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Pecci F, Cognigni V, Giudice GC, Paoloni F, Cantini L, Saini KS, Abushukair HM, Naqash AR, Cortellini A, Mazzaschi G, Alia S, Membrino V, Araldi E, Tiseo M, Buti S, Vignini A, Berardi R. Unraveling the link between cholesterol and immune system in cancer: From biological mechanistic insights to clinical evidence. A narrative review. Crit Rev Oncol Hematol 2025; 209:104654. [PMID: 39923921 DOI: 10.1016/j.critrevonc.2025.104654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 01/29/2025] [Accepted: 02/04/2025] [Indexed: 02/11/2025] Open
Abstract
Cholesterol and its metabolism seem to be involved not only in cancer progression but also in immune cells activity. In this comprehensive review, we summarize preclinical, translational, and clinical evidence regarding the crucial role of cholesterol and its metabolism in regulating the immune response against cancer cells, shedding light on the multifaceted mechanisms by which cholesterol influences immune cell function and anti-tumor immunity. By synthesizing findings from preclinical studies, we have elucidated the impact of cholesterol on immune cell activation, differentiation, and effector functions. These investigations have revealed that cholesterol metabolism plays a pivotal role in shaping the immune response, with alterations in cholesterol levels directly impacting immune cell behavior and anti-tumor activity. All the steps related to cholesterol metabolism, including its de-novo synthesis, its influx and efflux mechanisms, as well as its metabolites, have a distinct impact on immune cells function and activity, which, if altered, might influence tumor progression. In addition, we have reviewed clinical studies investigating the role of circulating cholesterol on outcomes of patients with advanced tumors treated with immune checkpoint inhibitors, highlighting again in a clinical scenario the correlation between cholesterol and the immune system. Overall, our review emphasizes the importance of cholesterol and its metabolism in orchestrating the immune response against cancer cells. Herein we have provided a comprehensive overview of this emerging field by illustrating the intricate interplay between cholesterol and immune system.
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Affiliation(s)
- Federica Pecci
- Dana-Farber Cancer Institute, Boston, MA, USA; Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
| | - Valeria Cognigni
- Department of Medical Oncology, Università Politecnica delle Marche, AOU delle Marche, Ancona, Italy
| | - Giulia Claire Giudice
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Francesco Paoloni
- Department of Medical Oncology, Università Politecnica delle Marche, AOU delle Marche, Ancona, Italy
| | | | - Kamal S Saini
- Fortrea, Inc., Durham, NC, USA; Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Hassan Mohammed Abushukair
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, USA; Division of Oncology Sciences, University of Oklahoma Health Sciences Center, USA
| | - Abdul Rafeh Naqash
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, USA; Division of Oncology Sciences, University of Oklahoma Health Sciences Center, USA; Medical Oncology/TSET Phase 1 Program, Stephenson Cancer Center, The University of Oklahoma, Oklahoma City, OK, USA
| | - Alessio Cortellini
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy; Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, UK
| | - Giulia Mazzaschi
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Sonila Alia
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy
| | - Valentina Membrino
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy
| | - Elisa Araldi
- Systems Medicine Laboratory, Department of Medicine and Surgery (DiMeC), Università degli Studi di Parma, Parma, Italy; Preventive Cardiology and Preventive Medicine, University Medical Center Of The Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Germany
| | - Marcello Tiseo
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Sebastiano Buti
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Arianna Vignini
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy; Research Center of Health Education and Health Promotion, Università Politecnica delle Marche, Ancona, Italy
| | - Rossana Berardi
- Department of Medical Oncology, Università Politecnica delle Marche, AOU delle Marche, Ancona, Italy
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Horisaki K, Yoshikawa S, Mori S, Omata W, Tsutsumida A, Kiyohara Y. Prognostic value of the CONUT score with immune checkpoint inhibitors as first-line therapy for metastatic malignant melanoma. J Dermatol 2025; 52:615-623. [PMID: 39916640 PMCID: PMC11975212 DOI: 10.1111/1346-8138.17613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 12/13/2024] [Accepted: 12/20/2024] [Indexed: 04/08/2025]
Abstract
The recent availability of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced malignant melanoma (MM). However, many patients with MM do not benefit from ICI treatment. As immunotherapy is associated with significant toxicity and high treatment costs despite its excellent efficacy, it is pertinent to select patients who are likely to respond to ICIs. In this single-center, retrospective study we investigated whether the controlling nutritional status (CONUT) score is a useful prognostic marker in Japanese patients with advanced-stage cancer. We analyzed 123 patients with stage IV MM treated with ICIs as first-line systemic treatment at our hospital between February 2012 and July 2024. Receiver operating characteristic curve analysis was used to calculate the CONUT cut-off value and CONUT into two groups of ≥3 and ≤2. Progression-free survival (PFS) and overall survival (OS) were determined using the Kaplan-Meier method, and differences in survival were assessed using the log-rank test. The Cox proportional hazard regression model was used to evaluate independent prognostic factors. Objective response rate (ORR), PFS, and OS were significantly low in the CONUT ≥3 group, characterized by low nutritional status and high inflammation. Multivariate analysis identified the CONUT score as an independent prognostic factor for both PFS and OS. The CONUT score was not significantly associated with the development of serious immune-related adverse events. The simplicity of the CONUT score may aid in identifying patients with MM who are suitable candidates for ICI treatment.
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Affiliation(s)
- Ken Horisaki
- Department of DermatologyShizuoka Cancer CenterShizuokaJapan
- Department of DermatologyNagoya University Graduate School of MedicineNagoyaJapan
| | | | - Shoichiro Mori
- Department of DermatologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Wataru Omata
- Department of DermatologyShizuoka Cancer CenterShizuokaJapan
| | | | - Yoshio Kiyohara
- Department of DermatologyShizuoka Cancer CenterShizuokaJapan
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Tang W, Li C, Huang D, Zhou S, Zheng H, Wang Q, Zhang X, Fu J. NRS2002 score as a prognostic factor in solid tumors treated with immune checkpoint inhibitor therapy: a real-world evidence analysis. Cancer Biol Ther 2024; 25:2358551. [PMID: 38813753 PMCID: PMC11141475 DOI: 10.1080/15384047.2024.2358551] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 05/17/2024] [Indexed: 05/31/2024] Open
Abstract
To observe the antitumour efficacy of programmed death 1 (PD-1) inhibitors in the real world and explore the relationship between NRS2002 score or other clinical characteristics and immunotherapy efficacy, we retrospectively analyzed 341 tumor patients who received immune checkpoint inhibitor (ICI) treatment at one center. A total of 341 solid tumor patients treated with ICIs from June 2018 to December 2021 were retrospectively included in this study. Patient characteristics, ICI responses, and survival status were documented, and the relationships between clinical factors and survival were analyzed. Among all patients, the median progression-free survival (PFS) was 5.8 months, and the median overall survival (OS) was 12.5 months. The Performance Status (PS), NRS2002 score, The Naples Prognostic Score (NPS), Lymphocyte and C-reactive protein ratio (LCR), line of therapy, and nutritional support were significantly related to PFS or OS according to univariate analysis. The median PFS and OS were significantly better in the group without nutritional risk (NRS2002 0-2) than those with nutritional risk (NRS2002 ≥ 3) (PFS: HR = 1.82, 95% CI 1.30-2.54, p value < .001; OS: HR = 2.49, 95% CI 1.73-3.59, p value < .001). Cox regression analysis revealed that the NRS2002 score was an independent prognostic factor for both PFS and OS. The objective response rate (ORR) in the group at nutritional risk was lower than that in the group without nutritional risk (8.33% and 19.71%, respectively, p value = .037). Patients at nutritional risk according to the NRS2002 score at initial treatment had a poorer prognosis than those without nutritional risk. The NRS2002 could be used as a preliminary index to predict the efficacy of immune checkpoint inhibitor therapy.
