Pretreatment Inflammatory Markers Research Articles

Predictive strength of inflammatory scores for in-hospital mortality in infective endocarditis.

Inflammatory markers have been proposed as prognostic tools for predicting in-hospital mortality in infective endocarditis (IE). Nonetheless, it is unclear whether these markers provide additional prognostic value over established indicators. This study compared nine different inflammation scores to assess their effectiveness in enhancing the prediction of in-hospital mortality. Patients with IE diagnosed between 2017 and 2023 at two cardiology centers in Istanbul were included in this study. Pre-treatment inflammatory markers were obtained from the hospital electronic database system. In-hospital mortality prognostication was assessed using Cox proportional hazards models. Atotal of 122 patients who were diagnosed with IE were included in the analysis. Overall, 38patients died during the hospital stay. The patients were categorized into two groups based on their mortality status. The prognostic nutritional index (PNI), platelet-to-lymphocyte ratio (PLR), and modified Glasgow prognostic score (mGPS) were identified as statistically significant predictors of in-hospital mortality. Based on the results of Cox regression analysis, the PNI (hazard ratio [HR]: 0.921, 95%confidence interval [CI]: 0.853-0.994, p = 0.035) emerged as the only independent predictor of in-hospital mortality of IE patients. Nine inflammatory scores were evaluated in this study. The PNI, PLR, and mGPS were statistically significant predictors of in-hospital mortality in patients with IE. The PNI was identified as the optimal score.

A scoring system based on inflammatory and nutritional indicators to predict the long-term survival of patients with non-metastatic nasopharyngeal carcinoma

To develop a simple scoring system based on baseline inflammatory and nutritional markers to predict the long-term prognosis of patients with nasopharyngeal carcinoma (NPC). Conducted a retrospective analysis of clinical data from 1024 newly diagnosed non-metastatic NPC patients. A total of 15 pre-treatment inflammatory and nutritional markers were collected as candidate variables. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff points for each parameter. Survival analysis was performed using Kaplan–Meier method and Cox regression analysis. Besides, the Inflammation Nutrition Risk Score (INRS) was calculated for each patient by assigning each independent prognostic factor a score of 1. Multivariate Cox regression analysis showed that serum albumin (ALB), systemic immune-inflammation index, and monocyte count (M) were independent prognostic factors for OS (P < 0.05). Survival analysis showed that higher INRS was associated with a worsened prognosis. Patients in the high-risk group had shorter OS than in the low-risk group. In the training group, the 3-, 5-, and 8-years OS rates for the low-risk group versus high-risk group were 92.5% versus 87.8%, 87.4% versus 75.1%, and 84.6% versus 62.2%, respectively (P < 0.05). In the validation group, the 3-, 5-, and 8-years OS rates for the low-risk group vs. high-risk group were 95.0% versus 86.4%, 92.1% versus 82.2%, and 89.5% versus 74.3%, respectively (P < 0.05). Further subgroup analysis showed a significant difference in the OS between the high-risk group and low-risk group in patients with locally advanced disease (P < 0.05). The ROC curve demonstrated that INRS had a similar predictive value for long-term survival in NPC patients compared to TNM staging and serum EBV-DNA levels. Pretreatment ALB, M, and SIRI are independent prognostic factors for long-term survival in patients with NPC. INRS constructed based on these three factors can serve as a long-term prognostic indicator for NPC.

Hypofractionated radiotherapy plus PD-1 antibody and SOX chemotherapy as second-line therapy in metastatic pancreatic cancer: a single-arm, phase II clinical trial

