{"title":"结合血清炎症标志物和临床因素预测免疫检查点抑制剂治疗的转移性尿路上皮癌患者的生存。","authors":"Liang-Yun Cheng, Po-Jung Su, Ming-Chun Kuo, Chang-Ting Lin, Hao-Lun Luo, Chih-Chi Chou, Shih-Yu Huang, Chia-Che Wu, Chien-Hsu Chen, Chun-Chieh Huang, Kai-Lung Tsai, Harvey Yu-Li Su","doi":"10.1177/17588359241305091","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Despite the revolutionary impact of immune checkpoint inhibitors (ICIs) on the treatment of metastatic urothelial carcinoma (mUC), the clinical utility of reliable prognostic biomarkers to foresee survival outcomes remains underexplored.</p><p><strong>Objectives: </strong>The purpose of this study was to ascertain the prognostic significance of serum inflammatory markers in mUC patients undergoing ICI therapy.</p><p><strong>Design: </strong>This is a retrospective, multicenter study.</p><p><strong>Methods: </strong>Data were collected from two independent medical centers in Taiwan, encompassing a validation and a training cohort (TC). Patients with histopathologically confirmed urothelial carcinoma who received at least one cycle of ICI monotherapy were included. Serum inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated prior to ICI therapy. Statistical analyses involved the use of receiver operating characteristic (ROC) curves to determine optimal biomarker cutoffs and Cox proportional hazards models to evaluate the independent predictive capability of these markers.</p><p><strong>Results: </strong>A total of 192 patients were enrolled. In the univariate analysis, serum markers such as NLR, PLR, SII, and Hb were significantly associated with overall survival (OS) in both the training and validation cohorts (VC). White blood cells, NLR, and SII demonstrated a robust correlation with progression-free survival across both cohorts. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status ⩾2 (<i>p</i> < 0.001), visceral metastasis (<i>p</i> < 0.001), leukocytosis (<i>p</i> < 0.001), Hb levels ⩾10 mg/dL (<i>p</i> = 0.008), and NLR ⩾5 (<i>p</i> = 0.032) as independent predictors of OS. A prognostic nomogram integrating these independent factors yielded a C-index for a 3-year OS of 0.769 in the TC and 0.657 in the VC.</p><p><strong>Conclusion: </strong>Serum inflammatory markers, combined with clinicopathologic factors, provide a practical prognostic tool in mUC treatment with ICIs.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"16 ","pages":"17588359241305091"},"PeriodicalIF":4.3000,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648016/pdf/","citationCount":"0","resultStr":"{\"title\":\"Combining serum inflammatory markers and clinical factors to predict survival in metastatic urothelial carcinoma patients treated with immune checkpoint inhibitors.\",\"authors\":\"Liang-Yun Cheng, Po-Jung Su, Ming-Chun Kuo, Chang-Ting Lin, Hao-Lun Luo, Chih-Chi Chou, Shih-Yu Huang, Chia-Che Wu, Chien-Hsu Chen, Chun-Chieh Huang, Kai-Lung Tsai, Harvey Yu-Li Su\",\"doi\":\"10.1177/17588359241305091\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Despite the revolutionary impact of immune checkpoint inhibitors (ICIs) on the treatment of metastatic urothelial carcinoma (mUC), the clinical utility of reliable prognostic biomarkers to foresee survival outcomes remains underexplored.</p><p><strong>Objectives: </strong>The purpose of this study was to ascertain the prognostic significance of serum inflammatory markers in mUC patients undergoing ICI therapy.</p><p><strong>Design: </strong>This is a retrospective, multicenter study.</p><p><strong>Methods: </strong>Data were collected from two independent medical centers in Taiwan, encompassing a validation and a training cohort (TC). Patients with histopathologically confirmed urothelial carcinoma who received at least one cycle of ICI monotherapy were included. Serum inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated prior to ICI therapy. Statistical analyses involved the use of receiver operating characteristic (ROC) curves to determine optimal biomarker cutoffs and Cox proportional hazards models to evaluate the independent predictive capability of these markers.