Neutrophil to Lymphocyte Ratio as a Biomarker for the Prediction of Cancer Outcomes and Immune-Related Adverse Events in a CTLA-4-Treated Population.

IF 4.5 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2025-06-17 DOI:10.3390/cancers17122011
Michael M Cunningham, Rachel Romero, Carolina Alvarez, Shruti Saxena Beem, Todd A Schwartz, Rumey C Ishizawar
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引用次数: 0

Abstract

Background/Objectives: Immune-related adverse events (irAEs) triggered by immune checkpoint inhibitor therapy (ICI) have been paradoxically associated with both significant morbidity and improved cancer outcomes. While predictive markers for irAEs have been studied in the PD-1 blockade, less is known for their role in CTLA-4 inhibition. This study aims to fill this gap by evaluating NLR and irAE incidence in a CTLA-4-treated population. Methods: This study is a single-center retrospective cohort study investigating 111 patients treated with CTLA-4 inhibition (ipilimumab) to assess associations for baseline low NLR values with cancer outcomes and irAE type and incidence. Patient charts were manually reviewed by a single physician, and unclear clinical events were assessed by a second physician reviewer. Results: In this cohort, the occurrence of more than one irAE presentation was associated with an improved cancer outcome, OR 1.48 (1.02, 2.15). When stratified by organ-specific manifestation, only endocrinologic irAEs were associated with improved cancer outcome, OR 2.82 (1.19, 6.67). A low baseline NLR was statistically significantly associated with an increased incidence of irAEs of any type, OR 4.34 (1.73, 10.9). Conclusions: These data show that irAE occurrence in cancer patients treated with CTLA-4 inhibition is associated with improved cancer outcomes, similar to that previously seen with PD-1 inhibition. It also suggests that the NLR may serve as a practical peripheral biomarker to predict both cancer response and odds of irAEs in patients treated with CTLA-4 inhibition. This low-cost and widely available tool could provide additional information for modeling cancer outcomes.

中性粒细胞与淋巴细胞比率作为预测ctla -4治疗人群癌症结局和免疫相关不良事件的生物标志物
背景/目的:免疫检查点抑制剂治疗(ICI)引发的免疫相关不良事件(irAEs)与显著的发病率和改善的癌症结局矛盾地相关。虽然在PD-1阻断中已经研究了irae的预测标记物,但对其在CTLA-4抑制中的作用知之甚少。本研究旨在通过评估ctla -4治疗人群的NLR和irAE发生率来填补这一空白。方法:本研究是一项单中心回顾性队列研究,调查111例接受CTLA-4抑制(ipilimumab)治疗的患者,以评估基线低NLR值与癌症结局、irAE类型和发病率的关系。患者病历由一名医生手动审核,不明确的临床事件由另一名医生审核。结果:在该队列中,出现一次以上的irAE表现与改善的癌症预后相关,OR为1.48(1.02,2.15)。当按器官特异性表现分层时,只有内分泌学的irae与改善的癌症结局相关,OR为2.82(1.19,6.67)。低基线NLR与任何类型irae发生率增加有统计学意义,OR为4.34(1.73,10.9)。结论:这些数据表明,在接受CTLA-4抑制治疗的癌症患者中,irAE的发生与癌症预后的改善有关,这与先前使用PD-1抑制治疗的结果相似。该研究还表明NLR可作为一种实用的外周生物标志物,用于预测CTLA-4抑制治疗患者的癌症反应和irAEs发生率。这种低成本和广泛可用的工具可以为模拟癌症结果提供额外的信息。
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
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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