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乐伐替尼治疗间变性甲状腺癌时的炎症生物标志物及中性粒细胞与淋巴细胞比值的动态变化

Inflammatory biomarkers and dynamics of neutrophil-to-lymphocyte ratio in lenvatinib treatment for anaplastic thyroid carcinoma.

作者信息

Yamazaki Haruhiko, Iwasaki Hiroyuki, Suganuma Nobuyasu, Toda Soji, Masudo Katsuhiko, Nakayama Hirotaka, Rino Yasushi, Masuda Munetaka

机构信息

Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, Nakao, Asahi-ku, Yokohama City, Kanagawa, Japan.

Department of Surgery, Yokohama City University School of Medicine, Fukuura, Kanazawa-ku, Yokohama City, Kanagawa, Japan.

出版信息

Gland Surg. 2021 Mar;10(3):852-860. doi: 10.21037/gs-20-871.

Abstract

BACKGROUND

Inflammatory biomarkers have been reported to be associated with anticancer drug efficacy in various cancers. This study aimed to investigate the associations between baseline inflammatory biomarkers or dynamics of neutrophil-to-lymphocyte ratio (NLR) and treatment outcomes of lenvatinib in ATC.

METHODS

Twenty ATC patients whose complete blood count were available were included in this study. Patients characteristics, overall survival (OS), and the associations between baseline inflammatory biomarkers or dynamics of NLR and treatment outcomes of lenvatinib were investigated.

RESULTS

All 20 patients had a median baseline NLR of 4.5 (range, 1.4-19.7), a median platelet-to-lymphocyte ratio (PLR) of 169.9 (range, 66.8-671.1), and a median lymphocyte-to-monocyte ratio (LMR) of 2.6 (range, 0.5-5.5). The median OS was 4.2 (95% CI: 1.1-10.3) months in patients with baseline NLR ≤4.5 and 3.1 (95% CI: 1.1-8.3) months in patients with baseline NLR >4.5 (P=0.681). The median OS was 4.2 (95% CI: 1.1-7.8) months in patients with baseline PLR ≤169.9 and 3.9 (95% CI: 0.6-8.3) months in patients with baseline PLR >169.9 (P=0.822). The median OS was 3.7 (95% CI: 1.1-9.8) months in patients with baseline LMR ≤2.6 and 4.2 (95% CI: 0.6-5.4) months in patients with baseline LMR >2.6 (P=0.421). NLR was increased more than the standard deviation of the baseline NLR after lenvatinib initiation in two of 16 patients with follow-up NLR data available. The median OS was 2.0 (95% CI: 1.1- not estimable) months in the increased group but was 5.3 (95% CI: 3.1-9.8) months in the non-increased group (P=0.003).

CONCLUSIONS

There was seemed to be no association between prognosis or treatment efficacy of lenvatinib and baseline inflammatory biomarker values in our cases with ATC. However, we possibly estimate prognosis for ATC during lenvatinib treatment by observing the dynamics of NLR.

摘要

背景

炎症生物标志物已被报道与多种癌症的抗癌药物疗效相关。本研究旨在探讨基线炎症生物标志物或中性粒细胞与淋巴细胞比值(NLR)动态变化与甲状腺未分化癌(ATC)患者使用乐伐替尼治疗结局之间的关联。

方法

本研究纳入了20例有全血细胞计数数据的ATC患者。调查了患者特征、总生存期(OS),以及基线炎症生物标志物或NLR动态变化与乐伐替尼治疗结局之间的关联。

结果

所有20例患者的基线NLR中位数为4.5(范围:1.4 - 19.7),血小板与淋巴细胞比值(PLR)中位数为169.9(范围:66.8 - 671.1),淋巴细胞与单核细胞比值(LMR)中位数为2.6(范围:0.5 - 5.5)。基线NLR≤4.5的患者中位OS为4.2(95%CI:1.1 - 10.3)个月,基线NLR>4.5的患者中位OS为3.1(95%CI:1.1 - 8.3)个月(P = 0.681)。基线PLR≤169.9的患者中位OS为4.2(95%CI:1.1 - 7.8)个月,基线PLR>169.9的患者中位OS为3.9(95%CI:0.6 - 8.3)个月(P = 0.822)。基线LMR≤2.6的患者中位OS为3.7(95%CI:1.1 - 9.8)个月,基线LMR>2.6的患者中位OS为4.2(95%CI:0.6 - 5.4)个月(P = 0.421)。在有随访NLR数据的16例患者中,2例在开始使用乐伐替尼后NLR升高超过基线NLR的标准差。升高组的中位OS为2.0(95%CI:1.1 - 不可估计)个月,未升高组为5.3(95%CI:3.1 - 9.8)个月(P = 0.003)。

结论

在我们的ATC病例中,乐伐替尼的预后或治疗疗效与基线炎症生物标志物值之间似乎没有关联。然而,我们可能通过观察NLR的动态变化来评估ATC患者在乐伐替尼治疗期间的预后。

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