Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Arthur G. James Cancer Hospital, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Arthur G. James Cancer Hospital, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America.
Gynecol Oncol. 2022 Sep;166(3):522-529. doi: 10.1016/j.ygyno.2022.07.010. Epub 2022 Jul 28.
To determine the association of pre-treatment neutrophil-to-lymphocyte ratio (NLR) with progression-free survival (PFS) and overall survival (OS) for patients with recurrent endometrial cancer (EC) treated with immunotherapy.
Recurrent EC patients treated with immunotherapy alone or in combination from 2016 to 2021 were included. Demographics, pre-treatment laboratory results, pathologic data, response at first radiographic assessment, and cancer outcomes were obtained from the medical record. Kaplan-Meier curves were generated to compare PFS and OS stratified by NLR.
The 106 patients included in the study were stratified by NLR <6 (n = 77, 72.6%) or NLR ≥6 (n = 29, 27.3%). Most had endometrioid pathology (59%), widely metastatic disease, and 36.8% had received ≥2 treatment lines before initiating immunotherapy. Mismatch repair deficiency (dMMR) was noted in 52 (49.1%) tumors. Most dMMR patients (94.3%) were treated with single-agent pembrolizumab, and most MMR proficient patients (78.7%) were treated with lenvatinb plus pembrolizumab. In the overall cohort, 40.2% (partial response (PR) 29.9%, complete response (CR) 10.4%) of patients with a NLR <6 responded at first radiographic assessment, compared to 31% (PR 27.5%, CR 3.4%) of patients with NLR ≥6 (p 0.691). Kaplan-Meier curves stratified by NLR <6 vs. ≥6 showed no difference in PFS. However, NLR <6 was associated with improved OS (p < 0.05). In the NLR < 6 group, the probability of survival at one year was 69% (95% CI: 58%, 82%), compared to 41% (95% CI: 26%, 67%) for the NLR > 6 group.
Pre-treatment NLR <6 was associated with improved OS for recurrent EC patients treated with immunotherapy. NLR holds promise as a predictive biomarker for survival after immunotherapy treatment for patients with recurrent EC.
确定治疗复发性子宫内膜癌（EC）患者的中性粒细胞与淋巴细胞比值（NLR）与无进展生存期（PFS）和总生存期（OS）的相关性。
纳入 2016 年至 2021 年接受免疫治疗的单独或联合免疫治疗的复发性 EC 患者。从病历中获得人口统计学、治疗前实验室结果、病理数据、首次影像学评估时的反应以及癌症结局。通过 Kaplan-Meier 曲线比较 NLR 分层的 PFS 和 OS。
该研究共纳入 106 例患者，根据 NLR<6（n=77，72.6%）或 NLR≥6（n=29，27.3%）进行分层。大多数患者具有子宫内膜样病理（59%），广泛转移性疾病，36.8%在开始免疫治疗前接受了≥2 线治疗。52 例（49.1%）肿瘤存在错配修复缺陷（dMMR）。大多数 dMMR 患者（94.3%）接受了单药 pembrolizumab 治疗，大多数 MMR 阳性患者（78.7%）接受了 lenvatinb 联合 pembrolizumab 治疗。在整个队列中，NLR<6 的患者中有 40.2%（部分缓解（PR）29.9%，完全缓解（CR）10.4%）在首次影像学评估时出现反应，而 NLR≥6 的患者中有 31%（PR 27.5%，CR 3.4%）（p=0.691）。根据 NLR<6 与 NLR≥6 分层的 Kaplan-Meier 曲线显示，PFS 无差异。然而，NLR<6 与 OS 改善相关（p<0.05）。在 NLR<6 组中，一年生存率为 69%（95%CI：58%，82%），而 NLR>6 组为 41%（95%CI：26%，67%）。
复发性 EC 患者接受免疫治疗时，治疗前 NLR<6 与 OS 改善相关。NLR 有望成为预测复发性 EC 患者免疫治疗后生存的生物标志物。