PurposeTo assess the efficacy and safety of concurrent hypofractionated radiotherapy plus anti-PD-1 antibody and SOX chemotherapy in the treatment of metastatic pancreatic cancer (mPC) after failure of first-line chemotherapy.MethodsPatients with pathologically confirmed mPC who failed standard first-line chemotherapy were enrolled. The patients were treated with a regimen of hypofractionated radiotherapy, SOX chemotherapy, and immune checkpoint inhibitors at our institution. We collected the patients’ clinical information and outcome measurements. The median progression-free survival (mPFS) was the primary endpoint of the study, followed by disease control rate (DCR), objective response rate (ORR), median overall survival (mOS) and safety. Exploratory analyses included biomarkers related to the benefits.ResultsBetween February 24, 2021, and August 30, 2023, twenty-five patients were enrolled in the study, and twenty-three patients who received at least one dose of the study agent had objective efficacy evaluation. The mPFS was 5.48 months, the mOS was 6.57 months, and the DCR and ORR were 69.5% and 30.4%, respectively. Among the seven patients who achieved a PR, the median duration of the response was 7.41 months. On-treatment decreased serum CA19-9 levels were associated with better overall survival. Besides, pretreatment inflammatory markers were associated with tumor response and survival.ConclusionsClinically meaningful antitumor activity and favorable safety profiles were demonstrated after treatment with these combination therapies in patients with refractory mPC. On-treatment decreased serum CA19-9 levels and pretreatment inflammatory markers platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), lactate dehydrogenase (LDH) might be biomarkers related to clinical benefits.Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=130211, identifier: ChiCTR2100049799, date of registration: 2021–08-09.

Platelet-to-lymphocyte ratio (PLR), platelet-to-hemoglobin ratio (PHR) and systemic immune-inflammation index (SII) as predictive factors of amputation among Diabetic Foot Ulcer (DFU) in Ibnu Sina Gresik Regional Public Hospital, East Java, Indonesia

Introduction: Diabetic Foot Ulcer (DFU) is a common complication of Diabetic Mellitus, and predicting the result is a difficult task. In this context, the prediction of clinical outcomes such as amputation or wound healing manages further intervention of life-saving or limb-saving. Therefore, this research aimed to evaluate Platelet-to-Lymphocyte Ratio (PLR), Platelet-to-Hemoglobin Ratio (PHR), and Systemic Immune-inflammation Index (SII) as the predictive factors of amputation. Method: This retrospective analysis included hospitalized diabetic foot ulcer patients from January to December 2022 in Ibnu Sina Gresik Regional Public Hospital. Pre-treatment inflammatory markers, including the PLR, PHR, and SII, were performed by the Receiver Operating Characteristic (ROC) curve and Youden index to determine AUC and cut-off value, respectively. Results: This research comprised 58 amputated and 56 non-amputated patients. PLR, PHR and SII of amputation group showed a higher value significantly compared with the non-amputation group (p&lt;0.001). Meanwhile, ROC analysis identified optimal cut-off values for PLR, PHR, and SII as 186.1, 3.09, and 2780.1 based on Youden index, respectively. PLR, PHR, and SII reported 74.1%,74.1%, and 44.8% sensitivity, with 92.9% (AUC = 0.878, p &lt; 0.001), 82.1% (AUC = 0.834, p &lt; 0.001), and 91.1% (AUC = 0.720, p &lt; 0.001) specificity, respectively. Patients with higher PLR faced a 37.3-fold increased risk of amputation compared to those with lower scores (p &lt; 0.001, 95% CI = 11.513-120.626). Higher PHR resulted in a 13.2-fold increased risk of amputation compared to lower scores (p &lt; 0.001, 95% CI = 5.352-32.490), while higher SII obtained an 8.3-fold increased risk compared to lower scores (p &lt; 0.001; 95% CI = 2.888-23.783). Conclusion: PLR, PHR and SII served as the predictive factors of amputation among diabetic foot ulcer patients.

Predictors of HIV rebound differ by timing of antiretroviral therapy initiation.

