Fausti Valentina, De Vita Alessandro, Vanni Silvia, Ghini Virginia, Gurrieri Lorena, Riva Nada, Casadei Roberto, Maraldi Marco, Ercolani Giorgio, Cavaliere Davide, Pacilio Carlo Alberto, Pieri Federica, Foca Flavia, Bongiovanni Alberto, Ranallo Nicoletta, Calpona Sebastiano, Frassineti Giovanni Luca, Ibrahim Toni, Mercatali Laura
Clinical and Experimental Oncology, Immunotherapy, Rare Cancers and Biological Resource Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.
Preclinic and Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.
Cancers (Basel). 2023 Feb 8;15(4):1080. doi: 10.3390/cancers15041080.
A second-line standard of treatment has not yet been identified in patients with soft tissue sarcomas (STS), so identifying predictive markers could be a valuable tool. Recent studies have shown that the intratumoral and inflammatory systems significantly influence tumor aggressiveness. We aimed to investigate prognostic values of pre-therapy neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory index (SII), progression-free survival (PFS), and overall survival (OS) of STS patients receiving second-line treatment. In this single-center retrospective analysis, ninety-nine patients with STS were enrolled. All patients received second-line treatment after progressing to anthracycline. PFS and OS curves were calculated using the Kaplan-Meier method of RNA sequencing, and CIBERSORT analysis was performed on six surgical specimens of liposarcoma patients. A high NLR, PLR, and SII were significantly associated with worse PFS ( = 0.019; = 0.004; = 0.006). Low LMR was significantly associated with worse OS ( = 0.006). Patients treated with Trabectedin showed a better PFS when the LMR was low, while patients treated with other regimens showed a worse PFS when the LMR was low ( = 0.0154). The intratumoral immune infiltrates analysis seems to show a correlation between intratumoral macrophages and LMR. PS ECOG. The metastatic onset and tumor burden showed prognostic significance for PFS ( = 0.004; = 0.041; = 0.0086). According to the histologies, PFS was: 5.7 mo in liposarcoma patients vs. 3.8 mo in leiomyosarcoma patients vs. 3.1 months in patients with other histologies ( = 0.053). Our results confirm the prognostic role of systemic inflammatory markers in patients with STS. Moreover, we demonstrated that LMR is a specific predictor of Trabectedin efficacy and could be useful in daily clinical practice. We also highlighted a possible correlation between LMR levels and the percentage of intratumoral macrophages.
软组织肉瘤（STS）患者的二线标准治疗方案尚未确定，因此识别预测标志物可能是一种有价值的工具。最近的研究表明，肿瘤内和炎症系统会显著影响肿瘤的侵袭性。我们旨在研究接受二线治疗的STS患者治疗前中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）、全身炎症指数（SII）、无进展生存期（PFS）和总生存期（OS）的预后价值。在这项单中心回顾性分析中，纳入了99例STS患者。所有患者在蒽环类药物治疗进展后接受二线治疗。使用RNA测序的Kaplan-Meier方法计算PFS和OS曲线，并对6例脂肪肉瘤患者的手术标本进行CIBERSORT分析。高NLR、PLR和SII与较差的PFS显著相关（P = 0.019；P = 0.004；P = 0.006）。低LMR与较差的OS显著相关（P = 0.006）。当LMR较低时，接受曲贝替定治疗的患者PFS较好，而接受其他治疗方案的患者在LMR较低时PFS较差（P = 0.0154）。肿瘤内免疫浸润分析似乎显示肿瘤内巨噬细胞与LMR之间存在相关性。PS ECOG。转移的发生和肿瘤负荷对PFS具有预后意义（P = 0.004；P = 0.041；P = 0.0086）。根据组织学类型，PFS分别为：脂肪肉瘤患者5.7个月，平滑肌肉瘤患者3.8个月，其他组织学类型患者3.1个月（P = 0.053）。我们的结果证实了全身炎症标志物在STS患者中的预后作用。此外，我们证明LMR是曲贝替定疗效的特异性预测指标，在日常临床实践中可能有用。我们还强调了LMR水平与肿瘤内巨噬细胞百分比之间可能存在的相关性。
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