TY - JOUR
T1 - Characterization of Age-Associated, Neutrophil-to-Lymphocyte Ratio (NLR) and Systemic Immune-Inflammatory Index (SII) as Biomarkers of Inflammation in Geriatric Patients with Cancer Treated with Immune Checkpoint Inhibitors: Impact on Efficacy and Survival
AU - Choucair, K.
AU - Nebhan, C.
AU - Cortellini, A.
AU - Hentzen, S.
AU - Wang, Y.
AU - Liu, C.
AU - Giusti, R.
AU - Filetti, M.
AU - Ascierto, P. A.
AU - Vanella, V.
AU - Galetta, D.
AU - Catino, A.
AU - Al-Bzour, N.
AU - Saeed, A.
AU - Cavalcante, L.
AU - Pizzutilo, P.
AU - Genova, C.
AU - Bersanelli, M.
AU - Buti, S.
AU - Johnson, D. B.
AU - Fulgenzi, C. A. M.
AU - PINATO, David James
AU - Radford, M.
AU - Kim, C.
AU - Naqash, A. R.
AU - Saeed, A.
PY - 2023
Y1 - 2023
N2 - Background: Geriatric patients (≥80 years) are underrepresented in immune checkpoint inhibitor (ICIs) clinical trials. However, their unique biology may affect their response to ICIs. There are currently no established biomarkers of the response to ICIs in adult patients with cancer that can help with patient selection. Methods: We built a multicenter, international retrospective study of 885 patients (<80 years: n = 417, 47.12%; ≥80 years: n = 468, 52.88%) with different tumor types treated with ICIs between 2011 and 2021 from 11 academic centers in the U.S. and Europe. The main outcome measures were objective response rates (ORR), progression-free survival (PFS) and overall survival (OS) stratified by age and circulating inflammatory levels (neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammatory index (SII)). Results: Patients ≥80 years with low NLR (NLR-L) and SII (SII-L) had significantly higher ORR (vs. high NLR [NLR-H], p < 0.01 and SII-H, p < 0.05, respectively). At median follow-ups (13.03 months), and compared to SII-H, patients with SII-L had significantly longer median PFS and OS in patients <80 (p < 0.001), and ≥80 years (p < 0.001). SII-L was independently associated with longer PFS and OS (HR: 0.61 and 0.62, respectively, p < 0.01). Conclusion: Lower inflammation pre-ICI initiation may predict an improved response and survival in geriatric patients with cancer.
AB - Background: Geriatric patients (≥80 years) are underrepresented in immune checkpoint inhibitor (ICIs) clinical trials. However, their unique biology may affect their response to ICIs. There are currently no established biomarkers of the response to ICIs in adult patients with cancer that can help with patient selection. Methods: We built a multicenter, international retrospective study of 885 patients (<80 years: n = 417, 47.12%; ≥80 years: n = 468, 52.88%) with different tumor types treated with ICIs between 2011 and 2021 from 11 academic centers in the U.S. and Europe. The main outcome measures were objective response rates (ORR), progression-free survival (PFS) and overall survival (OS) stratified by age and circulating inflammatory levels (neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammatory index (SII)). Results: Patients ≥80 years with low NLR (NLR-L) and SII (SII-L) had significantly higher ORR (vs. high NLR [NLR-H], p < 0.01 and SII-H, p < 0.05, respectively). At median follow-ups (13.03 months), and compared to SII-H, patients with SII-L had significantly longer median PFS and OS in patients <80 (p < 0.001), and ≥80 years (p < 0.001). SII-L was independently associated with longer PFS and OS (HR: 0.61 and 0.62, respectively, p < 0.01). Conclusion: Lower inflammation pre-ICI initiation may predict an improved response and survival in geriatric patients with cancer.
KW - biomarkers
KW - circulating inflammatory markers
KW - geriatric oncology
KW - immune checkpoint inhibitors
KW - systemic immune-inflammatory index
KW - biomarkers
KW - circulating inflammatory markers
KW - geriatric oncology
KW - immune checkpoint inhibitors
KW - systemic immune-inflammatory index
UR - https://iris.uniupo.it/handle/11579/202310
U2 - 10.3390/cancers15205052
DO - 10.3390/cancers15205052
M3 - Article
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 20
ER -
