학술논문
Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Biomarkers in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab
Document Type
article
Author
Yue Linda Wu; Claudia Angela Maria Fulgenzi; Antonio D’Alessio; Jaekyung Cheon; Naoshi Nishida; Anwaar Saeed; Brooke Wietharn; Antonella Cammarota; Tiziana Pressiani; Nicola Personeni; Matthias Pinter; Bernhard Scheiner; Lorenz Balcar; Yi-Hsiang Huang; Samuel Phen; Abdul Rafeh Naqash; Caterina Vivaldi; Francesca Salani; Gianluca Masi; Dominik Bettinger; Arndt Vogel; Martin Schönlein; Johann von Felden; Kornelius Schulze; Henning Wege; Peter R. Galle; Masatoshi Kudo; Lorenza Rimassa; Amit G. Singal; Rohini Sharma; Alessio Cortellini; Vincent E. Gaillard; Hong Jae Chon; David J. Pinato; Celina Ang
Source
Cancers, Vol 14, Iss 23, p 5834 (2022)
Subject
Language
English
ISSN
2072-6694
Abstract
Systemic inflammation is a key risk factor for hepatocellular carcinoma (HCC) progression and poor outcomes. Inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may have prognostic value in HCC treated with standard of care atezolizumab plus bevacizumab (Atezo-Bev). We conducted a multicenter, international retrospective cohort study of patients with unresectable HCC treated with Atezo-Bev to assess the association of NLR and PLR with overall survival (OS), progression-free survival (PFS), and objective response rates. Patients with NLR ≥ 5 had a significantly shorter OS (9.38 vs. 16.79 months, p < 0.001) and PFS (4.90 vs. 7.58 months, p = 0.03) compared to patients with NLR < 5. NLR ≥ 5 was an independent prognosticator of worse OS (HR 2.01, 95% CI 1.22–3.56, p = 0.007) but not PFS. PLR ≥ 300 was also significantly associated with decreased OS (9.38 vs. 15.72 months, p = 0.007) and PFS (3.45 vs. 7.11 months, p = 0.04) compared to PLR < 300, but it was not an independent prognosticator of OS or PFS. NLR and PLR were not associated with objective response or disease control rates. NLR ≥ 5 independently prognosticated worse survival outcomes and is worthy of further study and validation.