Background: Previously, we proposed that the immune-modified Glasgow Prognostic Score (imGPS), which adds the lymphocyte count to the mGPS, is helpful as a prognostic marker for patients with head and neck squamous cell carcinoma. In this study, we investigated the imGPS as a marker for the therapeutic effect of pembrolizumab in treating recurrent and metastatic head and neck cancer (RMHNC). Methods: This study included RMHNC patients who were treated with pembrolizumab from December 2019 to April 2024. ALB, CRP, lymphocyte counts, neutrophil-to-lymphocyte ratios (NLRs), mGPSs, and imGPSs were extracted as biomarkers, and the response rate and prognosis were analyzed for each. Results: A total of 54 patients were enrolled. Lymphocyte counts were correlated with the overall response rates (ORRs) (p= 0.0082). Although the mGPS did not show significant differences in ORRs, imGPSs revealed a significant difference (p= 0.013). CRP, ALB, and lymphocyte counts were correlated with overall survival (OS) and/or progression-free survival (PFS). NLRs, mGPSs, and imGPSs were also correlated with OS and/or PFS, with imGPSs showing the greatest area under the curve (OS; AUC = 0.795, PFS; AUC = 0.754). Conclusions: This study demonstrates that the imGPS is an excellent predictive marker for the therapeutic effect and prognosis of pembrolizumab for RMHNC. The imGPS can be employed with daily blood tests, highlighting the potential to forecast the impact of the ICI with high reliability.
背景：先前我们提出，在改良格拉斯哥预后评分（mGPS）基础上加入淋巴细胞计数的免疫改良格拉斯哥预后评分（imGPS），可作为头颈部鳞状细胞癌患者的预后标志物。本研究旨在探讨imGPS作为帕博利珠单抗治疗复发转移性头颈部癌（RMHNC）疗效预测标志物的价值。方法：本研究纳入2019年12月至2024年4月期间接受帕博利珠单抗治疗的RMHNC患者。提取白蛋白（ALB）、C反应蛋白（CRP）、淋巴细胞计数、中性粒细胞与淋巴细胞比值（NLR）、mGPS及imGPS作为生物标志物，分析各指标与治疗反应率及预后的相关性。结果：共纳入54例患者。淋巴细胞计数与总缓解率（ORR）显著相关（p=0.0082）。虽然mGPS在ORR方面未显示显著差异，但imGPS显示出显著差异（p=0.013）。CRP、ALB和淋巴细胞计数与总生存期（OS）和/或无进展生存期（PFS）相关。NLR、mGPS和imGPS亦与OS和/或PFS相关，其中imGPS的曲线下面积最大（OS：AUC=0.795；PFS：AUC=0.754）。结论：本研究表明imGPS是预测帕博利珠单抗治疗RMHNC疗效及预后的优良标志物。imGPS可通过日常血液检测实现，凸显了其高可靠性预测免疫检查点抑制剂疗效的应用潜力。
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