Prognostic value of pretreatment immune inflammation indices in patients with immune-related tumors

Abstract

Background

Pretreatment high levels of lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), modified Glasgow prognostic scores (mGPS), prognostic nutritional index (PNI), and other prognostic biomarkers have been associated with poor overall survival (OS) in immune-related tumor types. Therefore, we explored a simple, inexpensive and effective method for cancer prognosis.

Methods

Between March 2017 and June 2022, 111 individuals who had immunotherapy were retrospectively examined. Oncologic outcomes of patients with immune-related tumor types, include OS and progression-free survival (PFS), and response rates (RR).

Results

Pretreatment ECOG (Eastern Cooperative Oncology Group) performance quality was independently linked with poor OS ECOG ≥2 (HR 4.80, 95% CI 2.57–8.96, p < .001) and inferior PFS (HR 3.31, 95% CI 2.023–5.445, p < .001). Additionally, a high LDH status prior to therapy was independently linked to an inferior OS (HR 1.004, 95% CI 1.001–1.007, p = .003) and inferior PFS (HR 1.004, 95% CI 1.002–1.006, p < .001). Higher MLR at baseline was a prognostic factor for both shorter PFS (HR = 3.691, 95% CI 1.582–8.610, p = .003) and OS (HR = 2.876, 95% CI 1.127–7.342, p = .027).

Conclusions

In our cohort, elevated pre-treatment MLR, LDH and ECOG ≥2 were associated with poor OS and PFS. Prospective studies need to determine the utility of them.

Keywords:

• Prognostic biomarkers
• monocyte-lymphocyte ratio (MLR)
• ECOG (Eastern Cooperative Oncology Group) performance
• lactate dehydrogenase levels (LDH)

Transparency

Declaration of funding

This paper was not sponsorship/funding.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors gave their final approval of the manuscript to be published.

Acknowledgements

Authors would like to acknowledge and thank our all physicians and friends at the Department of Oncology for their support in the course of this study.

Data availability statement

Data supporting the findings of this study are clearly not available. More questions can be directed to the corresponding author.