BACKGROUNDIdentifying factors that predict the timing of HIV rebound after treatment interruption will be crucial for designing and evaluating interventions for HIV remission.METHODSWe performed a broad evaluation of viral and immune factors that predict viral rebound (AIDS Clinical Trials Group A5345). Participants initiated antiretroviral therapy (ART) during chronic (N = 33) or early (N = 12) HIV infection with ≥ 2 years of suppressive ART and restarted ART if they had 2 viral loads ≥ 1,000 copies/mL after treatment interruption.RESULTSCompared with chronic-treated participants, early-treated individuals had smaller and fewer transcriptionally active HIV reservoirs. A higher percentage of HIV Gag-specific CD8+ T cell cytotoxic response was associated with lower intact proviral DNA. Predictors of HIV rebound timing differed between early- versus chronic-treated participants, as the strongest reservoir predictor of time to HIV rebound was level of residual viremia in early-treated participants and intact DNA level in chronic-treated individuals. We also identified distinct sets of pre-treatment interruption viral, immune, and inflammatory markers that differentiated participants who had rapid versus slow rebound.CONCLUSIONThe results provide an in-depth overview of the complex interplay of viral, immunologic, and inflammatory predictors of viral rebound and demonstrate that the timing of ART initiation modifies the features of rapid and slow viral rebound.TRIAL REGISTRATIONClinicalTrials.gov NCT03001128FUNDINGNIH National Institute of Allergy and Infectious Diseases, Merck.

Utilizing peripheral blood inflammatory biomarker (PBIB) to predict response to systemic therapy in patients with breast cancer.

Inflammation is a recognized factor in cancer progression and resistance to treatments. Several studies correlated inflammation-related peripheral blood inflammatory biomarkers (PBIB) to disease progression and poor survival in various cancer types and different populations. Nonetheless, inflammation is affected by the distinctive characteristics and environmental exposure of each population. There is no prior study addressing the association of pre-treatment inflammatory markers with outcomes in patients with breast cancer (BC) from Saudi Arabia. In this study, we evaluated the prognosis of locally advanced breast cancer (LABC) in relation to several PBIB. We retrospectively analyzed the data of female patients with LABC undergoing neoadjuvant chemotherapy (NACT). Demographics, body mass index (BMI), clinicopathologic characteristics and stage of the tumor, follow-up status, and response to treatment were collected. Outcomes were evaluated in relation to pre-treatment peripheral blood indices that were grouped based on the local laboratory cutoff values. Objective response rate (ORR) was predefined and assessed according to the post-NACT magnetic resonance imaging (MRI) breast and subcategorized into complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). A total of 172 female patients with BC met the eligibility criteria from January 2014 to December 2019. The mean age at diagnosis was 53.4 ± 11, and BMI was 31.2 ± 6. Left BC accounted for 54.7%, and the majority was invasive ductal carcinoma (85.5%), moderately differentiated (51%), stage III (AJCC 8th edition) (73%), and estrogen receptor (ER)-positive tumor (79.1%). Human epidermal growth factor receptor 2 (HER2)-positive BC was reported in 32% and triple-negative breast cancer (TNBC) in 10%. Radiologic CR accounted for the majority of ORR (71.5%). Higher percentage of patients with normal red cell distribution width (RDW) of red blood cell (RBC) and low neutrophil-lymphocyte ratio (NLR) had CR with a significant P value of 0.003 and 0.014, respectively. Among several peripheral blood indices, RDW and NLR significantly influenced ORR. They can be explored further to potentially predict response after systemic therapy in patients with LABC. The great advantage of these biomarkers stems from their availability and affordability in routine clinical practice.

Monocyte-to-lymphocyte ratio as predictor of cancer therapy-related cardiotoxicity in patients with breast cancer