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Affiliation(s)
- Wanfen Tang
- Department of Medical Oncology, Jinhua Municipal Central Hospital, Hangzhou, China
| | - Chenghui Li
- Department of Medical Oncology, Jinhua Municipal Central Hospital, Hangzhou, China
| | - Dong Huang
- Department of Colorectal Surgery, Jinhua Municipal Central Hospital, Hangzhou, China
| | - Shishi Zhou
- Department of Medical Oncology, Jinhua Municipal Central Hospital, Hangzhou, China
| | - Hongjuan Zheng
- Department of Medical Oncology, Jinhua Municipal Central Hospital, Hangzhou, China
| | - Qinghua Wang
- Department of Medical Oncology, Jinhua Municipal Central Hospital, Hangzhou, China
| | - Xia Zhang
- Department of Medical Oncology, Jinhua Municipal Central Hospital, Hangzhou, China
| | - Jianfei Fu
- Department of Medical Oncology, Jinhua Municipal Central Hospital, Hangzhou, China
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Xu H, Zhang B, Zhang Y, Yang C, Bo C, Guo Y, Cheng Y, He L. Prognostic Significance of the Cachexia Index in Patients with Non-Small-Cell Lung Cancer and Brain Metastases after Stereotactic Radiotherapy. Clin Med Insights Oncol 2024; 18:11795549231222362. [PMID: 38440045 PMCID: PMC10910881 DOI: 10.1177/11795549231222362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 12/04/2023] [Indexed: 03/06/2024] Open
Abstract
Background The cachexia index (CXI) has been proposed as a novel biomarker of cancer cachexia. We aimed to investigate the association between CXI and survival outcomes after stereotactic radiotherapy (SRT) in patients with non-small cell lung cancer (NSCLC) and brain metastases. Methods Data from 145 patients with NSCLC, who underwent SRT for brain metastases between April 2016 and August 2020, were retrospectively analyzed. Cachexia index was calculated as skeletal muscle index (SMI) × serum albumin level/neutrophil-to-lymphocyte ratio, whereas SMI was calculated from computed tomography images captured at the L1 level. Kaplan-Meier curves and Cox proportional hazards models were used to assess progression-free survival (PFS) and overall survival (OS). The prognostic values of CXI and other cachexia biomarkers were assessed using receiver operating characteristic (ROC) curve analysis. Results Lower pretreatment CXI (<30.8) was significantly associated with older age (P = .039), lower Karnofsky performance score (P = .009), and a high likelihood of extracranial metastases (P = .001). Patients with a lower pretreatment CXI had a significantly shorter PFS and OS than those with a higher CXI (P < .001). Multivariate analysis revealed that pretreatment CXI was an independent risk factor for both PFS, hazard ratio (HR) = 2.375; 95% confidence interval (CI) = 1.610-3.504; P < .001, and OS, HR = 2.340; 95% CI = 1.562-3.505; P < .001. Compared with other biomarkers, pretreatment CXI had the highest area under the ROC curve value for prognostic assessment, reaching 0.734. Moreover, the loss of CXI was a strong risk factor for survival independent of pretreatment CXI (P = .011). Conclusions Cachexia index may serve as a clinically useful tool for predicting survival outcomes of patients with NSCLC and brain metastases who undergo SRT.
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Affiliation(s)
- Hui Xu
- Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bin Zhang
- Department of Emergency, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yongqian Zhang
- Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chunchun Yang
- Department of Digestion, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Changwen Bo
- Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuanyuan Guo
- Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuan Cheng
- School of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Li He
- Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China
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Rugambwa TK, Abdihamid O, Zhang X, Peng Y, Cai C, Shen H, Zeng S, Qiu W. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as potential predictive markers of treatment response in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis. Front Oncol 2023; 13:1181248. [PMID: 38023176 PMCID: PMC10646751 DOI: 10.3389/fonc.2023.1181248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background The role of platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) as independent prognostic markers in different tumors is well established. However, there is a limited review of the potential of NLR and PLR as predictors of treatment outcomes from immune checkpoint inhibitors (ICIs). Objective To establish a correlation between NLR and PLR and the potential of clinical benefit from ICIs. Methods The literature search was performed for studies that reported the association between NLR, PLR, and treatment outcomes among cancer patients treated with ICIs. The outcomes of interest were objective response rate (ORR), disease control rate (DCR), and progressive disease (PD). ORR was the summation of patients who achieved complete response and partial response. DCR included patients who achieved stable disease. PD was the proportion of patients who progressed, relapsed, or discontinued the treatment. Statistical analysis was performed using the STATA 12.0 package. Heterogeneity was determined by the I2 value. Quality assessment was performed using the Newcastle-Ottawa Scale. Egger's test was used to establish publication bias and sensitivity analysis. Results A total of 40 papers that met the inclusion criteria were included in the systematic review. However, only 17 studies were used in the meta-analysis to determine the correlation between NLR, PLR, and treatment response. We found that treatment with ICIs and monitoring of outcomes and adverse events using PLR and NLR parameters have been studied in different tumors. Our analysis showed that low NLR correlated with higher ORR (OR = 0.62 (95% CI 0.47-0.81, p = 0.001) and higher DCR (OR = 0.23, 95% CI 0.14-0.36, p < 0.001). Higher NLR predicted a higher probability of PD (OR = 3.12, 95% CI 1.44, 6.77, p = 0.004). Similarly, low PLR correlated with higher ORR (OR = 0.69, 95% CI 0.5, 0.95, p = 0.025). Generally, patients with low NLR and PLR were more likely to achieve clinical benefit and better response (p-value < 0.001). Meanwhile, patients with high ratios were more likely to progress (p-value < 0.005), although there was significant heterogeneity among studies. There was no significant publication bias observed. Conclusion The study showed that high NLR and PLR either at baseline or during treatment is associated with poorer treatment outcome. Therefore, these ratios can be utilized in clinical practice with other markers to determine treatment efficacy from immunotherapy.
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Affiliation(s)
- Tibera K. Rugambwa
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Internal Medicine, Mbeya Zonal Referral Hospital and Mbeya College of Health and Allied Sciences, University of Dar-es-salaam, Mbeya, Tanzania
| | - Omar Abdihamid
- Garissa Cancer Center, Garissa County Referral Hospital, Garissa, Kenya
| | - Xiangyang Zhang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yinghui Peng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Changjing Cai
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hong Shen
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shan Zeng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wei Qiu
- Department of Oncology, The First People's Hospital of Loudi, Loudi, Hunan, China
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Zhang J, Li M, Zhang L, Kuang T, Yu J, Wang W. Prognostic value of controlling nutritional status on clinical and survival outcomes in cancer patients treated with immunotherapy. Sci Rep 2023; 13:17715. [PMID: 37853186 PMCID: PMC10584918 DOI: 10.1038/s41598-023-45096-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/16/2023] [Indexed: 10/20/2023] Open
Abstract
Cancer is a leading cause of death globally. Immunotherapy has shown promise in treating various types of cancer, but its effectiveness varies among patients. The Controlling Nutritional Status (CONUT) score has been linked to the prognosis of different cancers. However, its predictive value for immunotherapy outcomes is not well understood. Our research represents the pioneering meta-study to examine the prognostic value of the CONUT score on cancer patients treated with an immune checkpoint inhibitor (ICI). A comprehensive literature search was conducted using various databases including PubMed, the Cochrane Library, EMBASE, and Google Scholar. The study was conducted until July 28, 2023. This analysis encompassed a comprehensive evaluation of various clinical outcomes, namely overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). 663 patients from 8 studies were included in this study. It showed that cancer patients with high CONUT score had poorer OS (HR: 1.94, 95% CI, 1.52-2.47, p < 0.001) and PFS (HR: 2.22, 95% CI, 1.48-3.31, p < 0.001), as well as worse ORR (OR: 0.46, 95% CI, 0.25-0.85, p = 0.013) and DCR (HR: 0.29, 95% CI, 0.14-0.59, p = 0.001). The CONUT score can predict the prognosis of tumor patients treated with ICIs.
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Affiliation(s)
- Jiacheng Zhang
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Man Li
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Lilong Zhang
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Tianrui Kuang
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Jia Yu
- Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China.
| | - Weixing Wang
- Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China.
