TY - JOUR
T1 - Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab
AU - Wu, Yue Linda
AU - Fulgenzi, Claudia Angela Maria
AU - D’Alessio, Antonio
AU - Cheon, Jaekyung
AU - Nishida, Naoshi
AU - Saeed, Anwaar
AU - Wietharn, Brooke
AU - Cammarota, Antonella
AU - Pressiani, Tiziana
AU - Personeni, Nicola
AU - Pinter, Matthias
AU - Scheiner, Bernhard
AU - Balcar, Lorenz
AU - Huang, Yi Hsiang
AU - Phen, Samuel
AU - Naqash, Abdul Rafeh
AU - Vivaldi, Caterina
AU - Salani, Francesca
AU - Masi, Gianluca
AU - Bettinger, Dominik
AU - Vogel, Arndt
AU - Schönlein, Martin
AU - von Felden, Johann
AU - Schulze, Kornelius
AU - Wege, Henning
AU - Galle, Peter R.
AU - Kudo, Masatoshi
AU - Rimassa, Lorenza
AU - Singal, Amit G.
AU - Sharma, Rohini
AU - Cortellini, Alessio
AU - Gaillard, Vincent E.
AU - Chon, Hong Jae
AU - Pinato, David J.
AU - Ang, Celina
N1 - Funding Information:
The authors would like to acknowledge the infrastructure provided by the Tisch Cancer Institute and the Icahn School of Medicine at Mount Sinai. D.J.P. acknowledges infrastructural support by the Cancer Research UK Imperial Centre and the Imperial Experimental Cancer Medicine Centre.
Funding Information:
This research was funded in part by the National Cancer Institute (Support Grant P30CA196521-01 awarded to the Tisch Cancer Institute of the Icahn School of Medicine at Mount Sinai) and used the Biostatistics Shared Resource Facility. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A.D. is supported by the National Institute for Health Research (NIHR) Imperial BRC, by grant funding from the European Association for the Study of the Liver (Andrew Burroughs Fellowship) and from Cancer Research UK (RCCPDB-Nov21/100008). D.J.P. is supported by grant funding from the Wellcome Trust Strategic Fund (PS3416) and from the Associazione Italiana per la Ricerca sul Cancro (AIRC MFAG Grant ID 25697). D.J.P. acknowledges infrastructural and grant support from the NIHR Imperial Experimental Cancer Medicine Centre and the Imperial College BRC. A.G.S.’s research effort is supported in part by R01 MD012565.
Publisher Copyright:
© 2022 by the authors.
PY - 2022/12
Y1 - 2022/12
N2 - Systemic inflammation is a key risk factor for hepatocellular carcinoma (HCC) progression and poor outcomes. Inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may have prognostic value in HCC treated with standard of care atezolizumab plus bevacizumab (Atezo-Bev). We conducted a multicenter, international retrospective cohort study of patients with unresectable HCC treated with Atezo-Bev to assess the association of NLR and PLR with overall survival (OS), progression-free survival (PFS), and objective response rates. Patients with NLR ≥ 5 had a significantly shorter OS (9.38 vs. 16.79 months, p < 0.001) and PFS (4.90 vs. 7.58 months, p = 0.03) compared to patients with NLR < 5. NLR ≥ 5 was an independent prognosticator of worse OS (HR 2.01, 95% CI 1.22–3.56, p = 0.007) but not PFS. PLR ≥ 300 was also significantly associated with decreased OS (9.38 vs. 15.72 months, p = 0.007) and PFS (3.45 vs. 7.11 months, p = 0.04) compared to PLR < 300, but it was not an independent prognosticator of OS or PFS. NLR and PLR were not associated with objective response or disease control rates. NLR ≥ 5 independently prognosticated worse survival outcomes and is worthy of further study and validation.
AB - Systemic inflammation is a key risk factor for hepatocellular carcinoma (HCC) progression and poor outcomes. Inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may have prognostic value in HCC treated with standard of care atezolizumab plus bevacizumab (Atezo-Bev). We conducted a multicenter, international retrospective cohort study of patients with unresectable HCC treated with Atezo-Bev to assess the association of NLR and PLR with overall survival (OS), progression-free survival (PFS), and objective response rates. Patients with NLR ≥ 5 had a significantly shorter OS (9.38 vs. 16.79 months, p < 0.001) and PFS (4.90 vs. 7.58 months, p = 0.03) compared to patients with NLR < 5. NLR ≥ 5 was an independent prognosticator of worse OS (HR 2.01, 95% CI 1.22–3.56, p = 0.007) but not PFS. PLR ≥ 300 was also significantly associated with decreased OS (9.38 vs. 15.72 months, p = 0.007) and PFS (3.45 vs. 7.11 months, p = 0.04) compared to PLR < 300, but it was not an independent prognosticator of OS or PFS. NLR and PLR were not associated with objective response or disease control rates. NLR ≥ 5 independently prognosticated worse survival outcomes and is worthy of further study and validation.
KW - NLR
KW - PLR
KW - atezolizumab plus bevacizumab
KW - hepatocellular carcinoma
KW - immunotherapy
KW - inflammatory markers
UR - http://www.scopus.com/inward/record.url?scp=85143615588&partnerID=8YFLogxK
U2 - 10.3390/cancers14235834
DO - 10.3390/cancers14235834
M3 - Article
AN - SCOPUS:85143615588
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 23
M1 - 5834
ER -