Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab

Yue Linda Wu; Claudia Angela Maria Fulgenzi; Antonio D’Alessio; Jaekyung Cheon; Naoshi Nishida; Anwaar Saeed; Brooke Wietharn; Antonella Cammarota; Tiziana Pressiani; Nicola Personeni; Matthias Pinter; Bernhard Scheiner; Lorenz Balcar; Yi Hsiang Huang; Samuel Phen; Abdul Rafeh Naqash; Caterina Vivaldi; Francesca Salani; Gianluca Masi; Dominik Bettinger; Arndt Vogel; Martin Schönlein; Johann von Felden; Kornelius Schulze; Henning Wege; Peter R. Galle; Masatoshi Kudo; Lorenza Rimassa; Amit G. Singal; Rohini Sharma; Alessio Cortellini; Vincent E. Gaillard; Hong Jae Chon; David J. Pinato; Celina Ang

doi:10.3390/cancers14235834

Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab

Yue Linda Wu, Claudia Angela Maria Fulgenzi, Antonio D’Alessio, Jaekyung Cheon, Naoshi Nishida, Anwaar Saeed, Brooke Wietharn, Antonella Cammarota, Tiziana Pressiani, Nicola Personeni, Matthias Pinter, Bernhard Scheiner, Lorenz Balcar, Yi Hsiang Huang, Samuel Phen, Abdul Rafeh Naqash, Caterina Vivaldi, Francesca Salani, Gianluca Masi, Dominik BettingerArndt Vogel, Martin Schönlein, Johann von Felden, Kornelius Schulze, Henning Wege, Peter R. Galle, Masatoshi Kudo, Lorenza Rimassa, Amit G. Singal, Rohini Sharma, Alessio Cortellini, Vincent E. Gaillard, Hong Jae Chon, David J. Pinato, Celina Ang

Risultato della ricerca: Contributo su rivista › Articolo in rivista › peer review

Abstract

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.

Lingua originale	Inglese
Numero di articolo	5834
Rivista	Cancers
Volume	14
Numero di pubblicazione	23
DOI	https://doi.org/10.3390/cancers14235834
Stato di pubblicazione	Pubblicato - dic 2022
Pubblicato esternamente	Sì

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Wu, Y. L., Fulgenzi, C. A. M., D’Alessio, A., Cheon, J., Nishida, N., Saeed, A., Wietharn, B., Cammarota, A., Pressiani, T., Personeni, N., Pinter, M., Scheiner, B., Balcar, L., Huang, Y. H., Phen, S., Naqash, A. R., Vivaldi, C., Salani, F., Masi, G., ... Ang, C. (2022). Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab. Cancers, 14(23), Articolo 5834. https://doi.org/10.3390/cancers14235834

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title = "Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab",

abstract = "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.",

keywords = "NLR, PLR, atezolizumab plus bevacizumab, hepatocellular carcinoma, immunotherapy, inflammatory markers",

author = "Wu, {Yue Linda} and Fulgenzi, {Claudia Angela Maria} and Antonio D{\textquoteright}Alessio and Jaekyung Cheon and Naoshi Nishida and Anwaar Saeed and Brooke Wietharn and Antonella Cammarota and Tiziana Pressiani and Nicola Personeni and Matthias Pinter and Bernhard Scheiner and Lorenz Balcar and Huang, {Yi Hsiang} and Samuel Phen and Naqash, {Abdul Rafeh} and Caterina Vivaldi and Francesca Salani and Gianluca Masi and Dominik Bettinger and Arndt Vogel and Martin Sch{\"o}nlein and {von Felden}, Johann and Kornelius Schulze and Henning Wege and Galle, {Peter R.} and Masatoshi Kudo and Lorenza Rimassa and Singal, {Amit G.} and Rohini Sharma and Alessio Cortellini and Gaillard, {Vincent E.} and Chon, {Hong Jae} and Pinato, {David J.} and Celina Ang",

note = "Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = dec,

doi = "10.3390/cancers14235834",

language = "English",

volume = "14",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "23",

}

Wu, YL, Fulgenzi, CAM, D’Alessio, A, Cheon, J, Nishida, N, Saeed, A, Wietharn, B, Cammarota, A, Pressiani, T, Personeni, N, Pinter, M, Scheiner, B, Balcar, L, Huang, YH, Phen, S, Naqash, AR, Vivaldi, C, Salani, F, Masi, G, Bettinger, D, Vogel, A, Schönlein, M, von Felden, J, Schulze, K, Wege, H, Galle, PR, Kudo, M, Rimassa, L, Singal, AG, Sharma, R, Cortellini, A, Gaillard, VE, Chon, HJ, Pinato, DJ & Ang, C 2022, 'Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab', Cancers, vol. 14, n. 23, 5834. https://doi.org/10.3390/cancers14235834

Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab. / Wu, Yue Linda; Fulgenzi, Claudia Angela Maria; D’Alessio, Antonio et al.
In: Cancers, Vol. 14, N. 23, 5834, 12.2022.

Risultato della ricerca: Contributo su rivista › Articolo in rivista › peer review

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

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

SN - 2072-6694

VL - 14

JO - Cancers

JF - Cancers

IS - 23

M1 - 5834

ER -

Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab

Abstract

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