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Qi W, Wang X, Li C, Li S, Li H, Xu F, Chen J, Zhao S, Li H. Pretreatment absolute lymphocyte count is an independent predictor for survival outcomes for esophageal squamous cell carcinoma patients treated with neoadjuvant chemoradiotherapy and pembrolizumab: An analysis from a prospective cohort. Thorac Cancer 2023; 14:1556-1566. [PMID: 37089116 PMCID: PMC10260499 DOI: 10.1111/1759-7714.14898] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/30/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND The aim of the study was to analyze the relationship between pretreatment inflammatory biomarkers (IBs) and survival outcomes for patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (neo-CRT) and pembrolizumab. METHODS Clinical variables and IBs (absolute monocyte count [AMC], absolute lymphocyte count [ALC], platelet count [PLT], neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR], pan-immune inflammation value [PIV], systemic immunoinflammatory index [SII], systemic immunoreactivity index [SIRI] and prognostic nutritional index [PNI]) were collected. Univariate and multivariate analysis were performed to identify the independent factors for outcomes of ESCC. RESULTS A total of 51 patients were included. Of these, 35 patients achieved pathological complete response (pCR) after neo-CRT and pembrolizumab (pCR: 68.6%). With a median follow-up of 20 months, the two-year PFS and OS of the cohort was 64% and 91%, respectively. Multivariate logistic regression analysis indicated that ALC (overall response [OR] 4.4, p = 0.051) and PLT (OR 6.7, p = 0.023) were two independent predictors for achieving pCR among ESCC treated with neo-CRT and pembrolizumab. Multivariate Cox regression analysis showed that ALC (HR 0.27, p = 0.028) and SIRI (HR 3.13, p = 0.048) were two independent predictors associated with PFS. Kaplan Meier analysis demonstrated that the PFS of ESCC with high baseline ALC was significantly better than those with low ALC (2-year PFS: 77% vs. 47%, p = 0.027), but not for overall survival (2-year OS: 96% vs. 87%, p = 0.46). CONCLUSIONS This retrospective analysis based on a prospective cohort for the first time demonstrates that pretreatment ALC is an independent predictor for achieving pCR and favorable outcomes of ESCC treated with neo-CRT and pembrolizumab.
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Affiliation(s)
- Wei‐Xiang Qi
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xiaoyan Wang
- Department of Radiation OncologyThe Third Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Chengqiang Li
- Department of Thoracic Surgery, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Shuyan Li
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Huan Li
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Feifei Xu
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Jiayi Chen
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Shengguang Zhao
- Department of Radiation Oncology, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Hecheng Li
- Department of Radiation OncologyThe Third Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
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Zhang Y, Kong FF, Zhu ZQ, Shan HX. Controlling Nutritional Status (CONUT) score is a prognostic marker in III-IV NSCLC patients receiving first-line chemotherapy. BMC Cancer 2023; 23:225. [PMID: 36894927 PMCID: PMC9999605 DOI: 10.1186/s12885-023-10682-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND To investigate the prognostic impact of the controlling nutritional status (CONUT) score in non-small-cell lung cancer (NSCLC) patients receiving first-line chemotherapy. METHODS We retrospectively reviewed 278 consecutive patients undergoing chemotherapy for stage III-IV NSCLC between May 2012 and July 2020. CONUT score was calculated by incorporating serum albumin, total cholesterol, and total lymphocyte count. The patients were divided into two groups: CONUT ≥ 3 and CONUT < 3, according to receiver operating characteristic (ROC) analysis. The associations of CONUT with clinicopathological factors and survival were evaluated. RESULTS A high CONUT score was significantly associated with older age(P = 0.003), worse ECOG-PS(P = 0.018), advanced clinical stage(P = 0.006), higher systematic inflammation index (SII) (P < 0.001)and lower prognostic nutritional index (PNI) (P < 0.001).The high CONUT group had a significantly shorter progression-free survival(PFS) and overall survival(OS) than the low CONUT group. In the univariate analysis, higher SII, higher CONUT, advanced clinical stage and lower PNI were associated with worse PFS (Pall < 0.05). Worse ECOG-PS, higher SII, higher CONUT, advanced clinical stage and lower PNI were associated with worse OS (Pall < 0.05). In multivariate analysis, CONUT(HR, 2.487; 95%CI 1.818 ~ 3.403; P < 0.001) was independently associated with PFS, while PNI(HR, 0.676; 95%CI 0.494 ~ 0.927; P = 0.015) and CONUT(HR, 2.186; 95%CI 1.591 ~ 3.002; P < 0.001)were independently associated with OS. In ROC analysis, CONUT had a higher area under the ROC curve (AUC) for the prediction of 24-month PFS and OS than the SII or PNI. When the time-dependent AUC curve was used to predict PFS and OS, CONUT tended to maintain its predictive accuracy for long-term prognosis at a significantly higher level for an extended period after chemotherapy when compared with the other markers tested. The CONUT score showed better accuracy of predicting OS (C-index: 0.711) and PFS(C-index: 0.753). CONCLUSION CONUT score is an independent prognostic indicator of poor outcomes for patients with stage III-IV NSCLC and is superior to the SII and PNI in terms of prognostic ability.
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Affiliation(s)
- Yi Zhang
- Department of Oncology, the Suqian Clinical College of Xuzhou Medical University, Suqian, 223800, Jiangsu, China
| | - Fei-Fei Kong
- Department of Oncology, the affiliated hospital of Xuzhou Medical University, Jiangsu, 221000, Xuzhou, China
| | - Zheng-Qiu Zhu
- Department of Oncology, the affiliated hospital of Xuzhou Medical University, Jiangsu, 221000, Xuzhou, China.
| | - Hai-Xia Shan
- Department of Oncology, the affiliated hospital of Xuzhou Medical University, Jiangsu, 221000, Xuzhou, China.
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Zou Z, Li J, Ji X, Wang T, Chen Q, Liu Z, Ji S. Naples Prognostic Score as an Independent Predictor of Survival Outcomes for Resected Locally Advanced Non-Small Cell Lung Cancer Patients After Neoadjuvant Treatment. J Inflamm Res 2023; 16:793-807. [PMID: 36860794 PMCID: PMC9969868 DOI: 10.2147/jir.s401446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Background The Naples Prognostic Score (NPS) can reflect patient's nutritional and inflammatory status, which is identified as a prognostic indicator for various malignant tumors. However, its significance in patients with resected locally advanced non-small cell lung cancer (LA-NSCLC) patients who receive neoadjuvant treatment remains unclear so far. Methods A total of 165 LA-NSCLC patients surgically treated from May 2012 to November 2017 were retrospectively investigated. The LA-NSCLC patients were divided into three groups according to NPS scores. The receiver operating curve (ROC) analysis was performed to reveal the discriminatory ability of NPS and other indicators for predicting the survival. The NPS and clinicopathological variables were further evaluated the prognostic value by univariate and multivariate Cox analysis. Results The NPS was related to age (P = 0.046), smoking history (P = 0.004), Eastern Cooperative Oncology Group (ECOG) score (P = 0.005), and adjuvant treatment (P = 0.017). Patients with high NPS scores had worse overall survival (OS) (group 1 vs 0, P = 0.006; group 2 vs 0, P < 0.001) and disease-free survival (DFS) (group 1 vs 0, P < 0.001; group 2 vs 0, P < 0.001). The ROC analysis demonstrated that NPS had better predictive ability than other prognostic indicators. Multivariate analysis revealed that NPS was independent prognostic indicator of OS (group 1 vs 0, hazard ratio [HR] =2.591, P = 0.023; group 2 vs 0, HR = 8.744, P = 0.001) and DFS (group 1 vs 0, HR =3.754, P < 0.001; group 2 vs 0, HR = 9.673, P < 0.001). Conclusion The NPS could be an independent prognostic indicator in patients with resected LA-NSCLC receiving neoadjuvant treatment and more reliable than the other nutritional and inflammatory indicators.
