免疫检查点抑制剂治疗IV期黑色素瘤患者衍生中性粒细胞与淋巴细胞比率的预后表现

T. Gambichler, Rita Mansour, C. Scheel, Shayda Said, N. Abu Rached, L. Susok
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引用次数: 2

摘要

目的是评估在接受免疫检查点抑制剂(ICI)治疗的转移性皮肤黑色素瘤(CM)患者中衍生中性粒细胞与淋巴细胞比率(dNLR)的预后表现。我们回顾性调查了41例有ICI治疗指征的IV期CM患者。在ICI治疗开始前常规测定dNLR和NLR。dNLR和NLR计算公式如下:dNLR =绝对中性粒细胞计数(ANC)/白细胞计数- ANC和NRL = ANC/绝对淋巴细胞计数。按照现行指南对患者进行随访。在单因素分析中,dNLR (p = 0.027和p = 0.032)和NLR (p = 0.0023和p = 0.0036)是ROC曲线分析中唯一与最佳总反应(BOR)和疾病控制率(DCR)显著相关的参数。NLR与cm特异性生存率呈负相关(r = - 0.32, p = 0.043)。cm特异性死亡与无免疫相关不良事件(p = 0.043)、基线时S100钙结合蛋白B (S100B)升高(p = 0.0006)和dNLR (p = 0.024)显著相关。在多变量分析中,NLR是BOR的唯一显著独立预测因子(p = 0.014;优势比:1.7;95% CI 1.11 ~ 2.61)和DCR (p = 0.019;优势比:1.5;95% CI 1.07 ~ 2.19)。然而,对于cm特异性死亡,正常基线S100B是唯一显著的独立预测因子(p = 0.0020;优势比:0.074;95% CI为0.014 ~ 0.38)。我们的数据表明,基线NLR在预测CM患者ICI反应方面似乎优于dNLR。
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Prognostic Performance of the Derived Neutrophil-to-Lymphocyte Ratio in Stage IV Melanoma Patients Treated with Immune Checkpoint Inhibitors
The purpose was to evaluate the prognostic performance of the derived neutrophil–to-lymphocyte ratio (dNLR) in patients with metastatic cutaneous melanoma (CM) treated with immune checkpoint inhibitors (ICI). We retrospectively investigated 41 CM patients with stage IV disease who had the indication for treatment with ICI. dNLR as well as NLR were routinely determined prior to the start of ICI treatment. The dNLR and NLR were calculated as follows: dNLR = absolute neutrophil counts (ANC)/white blood cell count −ANC and NRL = ANC/absolute lymphocyte counts, respectively. Follow-up of the patients was performed in line with current guidelines. In univariate analysis, dNLR (p = 0.027 and p = 0.032) as well as NLR (p = 0.0023 and p = 0.0036) were the only parameters which were significantly associated with the best overall response (BOR) and disease control rate (DCR) on ROC curve analyses. NLR negatively correlated with CM-specific survival (r = −0.32, p = 0.043). CM-specific deaths were significantly associated with the absence of immune-related adverse events (p = 0.043), elevated S100 calcium-binding protein B (S100B) at baseline (p = 0.0006), and dNLR (p = 0.024). In multivariate analyses, NLR was the only significant independent predictor for BOR (p = 0.014; odds ratio: 1.7; and 95% CI 1.11 to 2.61) and DCR (p = 0.019; odds ratio: 1.5; and 95% CI 1.07 to 2.19). Regarding CM-specific death, however, normal baseline S100B was the only significant independent predictor (p = 0.0020; odds ratio: 0.074; and 95% CI 0.014 to 0.38) for survival. Our data demonstrate that baseline NLR seems to be superior to dNLR in the prediction of ICI response in CM patients.
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