Real world prognostic utility of platelet lymphocyte ratio and nutritional status in first-line immunotherapy response in stage IV non-small cell lung cancer

Q3 Medicine

Cancer treatment and research communications Pub Date : 2023-01-01 DOI:10.1016/j.ctarc.2023.100752

Madeline MacDonald , Darin Poei , Alexis Leyba , Raymond Diep , Krithika Chennapan , Christopher Leon , Bing Xia , Jorge J. Nieva , Robert Hsu

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引用次数: 0

Abstract

Background

Elevated platelet lymphocyte ratio (PLR) and low body mass index (BMI) are associated with inferior survival in non-small cell lung cancer (NSCLC) patients receiving immunotherapy (IO). We evaluated real-world prognostic utility of PLR, BMI, and albumin level in stage IV NSCLC patients receiving first line (1L) IO.

Methods

We identified 75 stage IV patients who received 1L IO therapy at USC Norris Comprehensive Cancer Center and Los Angeles General Medical Center from 2015 to 2022. The primary outcome was overall survival (OS) from time of IO with attention to pre-treatment BMI < 22, albumin < 3.5 g/dL, and PLR > 180.

Results

Median age was 66.5 years with 49 (65.3%) males. 25 (33.3%) had BMI < 22. 45/75 (60%) had PLR > 180. Patients with BMI < 22 had inferior OS (13.1 months (m) vs. 37.4 m in BMI > 28, p-value = 0.042) along with patients with albumin<3.5 g/dL (OS: 2.8 m vs. 14.6 m, p-value = 0.0027), and patients with PLR>180 (OS: 8.7 m vs. 23.0 m, p = 0.028). Composite BMI < 22, PLR > 180 had the worst OS, p-value = 0.0331. Multivariate analysis controlling for age, smoking, gender, PD-L1 tumor proportion score (TPS), and histology (adenocarcinoma, squamous, adenosquamous, and large cell) showed that BMI (HR: 0.8726, 95% CI: 0.7892–0.954) and PLR > 180 (HR: 2.48, 95% CI: 1.076–6.055) were significant in OS mortality risk.

Conclusion

Patients with a composite of BMI < 22, albumin < 3.5 g/dL, and PLR > 180 had significantly worse OS. This highlights the importance of screening for poor nutritional status and high PLR to better inform stage IV NSCLC patients receiving IO therapy of their prognosis and supportive care.

MicroAbstract

We evaluated real-world prognostic utility of platelet lymphocyte ratio (PLR), body mass index (BMI), and albumin level in 75 Stage IV NSCLC patients receiving first line IO. Patients with a composite of BMI < 22, albumin < 3.5 g/dL, and PLR > 180 had significantly worse OS. This highlights the importance of screening for poor nutritional status and high PLR to better inform stage IV NSCLC patients of their prognosis and to emphasize supportive care needs.

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血小板淋巴细胞比率和营养状况在IV期非小细胞肺癌癌症一线免疫治疗反应中的现实预后效用

背景接受免疫疗法（IO）的非小细胞肺癌（NSCLC）患者血小板淋巴细胞比率（PLR）升高和体重指数（BMI）降低与生存率低下有关。我们评估了接受一线（1L）IO的IV期NSCLC患者PLR、BMI和白蛋白水平在现实世界中的预后效用。方法我们确定了2015年至2022年在南加州大学诺里斯综合癌症中心和洛杉矶综合医疗中心接受1L IO治疗的75名IV期患者。主要结果是从IO开始的总生存率（OS），注意治疗前BMI<；22、白蛋白<；3.5g/dL和PLR>；结果中位年龄66.5岁，男性49例（65.3%）。25人（33.3%）的BMI<；22.45/75（60%）的PLR>；180.患有BMI<；22例具有较差的OS（13.1个月（m）vs.37.4 m的BMI>；28，p值=0.042）以及白蛋白<；3.5 g/dL（OS:2.8米vs.14.6米，p值=0.0027），PLR>；180（OS:8.7m对23.0m，p=0.028）；22、PLR>；180的OS最差，p值=0.0031。控制年龄、吸烟、性别、PD-L1肿瘤比例评分（TPS）和组织学（腺癌、鳞状细胞、腺鳞状细胞和大细胞）的多因素分析显示，BMI（HR:0.8726，95%CI:0.7892–0.954）和PLR>；180（HR:2.48，95%CI:1.076-6.055）在OS死亡率中具有显著性。结论复合BMI＜0.01的患者；22、白蛋白<；3.5g/dL和PLR>；180的OS明显较差。这突出了筛查不良营养状况和高PLR的重要性，以更好地告知接受IO治疗的IV期NSCLC患者的预后和支持性护理。MicroAbstracts我们评估了75名接受一线IO的IV期NSCLC患者的血小板淋巴细胞比率（PLR）、体重指数（BMI）和白蛋白水平在现实世界中的预后效用；22、白蛋白<；3.5g/dL和PLR>；180的OS明显较差。这突出了筛查营养不良和PLR高的重要性，以更好地告知IV期NSCLC患者的预后，并强调支持性护理需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer treatment and research communications Medicine-Oncology

CiteScore

4.30

自引率

0.00%

发文量

148

审稿时长

56 days

期刊介绍： Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.