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Affiliation(s)
- Zhonghua Zou
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
| | - Jinping Li
- Department of Gastroenterology, Fangzi People’s Hospital, Weifang, People’s Republic of China
| | - Xiang Ji
- Department of Gastroenterology, Fangzi People’s Hospital, Weifang, People’s Republic of China
| | - Tingxing Wang
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
| | - Qingqing Chen
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
| | - Zhengcao Liu
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China
| | - Shengjun Ji
- Department of Radiotherapy & Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, People’s Republic of China,Correspondence: Shengjun Ji, Department of Radiotherapy & Oncology, the affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, No. 16 Baita Road, Suzhou, 215001, People’s Republic of China, Email
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10
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Chang L, Cheng Q, Ma Y, Wu C, Zhang X, Ma Q, He L, Li Q, Tao J. Prognostic Effect of the Controlling Nutritional Status Score in Patients With Esophageal Cancer Treated With Immune Checkpoint Inhibitor. J Immunother 2022; 45:415-422. [PMID: 36006239 PMCID: PMC9528939 DOI: 10.1097/cji.0000000000000438] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/05/2022] [Indexed: 12/20/2022]
Abstract
In recent years, a growing number of clinical studies have shown that immune checkpoint inhibitor (ICI) can increase the remission rate and improve the prognosis of patients with esophageal cancer. The Controlling Nutritional Status (CONUT) score is a novel nutritional indicator that can predict the prognosis of certain malignancies. We retrospectively analyzed the clinical data of 69 patients with advanced esophageal cancer treated with ICI and assessed the relationship between clinicopathological factors including CONUT score, systemic immune-inflammatory index (SII), and neutrophil-to-lymphocyte ratio and the prognosis. We found the CONUT score and SII, neutrophil-to-lymphocyte ratio were an independent prognostic factor for overall survival ( P <0.05). Furthermore, among patients treated with ICI, a high CONUT score was associated with a significantly worse progression-free survival (PFS) and overall survival compared with a low CONUT group. In conclusion, the CONUT can be used to predict the efficacy and prognosis of ICI therapy in patients with esophageal cancer. Our studies have shown that the CONUT score can be used as an effective indicator for the prognosis of patients with esophageal cancer receiving ICI.
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Affiliation(s)
- Lele Chang
- Departments of Gastrointestinal Medical Oncology
| | - Qian Cheng
- Departments of Gastrointestinal Medical Oncology
| | - Yue Ma
- Departments of Gastrointestinal Medical Oncology
| | | | - Xuemei Zhang
- Thoracic Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Qian Ma
- Departments of Gastrointestinal Medical Oncology
| | - Lei He
- Departments of Gastrointestinal Medical Oncology
| | - Qingwei Li
- Departments of Gastrointestinal Medical Oncology
| | - Ji Tao
- Departments of Gastrointestinal Medical Oncology
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11
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Morelli C, Formica V, Patrikidou A, Rofei M, Shiu KK, Riondino S, Argirò R, Floris R, Ferlosio A, Orlandi A, Roselli M, Arkenau HT. Nutritional index for immune-checkpoint inhibitor in patients with metastatic gastro-esophageal junction/gastric cancer. J Gastrointest Oncol 2022; 13:2072-2081. [PMID: 36388663 PMCID: PMC9660047 DOI: 10.21037/jgo-22-217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/02/2022] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Nutritional status is strongly associated to prognosis in metastatic gastrooesophageal junction (mGOJ)/gastric cancer (GC) patients. The aim of the present study was to develop an immune-checkpoint inhibitor (ICI)-specific nutritional index (NI). METHODS Ten serum and anthropometric nutritional markers derived from blood tests or CT scans were analyzed at baseline in patients treated with second-line ICI and correlated with overall survival (OS). An ICI-specific NI (the NUTRIICI) was developed with its specificity assessed in an independent group of patients treated with standard second-line chemotherapy. RESULTS From June 2014 to December 2018, 57 mGOJ/GC patients (14 females, 43 males) with a median(m) age of 61 years (range 29-85) received ICI as second-line therapy (Pembrolizumab n=26, Nivolumab n=16, Avelumab n=15). Among the 10 analyzed variables, Onodera's prognostic NI (PNI) ≤33 and waist-to-hip (WHR) <1 were independent predictors of OS and used to build the NUTRIICI. Patients with both favorable factors (i.e., PNI >33 and WHR ≥1, comparator group) had a mOS of 18.0 vs. 6.7 months of patients with one unfavorable factor (either PNI ≤33 or WHR <1, Hazard Ratio, HR 3.06), vs. 1.3 months of patients with both unfavorable factors (HR 17.56), overall P<0.0001. In the independent group of patients treated with standard chemotherapy NUTRIICI was not associated with prognosis (P=0.57). CONCLUSIONS NUTRIICI is the first ICI-specific NI for mOGJ/GC patients receiving second-line ICI. A validation in larger cohorts is strongly encouraged.
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Affiliation(s)
- Cristina Morelli
- Medical Oncology Unit and PhD program in Systems and Experimental Medicine (XXXV cycle), Tor Vergata University Hospital, Rome, Italy
| | - Vincenzo Formica
- Medical Oncology Unit and PhD program in Systems and Experimental Medicine (XXXV cycle), Tor Vergata University Hospital, Rome, Italy
| | - Anna Patrikidou
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Michela Rofei
- Medical Oncology Unit and PhD program in Systems and Experimental Medicine (XXXV cycle), Tor Vergata University Hospital, Rome, Italy
| | - Kai Keen Shiu
- Department of Oncology, University College Hospital, London, UK
| | - Silvia Riondino
- Medical Oncology Unit and PhD program in Systems and Experimental Medicine (XXXV cycle), Tor Vergata University Hospital, Rome, Italy
| | - Renato Argirò
- Diagnostic Imaging and Interventional Radiology, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging and Interventional Radiology, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Amedeo Ferlosio
- Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Augusto Orlandi
- Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Mario Roselli
- Medical Oncology Unit and PhD program in Systems and Experimental Medicine (XXXV cycle), Tor Vergata University Hospital, Rome, Italy
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12
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Prognostic Value of Combination of Controlling Nutritional Status and Tumor Marker in Patients with Radical Non-Small-Cell Lung Cancer. DISEASE MARKERS 2022; 2022:4764609. [PMID: 36193507 PMCID: PMC9525734 DOI: 10.1155/2022/4764609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022]
Abstract
Background Controlling nutritional status (CONUT) and tumor markers are associated with prognosis in patients with non-small-cell lung cancer (NSCLC). This study is aimed at exploring the potential usefulness of T-CONUT, constructed by combining CONUT and tumor markers, for NSCLC patients undergoing radical surgery. Methods A total of 483 patients with NSCLC underwent radical surgical resection. The receiver characteristic operating curve (ROC) was used to select the tumor marker with the highest predictive performance, and CONUT was combined with this marker to construct the T-CONUT. The Kaplan–Meier method and log-rank test were used to analyze the overall survival (OS), and chi-square analysis was used to analyze the association between T-CONUT and clinicopathological characteristics. The independent risk factors were analyzed by Cox regression. A nomogram was constructed by R studio. Calibration plots, the c-index, and decision curves were evaluated for the performance of the nomogram. Results ROC analysis showed that the predictive performance of CYFRA21–1 was better than that of CEA, NSE, and SCC. CYFRA21–1 was selected for combining with CONUT to construct T-CONUT. Elevated T-CONUT indicates poor prognosis of patients. Histological type, pTNM, and T-CONUT are independent risk factors associated with patient prognosis. The areas under the curve of the nomogram for predicting 3- and 5-year OS were 0.760 and 0.761, respectively. Conclusion T-CONUT comprising CYFRA21–1 and CONUT can effectively predict the prognosis of NSCLC patients.
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13
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Chen J, Song P, Peng Z, Liu Z, Yang L, Wang L, Zhou J, Dong Q. The Controlling Nutritional Status (CONUT) Score and Prognosis in Malignant Tumors: A Systematic Review and Meta-Analysis. Nutr Cancer 2022; 74:3146-3163. [PMID: 35382655 DOI: 10.1080/01635581.2022.2059091] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Increasing evidences indicate that the controlling nutritional status (CONUT) score is associated with cancer prognosis. This study was conducted to investigate the prognostic significance of pretreatment CONUT score on patients with various malignant tumors. The correlation between CONUT score and clinical outcomes of tumor patients were studied by electronic literature retrieval. Pooled hazard ratios (HR), odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to clarify the conclusion. Subgroup analysis were conducted in line with cancer type, cancer stage, treatment, sample size and cut-off value. A total of 62 studies involving 25224 patients were included in this study. Pooled analysis showed that higher CONUT scores were associated with shorter overall survival (HR 1.62, 95% CI 1.45-1.79, p < 0.001), cancer-specific survival (HR 1.80, 95% CI 1.48-2.13, p < 0.001), progress/recurrence-free survival (HR 1.54, 95% CI 1.23-1.85, p < 0.001) and disease-free survival (HR 1.56, 95% CI 1.39-1.74, p < 0.001). In addition, high CONUT score was correlated to higher incidence of postoperative complications (OR 1.64, 95% CI 1.38-1.95, p < 0.001) and mortality (OR 4.22, 95% CI 2.22-8.02, p < 0.001). Consequently, the pretreatment CONUT score is a valuable indicator to predict the clinical outcomes of patients with various malignant tumors.
