Neutrophil-to-Lymphocyte Ratio and Pembrolizumab Outcomes in Oral Cavity Squamous Cell Carcinoma.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Otolaryngology- Head and Neck Surgery Pub Date : 2024-12-15 DOI:10.1002/ohn.1088
Angeline A Truong, Rex H Lee, Xin Wu, Alain P Algazi, Hyunseok Kang, Ivan H El-Sayed, Jonathan R George, Chase M Heaton, William R Ryan, Yena Jeon, Mi-Ok Kim, Patrick K Ha, Katherine C Wai
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Abstract

Objective: To determine the relationship between pretreatment neutrophil-to-lymphocyte ratio (NLR) and 6-month progression-free survival (PFS)/2-year overall survival (OS) among patients with recurrent or metastatic (R/M) oral cavity cancer on pembrolizumab.

Study design: This study was a retrospective, observational study performed at a tertiary care academic center.

Setting: Participants included patients with oral cavity squamous cell carcinoma (OCSCC) who began pembrolizumab treatment at the University of California, San Francisco between May 2016 and May 2022.

Methods: The primary outcome was a 6-month PFS. The secondary outcome was a 2-year OS. NLR was treated as a continuous variable. Disease progression was determined using radiographic criteria, adopted from the Response Evaluation Criteria in Solid Tumors.

Results: Fifty-two patients with OCSCC were included. Immune checkpoint inhibitor (ICI) indication was recurrence/metastasis for all patients. The median pretreatment NLR was 5.7 (interquartile range: 3.6-7.6). Twenty-seven (55%) patients received pembrolizumab alone. Of those receiving treatment for R/M prior to ICI, 9 (18%) received salvage surgery and adjuvant therapy, 2 (4%) received chemotherapy alone, 1 (2%) received chemoradiation, and 10 (20%) received salvage surgery. Nineteen (36.5%) patients had distant metastases at the start of ICI. Six-month PFS was 46%. Two-year OS was 44%. NLR was independently associated with 6-month PFS [hazard ratio, HR: 1.05 (95% confidence interval, CI: 1.01-1.11), P = .028] and 2-year OS [HR: 1.12 (95% CI: 1.05-1.20), P < .001].

Conclusion: Higher pretreatment NLR was associated with poorer 6-month PFS and 2-year OS in OCSCC patients treated with pembrolizumab.

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中性粒细胞与淋巴细胞比率与 Pembrolizumab 在口腔鳞状细胞癌中的疗效
目的目的:确定接受pembrolizumab治疗的复发性或转移性(R/M)口腔癌患者治疗前中性粒细胞与淋巴细胞比率(NLR)与6个月无进展生存期(PFS)/2年总生存期(OS)之间的关系:本研究是一项回顾性观察研究,在一家三级医疗学术中心进行:参与者包括2016年5月至2022年5月期间在加州大学旧金山分校开始接受pembrolizumab治疗的口腔鳞状细胞癌(OCSCC)患者:主要结果是6个月的PFS。次要结果为 2 年 OS。NLR被视为连续变量。采用实体瘤反应评估标准(Response Evaluation Criteria in Solid Tumors)中的放射学标准确定疾病进展:共纳入52例OCSCC患者。所有患者的免疫检查点抑制剂(ICI)适应症均为复发/转移。治疗前 NLR 中位数为 5.7(四分位间范围:3.6-7.6)。27名患者(55%)单独接受了pembrolizumab治疗。在 ICI 之前接受 R/M 治疗的患者中,9 人(18%)接受了抢救性手术和辅助治疗,2 人(4%)接受了单独化疗,1 人(2%)接受了化学放疗,10 人(20%)接受了抢救性手术。19名(36.5%)患者在开始接受 ICI 治疗时有远处转移。6个月的PFS为46%。两年 OS 为 44%。NLR与6个月的PFS[危险比,HR:1.05(95% 置信区间,CI:1.01-1.11),P = .028]和2年的OS[HR:1.12(95% 置信区间,CI:1.05-1.20),P 结论:NLR与6个月的PFS和2年的OS密切相关:在接受pembrolizumab治疗的OCSCC患者中,治疗前较高的NLR与较差的6个月PFS和2年OS有关。
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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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