Role of Hematological Markers in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma Treated With Pembrolizumab.

IF 1.6 4区 医学 Q4 ONCOLOGY Anticancer research Pub Date : 2024-09-01 DOI:10.21873/anticanres.17235
Kohei Hagiwara, Takashi Matsuki, Takuro Okada, Chihiro Fushimi, Takahito Kondo, Hideaki Takahashi, Isaku Okamoto, Kunihiko Tokashiki, Kenji Hanyu, Takuma Kishida, Tatsuya Ito, Gai Yamashita, Kiyoaki Tsukahara, Tatsuo Masubuchi, Yuichiro Tada, Kaho Momiyama, Ryohei Yaguchi, Nobuhiko Oridate, G O Omura, Taku Yamashita
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Abstract

Background/aim: The predictive role of hematological markers in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) treated with pembrolizumab remains unclear.

Patients and methods: We conducted a multicenter retrospective cohort study to investigate the predictive impact of the pre-treatment hematological markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), CRP-albumin-lymphocyte (CALLY) index, and the modified Glasgow prognostic score (mGPS) on overall survival (OS) and progression-free survival (PFS) in patients with R/M SCCHN treated with pembrolizumab. From December 2019 to February 2022, 119 and 28 patients were treated with pembrolizumab alone and pembrolizumab plus chemotherapy, respectively. The optimal cut-off point of dichotomized hematological markers was calculated using the area under the receiver operating characteristic curve. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) were estimated using Cox proportional hazard models with adjustment for potential confounders.

Results: In the pembrolizumab monotherapy group, patients with higher NLR, PLR, and mGPS and a lower CALLY index showed significantly shorter OS after adjustment for potential confounders. In addition, all hematological markers examined in this study tended to be associated with clinical response, such as overall response rate or disease control rate (DCR); in particular, a lower CALLY index and higher mGPS were significantly associated with poor DCR. In the pembrolizumab with chemotherapy group, these hematological markers had a similar association with OS but not with clinical response.

Conclusion: Pre-treatment NLR, PLR, CALLY index, and mGPS might be predictive markers of survival in patients with R/M SCCHN treated with pembrolizumab.

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血液标志物在使用 Pembrolizumab 治疗复发性/转移性头颈部鳞状细胞癌中的作用
背景/目的:血液学指标对接受pembrolizumab治疗的复发性或转移性头颈部鳞状细胞癌(R/M SCCHN)患者的预测作用仍不明确:我们开展了一项多中心回顾性队列研究,调查治疗前血液学指标中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、CRP-白蛋白-淋巴细胞(CALLY)指数和改良格拉斯哥预后评分(mGPS)对接受pembrolizumab治疗的R/M SCCHN患者总生存期(OS)和无进展生存期(PFS)的预测影响。从2019年12月至2022年2月,分别有119名和28名患者接受了pembrolizumab单药治疗和pembrolizumab联合化疗治疗。使用接收者操作特征曲线下面积计算了二分法血液学标志物的最佳截断点。利用调整潜在混杂因素的考克斯比例危险模型估算了危险比(HRs)和95%置信区间(95%CIs):在pembrolizumab单药治疗组中,NLR、PLR和mGPS较高而CALLY指数较低的患者在调整潜在混杂因素后,OS明显缩短。此外,本研究中检测的所有血液学指标都倾向于与临床反应相关,如总体反应率或疾病控制率(DCR);特别是,较低的CALLY指数和较高的mGPS与较差的DCR显著相关。在pembrolizumab联合化疗组中,这些血液学指标与OS有相似的关系,但与临床反应无关:结论:治疗前NLR、PLR、CALLY指数和mGPS可能是预测接受pembrolizumab治疗的R/M SCCHN患者生存率的指标。
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来源期刊
Anticancer research
Anticancer research 医学-肿瘤学
CiteScore
3.70
自引率
10.00%
发文量
566
审稿时长
2 months
期刊介绍: ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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