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Affiliation(s)
- Junhao Chen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Pan Song
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Zhufeng Peng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenghuan Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Luchen Yang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Linchun Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jing Zhou
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Qiang Dong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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14
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Wang H, Li C, Yang R, Jin J, Liu D, Li W. Prognostic Value of the Geriatric Nutritional Risk Index in Non-Small Cell Lung Cancer Patients: A Systematic Review and Meta-Analysis. Front Oncol 2022; 11:794862. [PMID: 35117996 PMCID: PMC8804216 DOI: 10.3389/fonc.2021.794862] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022] Open
Abstract
Background Novel evidence showed that the Geriatric Nutritional Risk Index (GNRI) may lead to poor prognosis of human cancers. Therefore, we conducted a meta-analysis to explore the impact of GNRI in lung cancer and its prognostic value. Methods We searched the databases of PubMed, Web of Science, Embase, Scopus, and Cochrane Library up to July 2021 for relevant research and merged the hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the association between GNRI and overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) in patients with lung cancer. Results Eight studies involving 2,399 patients were included in our primary meta-analysis. The results indicated that lower level of GNRI was associated with poorer OS, RFS, and CSS of lung cancer patients (OS: HR = 1.99, 95% CI: 1.68–2.35, p < 0.0001; RFS: HR = 2.34, 95% CI: 1.11–4.95, p = 0.0258; CSS: HR = 2.45, 95% CI: 1.43–4.18, p = 0.0011). The association was robust after subgroup analysis and sensitivity analysis. Conclusions GNRI may be a prognostic factor of lung cancer, which can lead to poorer survival. However, more prospective studies are necessary to confirm the results. Systematic Review Registration International Prospective Register of Systematic Reviews (PROSPERO), identifier CRD42021269574.
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Affiliation(s)
- Haoyu Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Cui Li
- Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Ruiyuan Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Jin
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Dan Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Weimin Li,
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15
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Liu XY, Zhang X, Zhang Q, Xie HL, Ruan GT, Liu T, Song MM, Ge YZ, Xu HX, Song CH, Shi HP. The value of the controlling nutritional status score in predicting the prognosis of patients with lung cancer: A multicenter, retrospective study. JPEN J Parenter Enteral Nutr 2021; 46:1343-1352. [PMID: 34961947 DOI: 10.1002/jpen.2321] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The body's immune-nutritional status affects prognosis in patients with lung cancer. The Controlling Nutritional Status (CONUT) score is an immune-nutrition-related index associated with prognosis in other tumors. We aimed to assess the value of CONUT in predicting prognosis in patients with lung cancer. METHODS In this retrospective multicenter study, 1,339 patients with lung cancer were divided into low- and high-CONUT score groups. The relationship between CONUT scores and overall survival (OS) was assessed by survival curves and Cox's proportional hazards regression modelling. A nomogram including CONUT and other clinical variables was established. RESULTS There were 659 (49.2%; mean age 59.91 years) low- and 680 (50.8%; mean age 62.23 years) high-CONUT score patients. OS was significantly worse in patients with high than in those with low CONUT scores (P < 0.001), even after stratification by pathological types (non-small-cell lung cancer and small-cell lung cancer) and Tumor-Node-Metastasis (TNM) stages. A high CONUT score independently predicted risk in patients with lung cancer (adjusted hazard ratio: 1.48, 95% confidence interval: 1.26-1.73; P < 0.001). The CONUT-based nomogram could predict prognosis well (C-index: 0.701), with better resolution and accuracy than TNM staging for predicting OS at 1, 2, and 3 years (Area under the ROC curve: 0.735 vs. 0.678; 0.742 vs. 0.696; and 0.768 vs. 0.743). CONCLUSION The CONUT score can predict prognosis in patients with lung cancer. A CONUT-based nomogram can improve the accuracy of survival prediction in such patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xiao-Yue Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.,Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, 071000, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Hai-Lun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Yi-Zhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Hong-Xia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Chun-Hua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
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16
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Takamori S, Ohba T, Shimokawa M, Matsubara T, Haratake N, Miura N, Toyozawa R, Yamaguchi M, Seto T, Takenoyama M. Prospective observational study of nutritional/immunologic indices as predictive biomarkers for the response to anti-PD-1 drugs in non-small cell lung cancer (ICI-PREDICT study). PLoS One 2021; 16:e0258616. [PMID: 34679113 PMCID: PMC8535181 DOI: 10.1371/journal.pone.0258616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/04/2021] [Indexed: 11/30/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) targeting programmed cell death-1 (PD-1) and programmed cell death-ligand 1 (PD-L1) have markedly improved the prognosis of many patients with advanced non-small cell lung cancer (NSCLC). However, the relationship between the patient’s nutritional/immunologic status and the outcomes of ICI treatment remains unclear. In previous retrospective studies, we reported that the controlling nutritional status (CONUT) score, skeletal muscle area, and neutrophil-to-lymphocyte ratio were independent predictors of the response of NSCLC patients to anti-PD-1 drugs. The aim of this prospective multi-center study is to investigate the clinical impact of pre-treatment nutritional/immunologic indices and early post-treatment changes in the indices on treatment outcomes in advanced NSCLC. The main inclusion criteria are: (1) stage IV NSCLC, or stage III NSCLC not applicable for definitive chemoradiotherapy; (2) treatment with ICIs (monotherapy or combined with chemotherapy) as first-line therapy; and (3) available data on PD-L1 expression on tumor cells. A total of 300 patients will be enrolled prospectively. Enrollment will begin in 2020 and the final analyses will be completed by 2025.
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Affiliation(s)
- Shinkichi Takamori
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-ku, Fukuoka, Japan
| | - Taro Ohba
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Minamiogushi, Ube-shi, Yamaguchi, Japan
| | - Taichi Matsubara
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-ku, Fukuoka, Japan
| | - Naoki Haratake
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-ku, Fukuoka, Japan
| | - Naoko Miura
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-ku, Fukuoka, Japan
| | - Ryo Toyozawa
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-ku, Fukuoka, Japan
| | - Masafumi Yamaguchi
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-ku, Fukuoka, Japan
| | - Takashi Seto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-ku, Fukuoka, Japan
| | - Mitsuhiro Takenoyama
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Notame, Minami-ku, Fukuoka, Japan
- * E-mail:
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17
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Peng J, Hao Y, Rao B, Cao Y. Prognostic impact of the pre-treatment controlling nutritional status score in patients with non-small cell lung cancer: A meta-analysis. Medicine (Baltimore) 2021; 100:e26488. [PMID: 34190175 PMCID: PMC8257916 DOI: 10.1097/md.0000000000026488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/08/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The influence of pre-treatment controlling nutritional status (CONUT) score on the prognosis of non-small cell lung cancer (NSCLC) patients is inconclusive. We performed this meta-analysis to evaluate the prognostic significance of CONUT score in NSCLC patients. METHODS A systematic literature review was conducted using PubMed, Embase, and the Cochrane Library databases. The hazard ratio (HR) and 95% confidence interval (CI) were extracted to assess the correlation between the CONUT score and the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), as well as the cancer-specific survival. RESULTS A total of 11 studies with 3029 patients were included in the analysis. Pooled results indicated that a high CONUT score was positively correlated with poor OS (HR: 1.63, 95%CI: 1.40-1.88, P < .001) and shortened DFS/RFS (HR: 1.65, 95%CI: 1.35-2.01, P < .001), but no significant relationship with the cancer-specific survival (HR: 1.28, 95%CI: 0.60-2.73, P = .517) was identified. The negative effect of high CONUT score on the OS and DFS/RFS was detected in every subgroup with varying treatment methods, cancer stage, CONUT cut-off values, sample size, and analysis methods of HR. Additionally, preoperative high CONUT score was an independent predictor of postoperative complications (odds ratio: 1.58, 95%CI: 1.21-2.06, P = .001) in NSCLC. Last but not least, high CONUT score was not significantly correlated with the patients' sex, smoking status, cancer stage, lymphatic invasion, vascular invasion, pleural invasion, and pathological cancer type. CONCLUSION These results demonstrate that high CONUT score is positively related to poor prognoses. The CONUT score may therefore be considered as an effective prognostic marker in NSCLC patients.
