Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Pulmonary Medicine, Henan Provincial People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou, Henan, China.
Ann Med. 2024 Dec;56(1):2413415. doi: 10.1080/07853890.2024.2413415. Epub 2024 Oct 9.
The prognostic significance of the systemic inflammatory response index (SIRI) in patients with cancer receiving programmed cell death 1 (PD-1)/PD-1 ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) has been widely investigated; however, the results have been conflicting. As such, the present meta-analysis aimed to analyze the precise significance of the SIRI in predicting prognosis in patients with cancer undergoing ICI therapy.
A comprehensive literature search of the Web of Science, PubMed, Embase, and Cochrane Library databases for relevant studies, published from inception to April 25, 2024, was performed. The SIRI was analyzed for its prognostic utility in patients undergoing ICI therapy by calculating combined hazard ratios (HRs) and corresponding 95% confidence intervals (CIs).
Six studies comprising 1133 patients were included in the analysis. Pooled data revealed that a higher SIRI was significantly associated with poor overall survival (OS) (HR 1.96 [95% CI 1.55-2.47]; < 0.001) and progression-free survival (PFS) (HR 1.41 [95% CI 1.19-1.67]; < 0.001) for patients who underwent PD-1/PD-L1 ICI treatment. Subgroup analysis revealed that SIRI was markedly associated with dismal OS and PFS, independent of sample size, cut-off value, and survival analysis ( < 0.05). The findings were verified to be robust against publication bias and sensitivity analyses.
In summary, an elevated SIRI was significantly associated with OS and PFS in patients with cancer undergoing PD-1/PD-L1 ICI treatment. SIRI may a candidate indicator for predicting the prognosis of patients undergoing ICI therapy.
全身性炎症反应指数（SIRI）在接受程序性细胞死亡 1（PD-1）/PD-1 配体 1（PD-L1）免疫检查点抑制剂（ICI）治疗的癌症患者中的预后意义已被广泛研究；然而，结果却存在矛盾。因此，本荟萃分析旨在分析 SIRI 在预测接受 ICI 治疗的癌症患者预后中的精确意义。
对 Web of Science、PubMed、Embase 和 Cochrane Library 数据库进行全面文献检索，检索时间截至 2024 年 4 月 25 日，检索与 SIRI 在接受 ICI 治疗的患者中的预后价值相关的研究。通过计算合并风险比（HR）和相应的 95%置信区间（CI）来分析 SIRI 的预后作用。
纳入的 6 项研究共包含 1133 例患者。汇总数据显示，较高的 SIRI 与接受 PD-1/PD-L1 ICI 治疗的患者较差的总生存期（OS）（HR 1.96 [95% CI 1.55-2.47]；<0.001）和无进展生存期（PFS）（HR 1.41 [95% CI 1.19-1.67]；<0.001）显著相关。亚组分析显示，SIRI 与较差的 OS 和 PFS 显著相关，与样本量、截断值和生存分析无关（<0.05）。研究结果在考虑到发表偏倚和敏感性分析后仍然稳健。
总之，升高的 SIRI 与接受 PD-1/PD-L1 ICI 治疗的癌症患者的 OS 和 PFS 显著相关。SIRI 可能是预测接受 ICI 治疗的患者预后的候选指标。