Abstract Background Elevated pre-treatment baseline inflammation has been associated with cancer therapy-related cardiac dysfunction (CTRCD) in patients with breast cancer. Monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index [SII = (neutrophil × platelets)/ lymphocyte] are inflammation markers easily obtained through of the blood count. Purpose To evaluate the development of CTRCD according to pre-treatment blood inflammatory biomarkers in patients with breast cancer. To evaluate the development of CTRCD in patients with HER2+ early breast cancer according to MLR, NLR, PLR, and SII inflammatory markers obtained from pre-cancer therapy blood count. Methods Prospective cohort study including consecutive female patients ≥ 18 years with HER2+ early breast cancer who consulted at the institution's breast oncology outpatient clinic between march/2019 and march/2022. This study was approved by the Institutional Review Board (protocol No. 2019-0010). Furthermore, it was conducted in accordance with Resolution no.466/12 of the National Health Council. CTRCD: absolute reduction in LVEF &amp;gt; 10% to below 53% (2D-echocardiogram). Survival analysis was performed using Kaplan-Meier curves, compared by the log-rank test, and discrimination ability was evaluated through area under the ROC curve (AUC-ROC). P &amp;lt; 0.05 was considered statistically significant. Results Forty-nine patients (53.3±13.3y) were included and followed up for a median of 13.2 (IQR 25-75%: 10.8-16.1) months. CTRCD was observed in 6 (12.2%) patients. Patients with high blood inflammatory biomarkers had lower CTRCD-free survival (P &amp;lt; 0.050 for all, Figure A-D). MLR showed statistically significant AUC-ROC (0.802; P = 0.017). CTRCD was observed in 27.8% of patients with high MLR vs. 3.2% with low MLR (P = 0.020); negative predictive value was 96.8% (95%CI: 83.3-99.4%). Conclusions In patients with breast cancer, elevated pre-treatment inflammatory markers were associated with increased risk of cardiotoxicity. Among these markers, MLR had good discriminatory performance and high negative predictive value. The incorporation of MLR might improve risk evaluation and selection of patients for follow-up during cancer therapy.Figure (A-D)

1953P Prognostic value of pretreatment inflammatory markers and other clinicopathological factors for early recurrence in soft tissue sarcoma

1953P Prognostic value of pretreatment inflammatory markers and other clinicopathological factors for early recurrence in soft tissue sarcoma

Prognostic value of pretreatment inflammatory markers in localised prostate cancer before radical prostatectomy

PurposeThere is growing evidence of an association between inflammatory processes and cancer development and progression. In different solid tumor entities, a pronounced inflammatory response is associated with worse oncological outcome. In this study, we aim to evaluate the prognostic role of clinically established pretreatment inflammatory markers in patients with localised prostate cancer (PCa) before radical prostatectomy (RP).MethodsA total of 641 men met our inclusion criteria and were followed prospectively for a median of 2.85 years. Univariable logistic and Cox regression analysis were performed to analyse associations between preoperative inflammatory markers and tumor characteristics, and biochemical recurrence free survival (BRFS).ResultsMedian age at RP was 64 years. Gleason Score (GS) 7a (263, 41%) was the most prevalent histology, whereas high-risk PCa (≥ GS 8) was present in 156 (24%) patients. Lympho-nodal metastasis and positive surgical margin (PSM) were detected in 69 (11%) and 180 (28%) patients, respectively. No statistically relevant association could be shown between pretreatment inflammatory markers with worse pathological features like higher tumor stage or grade, nodal positive disease or PSM (for all p > 0.05). Additionally, pretreatment inflammatory markers were not associated with a shorter BRFS (p > 0.05). Known risk factors (tumor grade, tumor stage, nodal positivity and positive surgical margins) were all associated with a shorter BRFS (for all p < 0.0001).ConclusionIn this large prospective cohort, preoperative inflammatory markers were not associated with worse outcome.

Monocyte-to-lymphocyte ratio as predictor of cancer therapy-related cardiotoxicity in patients with breast cancer: a pilot cohort study.

