文章：

年龄相关中性粒细胞-淋巴细胞比值（NLR）与全身免疫炎症指数（SII）作为老年癌症患者免疫检查点抑制剂治疗炎症生物标志物的特征分析：对疗效与生存的影响

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

原文发布日期：19 October 2023

DOI: 10.3390/cancers15205052

类型: Article

开放获取: 是

英文摘要：

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.

摘要翻译： 

背景：老年患者（≥80岁）在免疫检查点抑制剂（ICIs）临床试验中的代表性不足。然而，其独特的生物学特性可能影响其对ICIs的反应。目前尚无公认的成人癌症患者对ICIs反应的生物标志物可用于辅助患者选择。方法：我们开展了一项多中心国际回顾性研究，纳入2011年至2021年间来自美国和欧洲11个学术中心的885例接受ICIs治疗的不同肿瘤类型患者（<80岁：n=417，47.12%；≥80岁：n=468，52.88%）。主要结局指标为按年龄和循环炎症水平（中性粒细胞与淋巴细胞比值[NLR]及全身免疫炎症指数[SII]）分层的客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。结果：≥80岁且具有低NLR（NLR-L）和低SII（SII-L）的患者ORR显著更高（分别对比高NLR[NLR-H]，p<0.01和高SII[SII-H]，p<0.05）。在中位随访13.03个月时，与SII-H患者相比，SII-L患者在<80岁组（p<0.001）和≥80岁组（p<0.001）均表现出显著更长的中位PFS和OS。SII-L与更长的PFS和OS独立相关（风险比分别为0.61和0.62，p<0.01）。结论：ICIs治疗前较低的炎症水平可能预示老年癌症患者具有更好的治疗反应和生存获益。

原文链接：

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