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Affiliation(s)
- Jing Peng
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University
| | - Yan Hao
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
| | - Bihua Rao
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University
| | - Yunxia Cao
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University
- Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, China
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18
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Assessment of systematic inflammatory and nutritional indexes in extensive-stage small-cell lung cancer treated with first-line chemotherapy and atezolizumab. Cancer Immunol Immunother 2021; 70:3199-3206. [PMID: 33796915 DOI: 10.1007/s00262-021-02926-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/23/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The present study aims to investigate the prognostic role of systematic inflammatory and nutritional indexes in extensive-stage small-cell lung cancer (ES-SCLC) treated with first-line chemotherapy and atezolizumab. MATERIALS AND METHODS Prospective cohort population involving 53 patients were identified from NCT03041311 trial. The following peripheral blood-derived inflammatory and nutritional indexes, including neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), prognostic nutrition index (PNI), advanced lung cancer inflammation index (ALI), and lung immune prognostic index (LIPI) were evaluated. RESULTS The optimal cut-off values of the ALI, LMR, NLR, PLR, PNI, SII and SIRI were 323.23, 2.73, 2.57, 119.23, 48, 533.28 and 2.32, respectively. With a median follow-up of 17.1 months, the 1-year OS and PFS were 56% and 8%, respectively. Multivariate analysis showed that PLR was the only independent prognostic factors for OS among ES-SCLC patients treated with chemotherapy and atezolizumab (HR 4.63, 95%CI: 1.00-21.46, p = 0.05). K-M analysis showed that the OS and PFS for patients with high PLR (> 119.23) were significantly poorer than these with low PLR (≤ 119.23) (p = 0.0004 for OS and p = 0.014 for PFS). In external validation set, prognosis of patients with high PLR was also significantly poorer than these with low PLR in terms of OS (p = 0.038) and PFS (p = 0.028). CONCLUSION Pre-treatment PLR could serve as a valuable independent prognostic factor for ES-SCLC who receive chemotherapy and immune checkpoint inhibitors. Further, prospective studies are still needed to confirm our findings.
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Sonehara K, Tateishi K, Araki T, Komatsu M, Yamamoto H, Hanaoka M. Prognostic value of the geriatric nutritional risk index among patients with previously treated advanced non-small cell lung cancer who subsequently underwent immunotherapy. Thorac Cancer 2021; 12:1366-1372. [PMID: 33710780 PMCID: PMC8088948 DOI: 10.1111/1759-7714.13909] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 01/22/2023] Open
Abstract
Background The geriatric nutritional risk index (GNRI) is a simple and useful marker for predicting prognosis and treatment efficacy among patients with various cancers. However, to the best of our knowledge, there are no previous reports regarding the prognostic value of GNRI among patients with non‐small cell lung cancer (NSCLC) who were treated with immune checkpoint inhibitors (ICIs). Methods We retrospectively evaluated 85 patients with previously treated advanced NSCLC who were administered ICIs at Shinshu University Hospital between February 2016 and October 2020. Progression‐free survival (PFS) and overall survival (OS) were compared between groups with high (≥89.5) and low (<89.5) GNRI values. We used univariate and multivariate Cox regression analyses to identify prognostic factors that were associated with PFS and OS. Results The high and low GNRI groups included 61 and 24 patients, respectively. Relative to the low GNRI group, the high GNRI group had significantly longer median PFS (3.7 vs. 2.4 months, p = 0.041) and significantly longer median OS (14.2 vs. 6.1 months, p = 0.008). Multivariate analyses revealed that independent predictors of favorable OS were high GNRI, performance status of 0–1, and age of ≥70 years. The high GNRI group was significantly more likely to undergo subsequent therapy after immunotherapy (68.6 vs. 33.3%, p = 0.008). Conclusions The present study revealed that high GNRI was associated with good outcomes among patients with previously treated NSCLC who were treated with ICIs.
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Affiliation(s)
- Kei Sonehara
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazunari Tateishi
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Taisuke Araki
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masamichi Komatsu
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Yamamoto
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masayuki Hanaoka
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
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20
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Sun F, Zhang C, Liu Z, Ai S, Guan W, Liu S. Controlling Nutritional Status (CONUT) score as a predictive marker for short-term complications following gastrectomy of gastric cancer: a retrospective study. BMC Gastroenterol 2021; 21:107. [PMID: 33663423 PMCID: PMC7934386 DOI: 10.1186/s12876-021-01682-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/19/2021] [Indexed: 02/08/2023] Open
Abstract
Background It is well established that the controlling nutritional status (CONUT) score was correlated with long-term outcomes in gastric cancer (GC), but the significance of CONUT for postoperative short-term outcomes remains unclear. The study aimed to characterize the relationship between CONUT and short-term complications following gastrectomy of GC. Methods We collected data on 1479 consecutive GC patients at Nanjing Drum Tower Hospital between January 2016 and December 2018. Univariate and multivariate analyses of predictive factors for postoperative complications were performed. The cutoff value of the CONUT score was determined by Youden index. Results Among all of the patients, 431 (29.3%) patients encountered postoperative complications. Multivariate analyses identified CONUT was an independent predictor for postoperative short-term complications (OR 1.156; 95% CI 1.077–1.240; P < 0.001). Subgroup analysis elucidated that CONUT was related to postoperative complications both in early gastric cancer and advanced gastric cancer. We further explored that patients with high CONUT score had prolonged hospital stay (12.3 ± 6.0 vs 11.1 ± 4.6, P < 0.001) and more total hospital charges (7.6 ± 2.4 vs 7.1 ± 1.6, P < 0.001). Conclusions The present study demonstrated that the preoperative CONUT was an independent predictor for short-term complications following gastrectomy of GC.
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Affiliation(s)
- Feng Sun
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Chen Zhang
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Zhijian Liu
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Shichao Ai
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Wenxian Guan
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
| | - Song Liu
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
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Change of body composition, physical strength, and nutritional status of patients with mandibular fractures. J Craniomaxillofac Surg 2021; 49:292-297. [PMID: 33589334 DOI: 10.1016/j.jcms.2021.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 10/27/2020] [Accepted: 01/31/2021] [Indexed: 11/20/2022] Open
Abstract
The aim was to determine changes in various parameters indicating physical conditions and nutritional status of patients during surgical and conservative treatment of mandibular fractures. A round by a nutrition support team was done once postoperatively for the surgical treatment group. For the conservative treatment group, three rounds were performed during the period of intermaxillary fixation. Data obtained from the rounds were compared between the groups. There were 29 patients surgically and 30 patients conservatively treated. A significant weight loss was observed in both groups postoperatively. The mean weight loss of the surgical treatment group measured at the postoperative round was 1.73 kg (SD ± 1.78) (P < 0.001) and that of the conservative treatment group at the third round was 2.74 kg (SD ± 2.35) (P < 0.001). During the entire treatment period, weight loss, body fat percentage, skeletal muscle percentage, grip strength and parameters indicating body composition and nutritional status of the conservative treatment group did not substantially differ from those of the surgical group. The influence of the conservative procedure on the nutritional condition of the patients seems to be limited and reversible at the end of the treatment. The weight loss observed here suggests that systematic nutrition support is necessary during both surgical and conservative treatment.