Elevated pre-treatment baseline inflammation has been associated with cancer therapy-related cardiac dysfunction (CTRCD) in patients with breast cancer. Monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio and systemic immune-inflammation index (NLR × platelets) have emerged in clinical context as markers of disease-related inflammation. To evaluate development of CTRCD according to pre-treatment blood inflammatory biomarkers in patients with breast cancer. Pilot cohort study including consecutive female patients ≥ 18years with HER2-positive early breast cancer who consulted at the institution's breast oncology outpatient clinic between march/2019 and march/2022. CTRCD: absolute reduction in LVEF > 10% to below 53% (2D-echocardiogram). Survival analysis was performed using Kaplan-Meier curves, compared by the log-rank test, and discrimination ability was evaluated through AUC-ROC. Forty-nine patients (53.3 ± 13.3y) were included and followed-up for a median of 13.2months. CTRCD was observed in 6 (12.2%) patients. Patients with high blood inflammatory biomarkers had lower CTRCD-free survival (P < 0.050 for all). MLR showed statistically significant AUC (0.802; P = 0.017). CTRCD was observed in 27.8% of patients with high MLR versus 3.2% with low MLR (P = 0.020); negative predictive value was 96.8% (95%CI 83.3-99.4%). In patients with breast cancer, elevated pre-treatment inflammatory markers were associated with increased risk of cardiotoxicity. Among these markers, MLR had good discriminatory performance and high negative predictive value. The incorporation of MLR might improve risk evaluation and selection of patients for follow-up during cancer therapy.

Systemic Immune-Inflammation Index Predicts Restenosis after Interventions for Lower Extremity Arteriosclerosis Obliterans.

To investigate the association between the pretreatment systemic immune-inflammation index (SII) and restenosis after interventions for lower extremity arteriosclerosis obliterans (ASO). We retrospectively evaluated 309 patients with ASO who underwent endovascular interventions between January 2018 and December 2021. Pretreatment inflammatory markers, including the SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), and C-reactive protein (CRP) were collected. The logistic regression model was used to determine the associations between these inflammatory markers and restenosis. Clinical manifestations, ankle-brachial index (ABI), and quality of life after intervention also were compared. The pretreatment SII (p < 0.001), NLR (p < 0.001), PLR (p < 0.001), SIRI (p = 0.002), AISI (p < 0.001), and CRP (p = 0.036) were significantly higher in patients with restenosis than in those without restenosis. Among the four markers, SII had the highest area under the curve (AUC) in predicting restenosis (SII vs. NLR vs. PLR vs. SIRI vs. AISI vs. CRP: 0.715 vs. 0.689 vs. 0.695 vs. 0.643 vs. 0.691 vs. 0.596). Multivariate analysis revealed that the pretreatment SII was the only independent factor for restenosis (hazard ratio [HR]: 4.102; 95% confidence interval [CI]: 1.155-14.567; p = 0.029). Moreover, a lower SII was associated with significantly better improvements in clinical manifestations (Rutherford classification 1-2: 67.5% vs. 52.9%, p = 0.038) and ABI (median: 0.29 vs. 0.22; p = 0.029), together with better quality of life (p < 0.05 for physical functioning, social functioning, pain, and mental health). The pretreatment SII is an independent predictor of restenosis after interventions in patients with lower extremity ASO, providing more accurate prognosis prediction than other inflammatory markers.

Construction of the prognostic model for small-cell lung cancer based on inflammatory markers: A real-world study of 612 cases with eastern cooperative oncology group performance score 0-1.

This research aimed to explore the relationship between pre-treatment inflammatory markers and other clinical characteristics and the survival of small-cell lung cancer (SCLC) patients who received first-line platinum-based treatment and to construct nomograms for predicting overall survival (OS) and progression-free survival (PFS). A total of 612 patients diagnosed with SCLC between March 2008 and August 2021 were randomly divided into two cohorts: a training cohort (n=459) and a validation cohort (n=153). Inflammatory markers, clinicopathological factors, and follow-up information of patients were collected for each case. Cox regression was used to conduct univariate and multivariate analyses and the independent prognostic factors were adopted to develop the nomograms. Harrell's concordance index (C-index) and time-dependent receiver operating characteristic curve were used to verify model differentiation, calibration curve was used to verify consistency, and decision curve analysis was used to verify the clinical application value. Our results showed that baseline C-reactive protein/albumin ratio, neutrophil/lymphocyte ratio, NSE level, hyponatremia, the efficacy of first-line chemotherapy, and stage were independent prognostic factors for both OS and PFS in SCLC. In the training cohort, the C-index of PFS and OS was 0.698 and 0.666, respectively. In the validation cohort, the C-index of PFS and OS was 0.727 and 0.747, respectively. The nomograms showed good predictability and high clinical value. Also, our new clinical models were superior to the US Veterans Administration Lung Study Group (VALG) staging for predicting the prognosis of SCLC. The two prognostic nomograms of SCLC including inflammatory markers, VALG stage, and other clinicopathological factors had good predictive value and could individually assess the survival of patients.

