Neutrophil-Lymphocyte Ratio Predicts Overall Survival in Patients With HCC Treated With Durvalumab Plus Tremelimumab.

IF 3.4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Research Pub Date : 2025-06-14 DOI:10.1111/hepr.14224

Tomomitsu Matono, Toshifumi Tada, Takashi Kumada, Atsushi Hiraoka, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Hiroki Nishikawa, Kazunari Tanaka, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Yuichi Koshiyama, Hidenori Toyoda, Chikara Ogawa, Takeshi Hatanaka, Satoru Kakizaki, Kazuhito Kawata, Hideko Ohama, Fujimasa Tada, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Takashi Nishimura, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Tomoko Aoki, Hidekatsu Kuroda, Yutaka Yata, Hideyuki Tamai, Takanori Matsuura, Shohei Komatsu, Yoshihide Ueda, Yoshiko Nakamura, Osamu Yoshida, Shinichiro Nakamura, Hirayuki Enomoto, Masaki Kaibori, Takumi Fukumoto, Yoichi Hiasa, Masatoshi Kudo

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引用次数: 0

Abstract

Aim: To investigate the prognostic impact of the neutrophil-to-lymphocyte ratio (NLR) on outcomes in patients with hepatocellular carcinoma (HCC) treated with durvalumab plus tremelimumab (Dur/Tre).

Methods: A total of 182 patients with HCC who received Dur/Tre were included in the analysis. Univariate and multivariate survival analyses were conducted. Additionally, hazard ratio (HR) spline curve analysis was used to determine the optimal NLR cut-off values for predicting overall survival (OS).

Results: The median progression-free survival (PFS) was 3.5 months (95% confidence interval [CI]: 2.7-4.4), whereas the median OS was not reached (95% CI: 12.1 months-not reached). Multivariate analysis demonstrated that treatment with Dur/Tre as a second-line therapy or beyond was independently associated with worse PFS (HR: 1.819; 95% CI: 1.230-2.688; p = 0.003). Furthermore, an NLR of ≥ 2.56 was identified as an independent predictor of reduced OS (HR: 1.919; 95% CI: 1.033-3.566; p = 0.039). The median OS was not reached (95% CI: 12.3 months-not reached) in patients with an NLR of < 2.56, compared with 12.1 months (95% CI: 9.0 months-not reached) in those with an NLR of ≥ 2.56 (p = 0.016). A Sankey diagram illustrating post-treatment outcomes revealed that a significantly larger proportion of patients with high NLRs did not proceed to subsequent therapies but instead received best supportive care (p = 0.046). Spline curve analysis showed that an NLR range of approximately 2.3-3.0 represents an appropriate cut-off for predicting OS.

Conclusions: The NLR is a significant prognostic biomarker for OS in patients with HCC treated with Dur/Tre.

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中性粒细胞-淋巴细胞比率预测Durvalumab联合Tremelimumab治疗HCC患者的总生存期。

目的：探讨中性粒细胞与淋巴细胞比值（NLR）对接受durvalumab联合tremelimumab （Dur/Tre）治疗的肝细胞癌（HCC）患者预后的影响。方法：182例接受Dur/Tre治疗的HCC患者纳入分析。进行单因素和多因素生存分析。此外，采用风险比（HR）样条曲线分析确定预测总生存期（OS）的最佳NLR临界值。结果：中位无进展生存期（PFS）为3.5个月（95%置信区间[CI]: 2.7-4.4），而中位OS未达到（95% CI: 12.1个月-未达到）。多因素分析表明，Dur/Tre作为二线或以上治疗与更差的PFS独立相关(HR: 1.819；95% ci: 1.230-2.688；p = 0.003)。此外，NLR≥2.56被确定为OS降低的独立预测因子(HR: 1.919；95% ci: 1.033-3.566；p = 0.039)。NLR < 2.56的患者中位OS未达到（95% CI: 12.3个月-未达到），NLR≥2.56的患者中位OS为12.1个月（95% CI: 9.0个月-未达到）（p = 0.016）。Sankey图显示了治疗后的结果，高nlr患者没有继续进行后续治疗，而是接受了最好的支持治疗（p = 0.046）。样条曲线分析表明，NLR范围约为2.3-3.0代表了预测OS的适当截止值。结论：NLR是Dur/Tre治疗HCC患者OS的重要预后生物标志物。

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

Hepatology Research 医学-胃肠肝病学

CiteScore

8.30

自引率

14.30%

发文量

124

审稿时长

1 months

期刊介绍： Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.