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22
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Watanabe H, Yamada T, Komori K, Hara K, Kano K, Takahashi K, Kumazu Y, Fujikawa H, Numata M, Aoyama T, Tamagawa H, Inokuchi Y, Machida N, Shiozawa M, Yukawa N, Morinaga S, Rino Y, Masuda M, Ogata T, Oshima T. Effect of Prognostic Nutrition Index in Gastric or Gastro-oesophageal Junction Cancer Patients Undergoing Nivolumab Monotherapy. In Vivo 2021; 35:563-569. [PMID: 33402510 PMCID: PMC7880786 DOI: 10.21873/invivo.12292] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/04/2020] [Accepted: 11/08/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIM We hypothesised that the prognostic nutrition index (PNI) is useful for evaluating host immunity and response to immune checkpoint inhibitors. We investigated the effect of PNI on nivolumab monotherapy efficacy in advanced or recurrent gastric cancer (GC) or gastro-oesophageal junction cancer (GOC) patients. PATIENTS AND METHODS We retrospectively examined 110 patients, divided them into a high-PNI group and a low-PNI group, and compared treatment efficacy, adverse events (AEs), and survival between the groups. RESULTS Median overall survival (OS) was significantly longer in the high-PNI group than in the low-PNI group (205 vs. 109 days; p<0.001). Multivariate analysis revealed that low PNI was an independent risk factor for OS (hazard ratio=2.398; 95% confidence interval=1.384-4.154; p=0.002). The overall response rate and frequency of AEs were not significantly different between the groups. CONCLUSION PNI could be a useful prognostic factor in GC or GOC patients undergoing nivolumab monotherapy.
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Affiliation(s)
- Hayato Watanabe
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Takanobu Yamada
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan;
| | - Keisuke Komori
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Kentaro Hara
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Kazuki Kano
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Kosuke Takahashi
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Yuta Kumazu
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Hirohito Fujikawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Masakatsu Numata
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Toru Aoyama
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Hiroshi Tamagawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Yasuhiro Inokuchi
- Department of Gastroenterology, Kanagawa Cancer Centre, Yokohama, Japan
| | - Nozomu Machida
- Department of Gastroenterology, Kanagawa Cancer Centre, Yokohama, Japan
| | - Manabu Shiozawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Norio Yukawa
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Soichiro Morinaga
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Yasushi Rino
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Munetaka Masuda
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takashi Ogata
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Takashi Oshima
- Department of Gastrointestinal Surgery, Kanagawa Cancer Centre, Yokohama, Japan;
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Conde-Estévez D, Monge-Escartín I, Ríos-Hoyo A, Monzonis X, Echeverría-Esnal D, Moliner L, Duran-Jordà X, Taus Á, Arriola E. Prognostic factors and effect on survival of immune-related adverse events in patients with non-small-cell lung cancer treated with immune checkpoint blockage. J Chemother 2020; 33:32-39. [DOI: 10.1080/1120009x.2020.1849488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- David Conde-Estévez
- Department of Pharmacy, Hospital Universitari del Mar, Barcelona, Spain
- IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autónoma de Barcelona, Barcelona, Spain
| | | | - Alejandro Ríos-Hoyo
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
| | - Xavier Monzonis
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
| | | | - Laura Moliner
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
| | - Xavier Duran-Jordà
- IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
- Methodology & Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Álvaro Taus
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
- IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
| | - Edurne Arriola
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
- IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
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Katayama Y, Yamada T, Chihara Y, Tanaka S, Tanimura K, Okura N, Hirose K, Uda S, Shiotsu S, Hirai S, Hiranuma O, Harada T, Shimamoto T, Iwasaku M, Kaneko Y, Uchino J, Takeda T, Takayama K. Significance of inflammatory indexes in atezolizumab monotherapy outcomes in previously treated non-small-cell lung cancer patients. Sci Rep 2020; 10:17495. [PMID: 33060826 PMCID: PMC7566597 DOI: 10.1038/s41598-020-74573-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022] Open
Abstract
Cancer immunotherapy, including atezolizumab monotherapy, is a promising alternative strategy for patients with advanced non-small-cell lung cancer (NSCLC). Several inflammatory indices have been reported as potential biomarkers regarding the effectiveness of various treatments. This study aimed to analyze the efficacy of atezolizumab monotherapy using baseline inflammatory markers in NSCLC patients. We retrospectively enrolled 81 NSCLC patients who received atezolizumab monotherapy at six different medical institutions in Japan. The Cox proportional hazards model was used to assess the impact of the clinical variables, including inflammatory indexes, on clinical outcomes. Median progression-free survival (PFS) and overall survival (OS) were 60 days and 252 days, respectively. The objective response rate was 7.4%, and the disease control rate was 54.3%. Patients with high neutrophil to lymphocyte ratio (NLR), low lymphocyte to monocyte ratio (LMR), and/or high platelet to lymphocyte ratio (PLR), at baseline, demonstrated substantially shorter PFS and OS compared to those with a low NLR, high LMR, and/or low PLR. The multivariate analysis demonstrated that a high baseline NLR was substantially associated with short PFS and short OS. Our retrospective observations suggest that inflammatory indices may be a potential negative prognostic factor of atezolizumab monotherapy outcomes in NSCLC patients.
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Affiliation(s)
- Yuki Katayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Yusuke Chihara
- Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Uji, Japan
| | - Satomi Tanaka
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Keiko Tanimura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Naoko Okura
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kazuki Hirose
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Sayaka Uda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Soichi Hirai
- Department of Respiratory Medicine, Otsu City Hospital, Otsu, Japan
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Otsu, Japan
| | - Taishi Harada
- Department of Medical Oncology, Fukuchiyama City Hospital, Fukuchiyama, Japan
| | - Takayuki Shimamoto
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
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Yang QK, Su YN, Wang W, Wang N, Yao ZX, Zhang XJ. CONUT Score or/and Peripheral Blood CD4+/CD8+ Ratio-Based Web Dynamic Nomograms to Predict the Individualized Survival of Patients with Advanced Osteosarcoma. Cancer Manag Res 2020; 12:4193-4208. [PMID: 32581591 PMCID: PMC7276395 DOI: 10.2147/cmar.s251814] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/10/2020] [Indexed: 12/14/2022] Open
Abstract
Background Nutritional and immune status is paramount for the overall survival (OS) of patients with advanced osteosarcoma. Comprehensive prognostic predictors based on the two indices are scarce. This study aimed to construct and validate individualized web dynamic nomograms based on CONUT score or/and peripheral blood CD4+/CD8+ ratio for OS in patients with advanced osteosarcoma. Materials and Methods The clinical data of 376 advanced osteosarcoma patients from January 2000 to December 2019 were retrospectively collected. Data from the 301 patients (diagnosed in the first 15 years) were used as the development set and data from the remaining 75 patients were assigned as the validation set. Multivariate Cox regression analyses were conducted and three prediction models were constructed, namely, CD4+/CD8+ ratio univariate model (model 1), CONUT score univariate model (model 2), and CD4+/CD8+ ratio plus CONUT score (model 3). These models were visualized by conventional nomograms and individualized web dynamic nomograms, and their performances were further evaluated by C-index, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA), respectively. Results In multivariate Cox analysis, age, metastasis, ALP, CD4+/CD8+ ratio, chemotherapy, and CONUT score were identified as independent prognostic factors for OS. The calibration curves of the three models all showed good agreement between the actual observation and nomogram prediction for 1-year overall survival. In the development set, the C-index and area under the curve (AUC) of model 3 (0.837, 0.848) were higher than that of model 1 (0.765, 0.773) and model 2 (0.712, 0.749). Similar trends were observed in the validation set. The net benefits of model 3 were better than the other two models within the threshold probability of 36–80% in DCA. Conclusion CONUT score and peripheral CD4+/CD8+ ratio are easily available, reliable, and economical prognostic predictors for survival prediction and stratification in patients with advanced osteosarcoma, but the two predictors combined can establish a better prognosis prediction model.