</p><p><strong>Results: </strong>A total of 192 patients were enrolled. In the univariate analysis, serum markers such as NLR, PLR, SII, and Hb were significantly associated with overall survival (OS) in both the training and validation cohorts (VC). White blood cells, NLR, and SII demonstrated a robust correlation with progression-free survival across both cohorts. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status ⩾2 (<i>p</i> < 0.001), visceral metastasis (<i>p</i> < 0.001), leukocytosis (<i>p</i> < 0.001), Hb levels ⩾10 mg/dL (<i>p</i> = 0.008), and NLR ⩾5 (<i>p</i> = 0.032) as independent predictors of OS. A prognostic nomogram integrating these independent factors yielded a C-index for a 3-year OS of 0.769 in the TC and 0.657 in the VC.</p><p><strong>Conclusion: </strong>Serum inflammatory markers, combined with clinicopathologic factors, provide a practical prognostic tool in mUC treatment with ICIs.</p>\",\"PeriodicalId\":23053,\"journal\":{\"name\":\"Therapeutic Advances in Medical Oncology\",\"volume\":\"16 \",\"pages\":\"17588359241305091\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-12-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648016/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Medical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17588359241305091\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Medical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17588359241305091","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：尽管免疫检查点抑制剂（ICIs）对转移性尿路上皮癌（mUC）的治疗产生了革命性的影响，但可靠的预后生物标志物对预测生存结果的临床效用仍未得到充分探索：本研究旨在确定接受 ICI 治疗的 mUC 患者血清炎症标志物的预后意义：这是一项回顾性多中心研究：数据来自台湾两家独立的医疗中心，包括一个验证队列和一个训练队列（TC）。研究对象包括组织病理学确诊的尿路上皮癌患者，这些患者至少接受过一个周期的 ICI 单药治疗。在接受 ICI 治疗前计算血清炎症指标，如中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和全身免疫炎症指数（SII）。统计分析包括使用接收器操作特征曲线（ROC）确定最佳生物标志物截断点，以及使用 Cox 比例危险模型评估这些标志物的独立预测能力：共有 192 名患者入选。在单变量分析中，在训练组和验证组（VC）中，NLR、PLR、SII 和 Hb 等血清标志物与总生存期（OS）显著相关。在两个队列中，白细胞、NLR 和 SII 均与无进展生存期密切相关。多变量分析显示，东部合作肿瘤学组表现状态⩾2（p p p = 0.008）和 NLR ⩾5（p = 0.032）是 OS 的独立预测因子。综合这些独立因素的预后提名图得出，TC 和 VC 3 年 OS 的 C 指数分别为 0.769 和 0.657：血清炎症标志物与临床病理因素相结合，为使用 ICIs 治疗 mUC 提供了一种实用的预后工具。
Combining serum inflammatory markers and clinical factors to predict survival in metastatic urothelial carcinoma patients treated with immune checkpoint inhibitors.
Background: Despite the revolutionary impact of immune checkpoint inhibitors (ICIs) on the treatment of metastatic urothelial carcinoma (mUC), the clinical utility of reliable prognostic biomarkers to foresee survival outcomes remains underexplored.
Objectives: The purpose of this study was to ascertain the prognostic significance of serum inflammatory markers in mUC patients undergoing ICI therapy.
Design: This is a retrospective, multicenter study.
Methods: Data were collected from two independent medical centers in Taiwan, encompassing a validation and a training cohort (TC). Patients with histopathologically confirmed urothelial carcinoma who received at least one cycle of ICI monotherapy were included. Serum inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated prior to ICI therapy. Statistical analyses involved the use of receiver operating characteristic (ROC) curves to determine optimal biomarker cutoffs and Cox proportional hazards models to evaluate the independent predictive capability of these markers.
Results: A total of 192 patients were enrolled. In the univariate analysis, serum markers such as NLR, PLR, SII, and Hb were significantly associated with overall survival (OS) in both the training and validation cohorts (VC). White blood cells, NLR, and SII demonstrated a robust correlation with progression-free survival across both cohorts. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status ⩾2 (p < 0.001), visceral metastasis (p < 0.001), leukocytosis (p < 0.001), Hb levels ⩾10 mg/dL (p = 0.008), and NLR ⩾5 (p = 0.032) as independent predictors of OS. A prognostic nomogram integrating these independent factors yielded a C-index for a 3-year OS of 0.769 in the TC and 0.657 in the VC.
Conclusion: Serum inflammatory markers, combined with clinicopathologic factors, provide a practical prognostic tool in mUC treatment with ICIs.
期刊介绍：
Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
