Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Careggi University Hospital, Clinical Oncology, Florence, Italy.
Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy.
Clin Genitourin Cancer. 2024 Aug;22(4):102099. doi: 10.1016/j.clgc.2024.102099. Epub 2024 Apr 24.
Neutrophil-to-eosinophil ratio (NER) has been described to be associated with outcomes to immune checkpoint inhibitors (ICI) in several tumor types, but less is known about its role of in the response to avelumab in advanced urothelial cancer (aUC). Thus, we reported outcomes by NER of aUC patients treated with avelumab as maintenance after initial response to platinum-based chemotherapy and enrolled in the Maintenance with AVeLumAb ([MALVA] in advanced urothelial neoplasms in response to first-line chemotherapy: an observational retrospective study) study (Meet-URO 25).
Median NER at baseline and after 3 cycles of avelumab were calculated. Progression-free survival (PFS) and overall survival (OS) by NER were reported.
At the cutoff date (April 15, 2023), a total of 109 patients were included. The median NER was 28.05 at baseline and 24.46 after 3 cycles of avelumab, respectively. Median PFS was not reached for patients with baseline NER less than the median (<median) compared to 5.1 months for patients with baseline NER greater than the median (≥median) (P = .0005). Median OS was significantly longer for patients with baseline NER <median compared with patients with baseline NER ≥median (not reached vs. 11.7 months, respectively; P = .0016). Significantly better PFS and OS were confirmed for NER after 3 cycles of avelumab <median compared with NER ≥median at the same timepoint.
NER <median may be predictive of PFS in aUC patients treated with avelumab, and prognostic for OS regardless of treatment. Prospective studies are warranted to validate NER as a readily available and reproducible laboratory-biomarker for efficacy outcomes of avelumab in aUC.
中性粒细胞与嗜酸性粒细胞比值（NER）已被描述与几种肿瘤类型的免疫检查点抑制剂（ICI）的疗效相关，但对于 NER 在avelumab 治疗晚期尿路上皮癌（aUC）中的作用知之甚少。因此，我们报告了在初始铂类化疗后接受 avelumab 维持治疗的 aUC 患者的结局，这些患者来自 Maintenance with AVeLumAb（[MALVA] in advanced urothelial neoplasms in response to first-line chemotherapy: an observational retrospective study）研究（Meet-URO 25）。
计算基线和avelumab 治疗 3 个周期后的中位 NER。根据 NER 报告无进展生存期（PFS）和总生存期（OS）。
在截止日期（2023 年 4 月 15 日），共纳入 109 例患者。基线时的中位 NER 为 28.05，avelumab 治疗 3 个周期后的中位 NER 为 24.46。基线 NER<中位数的患者中位 PFS未达到，而基线 NER>中位数的患者中位 PFS为 5.1 个月（P =.0005）。基线 NER<中位数的患者中位 OS 显著长于基线 NER≥中位数的患者（分别为未达到与 11.7 个月；P =.0016）。在相同时间点，avelumab 治疗 3 个周期后的 NER<中位数与 NER≥中位数相比，PFS 和 OS 显著更好。
NER<中位数可能是 aUC 患者接受 avelumab 治疗的 PFS 的预测因素，无论治疗情况如何，均可预测 OS。需要前瞻性研究来验证 NER 是否可作为预测 avelumab 治疗 aUC 疗效的一种易于获取且可重复的实验室生物标志物。