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Affiliation(s)
- Qian-Kun Yang
- Department of Bone and Soft Tissue Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning 110042, People's Republic of China
| | - Yan-Na Su
- Clinical Laboratory, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110042, People's Republic of China
| | - Wei Wang
- Department of Bone and Soft Tissue Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning 110042, People's Republic of China
| | - Nan Wang
- Department of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning 110042, People's Republic of China
| | - Zhong-Xiang Yao
- Department of Physiology, Army Medical University, Chongqing 400038, People's Republic of China
| | - Xiao-Jing Zhang
- Department of Bone and Soft Tissue Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning 110042, People's Republic of China
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Yılmaz A, Tekin SB, Bilici M, Yılmaz H. The Significance of Controlling Nutritional Status (CONUT) Score as a Novel Prognostic Parameter in Small Cell Lung Cancer. Lung 2020; 198:695-704. [PMID: 32424800 DOI: 10.1007/s00408-020-00361-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/08/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE The immuno-nutritional status is closely related to the prognosis in many cancers. Controlling nutritional status (CONUT) score is a new parameter that reflects the immuno-nutritional status and is prognostic in some cancers. However, the prognostic significance of the CONUT score in small cell lung cancer (SCLC) is unknown. We aimed to demonstrate the prognostic significance of the CONUT score in patients with SCLC. METHODS Two hundred sixteen patients who were followed up with SCLC were included in the study retrospectively. According to the receiver operating characteristic (ROC) curve analysis, the optimal cutoff values were determined for the CONUT score, and the patients were divided into low (< 2) and high (≥ 2) CONUT groups. Neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and prognostic nutritional index (PNI) were grouped based on a cutoff point 2.84, 626, and 46.1, respectively. Cox regression analyses were used to assess their prognostic values for progression-free survival (PFS) and overall survival (OS). RESULTS The high CONUT group had significantly worse PFS and OS than the low CONUT group (p < 0.001, p < 0.001). In univariate analysis, stage, prophylactic cranial irradiation, extrapulmonary lesion, PNI, body mass index, CONUT score were found to be significant for both PFS and OS. In multivariate analysis, only CONUT score and stage were found as independent prognostic factors for both PFS (p: 0.018, p: 0.046) and OS (p: 0.038, p: 0.006). CONCLUSION The CONUT score at the time of diagnosis is an independent prognostic parameter that predicts recurrence and survival times in SCLC.
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Affiliation(s)
- Ali Yılmaz
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey.
| | - Salim Başol Tekin
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey
| | - Mehmet Bilici
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey
| | - Hatice Yılmaz
- Department Of Medical Oncology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
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Controlling nutritional status (CONUT) score is a predictive marker for patients with traumatic brain injury. Clin Neurol Neurosurg 2020; 195:105909. [PMID: 32652392 DOI: 10.1016/j.clineuro.2020.105909] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 02/08/2023]
Abstract
OBJECT We designed this study to evaluate whether controlling nutritional status (CONUT) score was valuable in predicting outcome of patients with traumatic brain injury (TBI). METHODS Clinical and laboratory data of patients admitted with TBI in our hospital between January 2015 and January 2018 was retrospectively collected. We divided patients into two groups according to in-hospital and 90-day outcome respectively and compared baseline characteristics of two groups. Multivariate analyses were conducted to evaluate whether CONUT score was associated with outcome of included patients. Receiver operating characteristics (ROC) curves were drawn to compare the predictive value of CONUT score and constructed models. RESULTS A total of 365 patients were included in our study. Multivariate logistic regression analyses showed that CONUT score was independently associated with in-hospital mortality (OR = 1.244, 95% CI: 1.099-1.408, p = 0.001) and 90-day outcome (OR = 1.441, 95% CI: 1.193-1.741, p < 0.001). ROC curve showed that area under the ROC curve (AUC) of CONUT score for predicting in-hospital mortality and 90-day outcome were 0.790 (95% CI: 0.745-0.836, p < 0.001) and 0.839 (95% CI: 0.792-0.886, p < 0.001), respectively. CONCLUSION CONUT score is independently associated with in-hospital mortality and 90-day outcome of patients with TBI.
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Shimizu T, Miyake M, Hori S, Ichikawa K, Omori C, Iemura Y, Owari T, Itami Y, Nakai Y, Anai S, Tomioka A, Tanaka N, Fujimoto K. Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab. Diagnostics (Basel) 2020; 10:diagnostics10050310. [PMID: 32429323 PMCID: PMC7277993 DOI: 10.3390/diagnostics10050310] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia is a muscle loss syndrome known as a risk factor of various carcinomas. The impact of sarcopenia and sarcopenia-related inflammatory/nutritional markers in metastatic urothelial carcinoma (mUC) treated with pembrolizumab was unknown, so this retrospective study of 27 patients was performed. Psoas muscle mass index (PMI) was calculated by bilateral psoas major muscle area at the L3 with computed tomography. The cut-off PMI value for sarcopenia was defined as ≤6.36 cm2/m2 for men and ≤3.92 cm2/m2 for women. Neutrophil-to-lymphocyte ratio (NLR) ≥ 4.0 and sarcopenia correlated with significantly shorter progression-free survival (PFS) (hazard ratio (HR) 3.81, p = 0.020; and HR 2.99, p = 0.027, respectively). Multivariate analyses identified NLR ≥ 4.0 and sarcopenia as independent predictors for PFS (HR 2.89, p = 0.025; and HR 2.79, p = 0.030, respectively). Prognostic nutrition index < 45, NLR ≥ 4.0 and sarcopenia were correlated with significantly worse for overall survival (OS) (HR 3.44, p = 0.046; HR 4.26, p = 0.024; and HR 3.92, p = 0.012, respectively). Multivariate analyses identified sarcopenia as an independent predictor for OS (HR 4.00, p = 0.026). Furthermore, a decrease in PMI ≥ 5% in a month was an independent predictor of PFS and OS (HR 12.8, p = 0.008; and HR 6.21, p = 0.036, respectively). Evaluation of sarcopenia and inflammatory/nutritional markers may help in the management of mUC with pembrolizumab.
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Affiliation(s)
- Takuto Shimizu
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
- Department of Urology, Saiseikai Chuwa Hospital, 323 Ooazaabe, Sakurai, Nara 633-0054, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Shunta Hori
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Kazuki Ichikawa
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Chihiro Omori
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Yusuke Iemura
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
- Department of Urology, Saiseikai Chuwa Hospital, 323 Ooazaabe, Sakurai, Nara 633-0054, Japan
| | - Takuya Owari
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Yoshitaka Itami
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Satoshi Anai
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Atsushi Tomioka
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
- Department of Urology, Saiseikai Chuwa Hospital, 323 Ooazaabe, Sakurai, Nara 633-0054, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (T.S.); (M.M.); (S.H.); (K.I.); (C.O.); (Y.I.); (T.O.); (Y.I.); (Y.N.); (S.A.); (A.T.); (N.T.)
- Correspondence: ; Tel.: +81-744-22-3051; Fax: +81-744-22-9282
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Matsubara T, Takamori S, Haratake N, Toyozawa R, Miura N, Shimokawa M, Yamaguchi M, Seto T, Takenoyama M. The impact of immune-inflammation-nutritional parameters on the prognosis of non-small cell lung cancer patients treated with atezolizumab. J Thorac Dis 2020; 12:1520-1528. [PMID: 32395289 PMCID: PMC7212122 DOI: 10.21037/jtd.2020.02.27] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Immunotherapy targeting programmed cell death-1 (PD-1) and programmed death-ligand 1 (PD-L1) has become the forefront strategy for systemic therapy in advanced non-small cell lung cancer (NSCLC) patients. PD-L1 expression on tumor cells has been reported as an eligible biomarker of response to such immunotherapies. However, useful biomarkers of response to atezolizumab, an anti PD-L1 antibody, are unestablished. Methods We retrospectively analyzed clinicopathological characteristics including PD-L1 expression in NSCLC patients treated with atezolizumab from January 2018 at our department. In addition, we investigated the prognostic effect of the following pretreatment immune-inflammation-nutritional parameters: prognostic nutritional index (PNI), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and modified Glasgow prognostic score (mGPS). Results Twenty-four patients were enrolled in this study. The median age was 64.5 (range, 49-82) years, and 17 (70.8%) were men. Among this cohort, two patients showed high PD-L1 expression (≥50%), seven showed low (1-49%) expression, and the other 15 patients showed 0% or unknown expression. Survival analyses showed that low PNI was an independent predictor of short time to treatment failure (TTF) [hazard ratio (HR) =6.87, P=0.0052], and high NLR (HR =3.53, P=0.0375) and high mGPS (HR =23.2, P=0.0038) were independent prognostic factors for overall survival (OS) after atezolizumab. Furthermore, the NLR high/mGPS high group had far worse prognosis than the NLR low/mGPS low group. Conclusions The therapeutic and prognostic effect of atezolizumab may depend on the host immune-nutritional status. This study provided novel but retrospective evidence, and thus further prospective studies are needed.
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Affiliation(s)
- Taichi Matsubara
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Shinkichi Takamori
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Naoki Haratake
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Ryo Toyozawa
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Naoko Miura
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Mototsugu Shimokawa
- Clinical Research Institute, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masafumi Yamaguchi
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Takashi Seto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Mitsuhiro Takenoyama
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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