Characterization of Age-Associated, Neutrophil-to-Lymphocyte Ratio (NLR) and Systemic Immune-Inflammatory Index (SII) as Biomarkers of Inflammation in Geriatric Patients with Cancer Treated with Immune Checkpoint Inhibitors: Impact on Efficacy and Survival
Year: 2023
Type: article
Study design: Observational Study
Abstract: Background: Geriatric patients (≥80 years) are underrepresented in immune checkpoint inhibitor (ICIs) clinical trials. However, their unique biology may affect their response to ICIs. There are currently no established biomarkers of the response to ICIs in adult patients with cancer that can help with patient selection. Methods: We built a multicenter, international retrospective study of 885 patients (<80 years: n = 417, 47.12%; ≥80 years: n = 468, 52.88%) with different tumor types treated with ICIs between 2011 and 2021 from 11 academic centers in the U.S. and Europe. The main outcome measures were objective response rates (ORR), progression-free survival (PFS) and overall survival (OS) stratified by age and circulating inflammatory levels (neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammatory index (SII)). Results: Patients ≥80 years with low NLR (NLR-L) and SII (SII-L) had significantly higher ORR (vs. high NLR [NLR-H], p < 0.01 and SII-H, p < 0.05, respectively). At median follow-ups (13.03 months), and compared to SII-H, patients with SII-L had significantly longer median PFS and OS in patients <80 (p < 0.001), and ≥80 years (p < 0.001). SII-L was independently associated with longer PFS and OS (HR: 0.61 and 0.62, respectively, p < 0.01). Conclusion: Lower inflammation pre-ICI initiation may predict an improved response and survival in geriatric patients with cancer.
Source: Cancers
Authors: Khalil Choucair, Caroline Nebhan, Alessio Cortellini, Stijn Hentzen, Yinghong Wang, Cynthia Liu, Raffaele Giusti, Marco Filetti, Paolo Antonio Ascierto, Vito Vanella, Domenico Galetta, Annamaria Catino, Nour Al-Bzour, Azhar Saeed, Ludimila Cavalcante, Pamela Pizzutilo, Carlo Genova, Melissa Bersanelli, Sebastiano Buti, Douglas B. Johnson, Claudia Angela Maria Fulgenzi, David J. Pinato, Maluki Radford, Chul Kim, Abdul Rafeh Naqash, Anwaar Saeed
Institutions: Wayne State University, The Barbara Ann Karmanos Cancer Institute, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Hammersmith Hospital, Campus Bio Medico University Hospital, Imperial College London, University of Kansas Medical Center, The University of Texas MD Anderson Cancer Center, Baylor College of Medicine, Azienda Ospedaliera Sant'Andrea, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Istituto Tumori Bari, University of Pittsburgh, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, University of Vermont Medical Center, Novant Health, Ospedale Policlinico San Martino, University of Genoa, University of Parma, Georgetown University, Georgetown Lombardi Comprehensive Cancer Center, OU Health Stephenson Cancer Center, University of Oklahoma
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,892
OpenAlex ID: W4387775546