Abstract
BackgroundIn view of the fact that peripheral blood parameters have been reported as predictors of immunotherapy to various cancers, this study aimed to determine the predictors of response to anti-programmed death-1 (anti-PD-1) therapy in patients with esophageal squamous cell carcinoma (ESCC) from peripheral blood parameters.MethodsA retrospective analysis was conducted to investigate the predictive value of peripheral blood parameters including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and systemic immune-inflammation index (SII) in the response to anti-PD-1 antibody treatment. 119 ESCC patients receiving combined treatment including anti-PD-1 antibody were enrolled in this study.ResultsThe median progression-free survival (PFS) of all ESCC patients was 3.73 months. PFS rate in ESCC patients with low NLR at 6 weeks post treatment was higher than patients with high NLR (HR = 2.097, 95% CI 0.996–4.417, P = 0.027). However, PFS rate in ESCC patients with low NLR at baseline (HR = 1.060, 95% CI 0.524–2.146, P = 0.869) or 3 weeks post treatment (HR = 1.293, 95% CI 0.628–2.663, P = 0.459) was comparable with high NLR. And no statistically different was found in PFS rate between low PLR and high PLR at baseline (HR = 0.786, 95% CI 0.389–1.589, P = 0.469), 3 weeks post treatment (HR = 0.767, 95% CI 0.379–1.552, P = 0.452) or 6 weeks post treatment (HR = 1.272, 95% CI 0.624–2.594, P = 0.488) in ESCC patients. PFS rate was also comparable between low MLR and high MLR at baseline (HR = 0.826, 95% CI 0.408–1.670, P = 0.587), 3 weeks post treatment (HR = 1.209, 95% CI 0.590–2.475, P = 0.580) or 6 weeks post treatment (HR = 1.199, 95% CI 0.586–2.454, P = 0.596). PFS rate was similar between patients with low SII and high SII at baseline (HR = 1.120, 95% CI 0.554–2.264, P = 0.749), 3 weeks post treatment (HR = 1.022, 95% CI 0.500–2.089, P = 0.951) and 6 weeks post treatment (HR = 1.759, 95% CI 0.851–3.635, P = 0.097).ConclusionsNLR at 6 weeks post treatment is a predictor of the response to anti-PD-1 treatment in patients with ESCC.
Highlights
Esophageal cancer (EC) with a poor overall 5-year survival rate ranging from 15 to 25% ranks the eighth most commonly diagnosed cancer worldwide, while the sixth most common cancer in China [1]
We evaluated whether age was able to influence neutrophil-to-lymphocyte ratio (NLR) level in tumor-free people and found that the median of NLR was 1.64 in people with age less than 60 years old and median of NLR was 1.51 in people with age greater than (See figure on page.) Fig. 1 Association between response to anti-Programmed death 1 (PD-1) treatment and NLR, platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII) at baseline, at 3 weeks post treatment and at 6 weeks post treatment
We evaluated whether NLR, PLR, MLR or SII was able to be a biomarker for predicting response to anti-progressive disease (PD)-1 antibody treatment in esophageal squamous cell carcinoma (ESCC) patients
Summary
Esophageal cancer (EC) with a poor overall 5-year survival rate ranging from 15 to 25% ranks the eighth most commonly diagnosed cancer worldwide, while the sixth most common cancer in China [1]. Esophageal squamous cell carcinoma (ESCC) predominantly found in Asia, Africa, and South America, and esophageal adenocarcinoma (EAC) predominant in North America and Europe are the two main subtypes of EC [2]. As a highly aggressive squamous cell carcinoma, ESCC occupies the main subtype of EC in China because of special living habits [3]. The effect of chemotherapy on patients with advanced ESCC is not ideal. The high recurrence and metastasis rate of patients, and the low 5-year survival rate make the therapy of ESCC still a big problem. In view of the fact that peripheral blood parameters have been reported as predictors of immunotherapy to various cancers, this study aimed to determine the predictors of response to anti-programmed death-1 (anti-PD-1) therapy in patients with esophageal squamous cell carcinoma (ESCC) from peripheral blood parameters
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