Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China.
Sci Rep. 2024 Aug 23;14(1):19583. doi: 10.1038/s41598-024-68048-9.
A high baseline NLR is associated with a poor prognosis of immunotherapy in patients with advanced HCC. As anti-tumour immune activation takes time, early dynamic changes in NLR may serve as a biomarker for predicting immunotherapy response. We conducted a retrospective study in which we enrolled 209 patients with aHCC who received ICIs (training cohort: N = 121, validation cohort: N = 88). In the training cohort, we categorized the patients based on the early changes in their NLR. Specifically, we defined patients as NLR Stable-Responder, NLR Responder and NLR Non-Responder. We compared the outcomes of these three patient groups using survival analysis. Additionally, we shortened the observation period to 6 weeks and validated the findings in the validation cohort. In the training cohort, early dynamic changes in NLR (HR 0.14, 95%CI 0.03-0.65, p = 0.012, HR 0.19, 95%CI 0.07-0.54, p = 0.002; HR 0.21, 95%CI 0.10-0.42, p < 0.001, HR 0.40, 95%CI 0.23-0.69, p = 0.001), PD-L1 < 1% (HR 5.36, 95%CI 1.12-25.66, p = 0.036; HR 2.98, 95%CI 1.51-5.91, p = 0.002) and MVI (HR 3.52, 95%CI 1.28-9.69, p = 0.015; HR 1.99, 95%CI 1.14-3.47, p = 0.015) were identified as independent predictors of OS and PFS. In the validation cohort, when the observation period was reduced to 6 weeks, early NLR changes still have predictive value. Early dynamic changes in NLR may be an easily defined, cost-effective, non-invasive biomarker to predict aHCC response to ICIs.
高基线 NLR 与晚期 HCC 患者免疫治疗的预后不良相关。由于抗肿瘤免疫激活需要时间，NLR 的早期动态变化可能成为预测免疫治疗反应的生物标志物。我们进行了一项回顾性研究，纳入了接受 ICI 治疗的 209 例 aHCC 患者（训练队列：N=121，验证队列：N=88）。在训练队列中，我们根据 NLR 的早期变化对患者进行分类。具体来说，我们将患者定义为 NLR 稳定应答者、NLR 应答者和 NLR 无应答者。我们使用生存分析比较了这三组患者的结局。此外，我们将观察期缩短至 6 周，并在验证队列中验证了这些发现。在训练队列中，NLR 的早期动态变化（HR 0.14，95%CI 0.03-0.65，p=0.012，HR 0.19，95%CI 0.07-0.54，p=0.002；HR 0.21，95%CI 0.10-0.42，p<0.001，HR 0.40，95%CI 0.23-0.69，p=0.001）、PD-L1<1%（HR 5.36，95%CI 1.12-25.66，p=0.036；HR 2.98，95%CI 1.51-5.91，p=0.002）和 MVI（HR 3.52，95%CI 1.28-9.69，p=0.015；HR 1.99，95%CI 1.14-3.47，p=0.015）被确定为 OS 和 PFS 的独立预测因素。在验证队列中，当观察期缩短至 6 周时，早期 NLR 变化仍具有预测价值。NLR 的早期动态变化可能是一种易于定义、具有成本效益、非侵入性的生物标志物，可预测 aHCC 对 ICI 的反应。
