Ali Ogul, Ali Alper Solmaz, Ilhan Birsenogul, Yunus Coskun, Mahmut Bakır Koyuncu, Abdullah Evren Yetisir, Mahmut Buyuksimsek, Mert Tohumcuoglu, Mehmet Turker, Mustafa Gurbuz, Berna Bozkurt Duman, Timucin Cil
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The aim of this retrospective study was to investigate the usability of inflammatory-nutritional indices and hemoglobin, albumin, lymphocyte and platelet (HALP) scores for predicting survival in patients with metastatic NSCLCs with driver mutations undergoing first-line treatment with tyrosine kinase inhibitors (TKIs).</p><p><strong>Patients & methods: </strong>Ninety-two patients using TKIs for metastatic disease with driver mutations were followed up in our center from December 2018 to May 2024. We retrospectively investigated the effects on progression-free survival (PFS) and overall survival (OS) by calculating inflammatory-nutritional indices and HALP scores using pre-treatment laboratory values.</p><p><strong>Results: </strong>Higher plate-let-to-lymphocyte ratios (PLRs) were associated with shorter PFS, whereas a higher prognostic nutritional index (PNI) predicted longer PFS. Similarly, high HALP and PNI scores were significantly associated with longer OS, while lower platelet-to-lymphocyte ratio (PLR), systemic immune inflammatory index (SII) and systemic inflammation response index (SIRI) were linked to improved OS. 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引用次数: 0
摘要
目的：在具有驱动突变的转移性非小细胞肺癌（NSCLC）中，耐药机制可能会限制治疗效果，而且检测耐药机制的成本很高。这项回顾性研究的目的是研究炎症营养指数和血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分在预测接受酪氨酸激酶抑制剂（TKIs）一线治疗的转移性非小细胞肺癌患者生存的可用性。患者与方法：2018年12月至2024年5月，本中心对92例转移性驱动突变患者使用TKIs进行随访。我们通过使用治疗前实验室值计算炎症-营养指数和HALP评分，回顾性研究了对无进展生存期（PFS）和总生存期（OS）的影响。结果：较高的血小板与淋巴细胞比率（PLRs）与较短的PFS相关，而较高的预后营养指数（PNI）预测较长的PFS。同样，高HALP和PNI评分与较长的生存期显著相关，而较低的血小板与淋巴细胞比率（PLR）、全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）与改善的生存期相关。多变量分析发现SII是独立的OS预后因素（OR = 7.182, p = 0.003）。结论：HALP评分、PLR、SII、PNI和SIRI可作为一线TKIs治疗的驱动突变NSCLC患者的潜在预后生物标志物。
Prognostic value of inflammatory-nutritional indexes and HALP score in advanced stage NSCLC treated with first-line TKI.
Aim: In metastatic Non-small cell lung cancer (NSCLC) with driver mutations, resistance mechanisms may limit treatment benefit, and their detection is expensive. The aim of this retrospective study was to investigate the usability of inflammatory-nutritional indices and hemoglobin, albumin, lymphocyte and platelet (HALP) scores for predicting survival in patients with metastatic NSCLCs with driver mutations undergoing first-line treatment with tyrosine kinase inhibitors (TKIs).
Patients & methods: Ninety-two patients using TKIs for metastatic disease with driver mutations were followed up in our center from December 2018 to May 2024. We retrospectively investigated the effects on progression-free survival (PFS) and overall survival (OS) by calculating inflammatory-nutritional indices and HALP scores using pre-treatment laboratory values.
Results: Higher plate-let-to-lymphocyte ratios (PLRs) were associated with shorter PFS, whereas a higher prognostic nutritional index (PNI) predicted longer PFS. Similarly, high HALP and PNI scores were significantly associated with longer OS, while lower platelet-to-lymphocyte ratio (PLR), systemic immune inflammatory index (SII) and systemic inflammation response index (SIRI) were linked to improved OS. Multivariate analysis identified only SII as an independent OS prognostic factor (OR = 7.182, p = 0.003).
Conclusions: HALP score, PLR, SII, PNI and SIRI may serve as potential prognostic biomarkers in NSCLC patients with driver mutations treated with first-line TKIs.
期刊介绍：
Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory.
Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice.
As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications.
Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest.
Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.
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