Onyx (Inst); Bristol-Myers Squibb (Inst); Genentech (Inst); Hengrui Pharmaceutical (Inst); Merck (Inst). Pillai A received consulting fee from AstraZeneca; Eisai; Exelixis; Genentech; Replimune, research funding from Target Pharmasolutions and speaker honoraria from Simply Speaking PAH. All remaining authors have declared no conflicts of interest.