Biomarkers for predicting tumor response to PD-1 inhibitors in patients with advanced pancreatic cancer

ABSTRACT Pancreatic cancer is among the most lethal malignant neoplasms, and few patients with pancreatic cancer benefit from immunotherapy. We retrospectively analyzed advanced pancreatic cancer patients who received PD-1 inhibitor-based combination therapies during 2019–2021 in our institution. The clinical characteristics and peripheral blood inflammatory markers (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR], and lactate dehydrogenase [LDH]) were collected at baseline. Chi-squared and Fisher’s exact tests were used to evaluate relationships between the above parameters and tumor response. Cox regression analyses were employed to assess the effects of baseline factors on patients’ survival and immune-related adverse events (irAEs). Overall, 67 patients who received at least two cycles of PD-1 inhibitor were considered evaluable. A lower NLR was independent predictor for objective response rate (38.1% vs. 15.2%, P = .037) and disease control rate (81.0% vs. 52.2%, P = .032). In our study population, patients with lower LDH had superior progression-free survival (PFS) and overall survival(OS) (mPFS, 5.4 vs. 2.8 months, P < .001; mOS, 13.3 vs. 3.6 months, P < .001). Liver metastasis was verified to be a negative prognostic factor for PFS (2.4 vs. 7.8 months, P < .001) and OS (5.7 vs. 18.0 months, P < .001). The most common irAEs were hypothyroidism (13.4%) and rash (10.5%). Our study demonstrated that the pretreatment inflammatory markers were independent predictors for tumor response, and the baseline LDH level and liver metastasis were potential prognostic markers of survival in patients with pancreatic cancer treated with PD-1 inhibitors.

Platelet-to-lymphocyte ratio might predict the response to dupilumab treatment for patients with nasal polyposis

BackgroundDupilumab is a monoclonal antibody against interleukin 4 receptor alpha and has proven to be clinically effective in treating patients with chronic rhinosinusitis with nasal polyps (CRSwNP). However, a certain number of patients are non- or partial responders. This study aims to investigate the relevance of inflammatory markers with regard to therapy response to dupilumab in CRSwNP patients.MethodsAll patients with CRSwNP treated with dupilumab at a tertiary healthcare center with available pretreatment inflammatory markers were included. The values of pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with the outcome. Patients were stratified according to the respective median value (> median was considered high). The binary logistic regression was performed with regard to total treatment response (post-treatment total nasal polyp score (NPS) 0).ResultsA total of 65 CRSwNP patients with available pretreatment peripheral blood values were included in the study. The mean pre- and post-treatment total NPS values were 4.3 ± 1.9 and 1.2 ± 1.6, respectively. High PLR (> 131.2) was independently associated with a 3.9-fold higher probability of reaching the NPS value of 0 in the multivariable analysis. On the other hand, High NLR (> 1.9) did not significantly associate with the outcome.ConclusionsThe current study provides insights into the potential positive predictive value of the high PLR (> 131.2) in CRSwNP patients regarding treatment with dupilumab. There is a need for further prospective studies for validation of these results, especially in cohorts of patients with severe CRSwNP.

Prognostic relevance of pre-treatment inflammatory biomarkers along with other clinicopathological and treatment factors in oral cavity cancers.

Inflammation has traditionally been considered to be one of the hallmarks of cancer, and systemic inflammatory responses have a prognostic value in many solid cancers. The use of inflammation-based prognostic markers along with traditional clinicopathological prognostic markers in oral cavity cancers has not been studied well. This is a retrospective study from a prospectively maintained database of patients with oral cancers who were managed in a regional cancer center in south India. The study included patients with squamous cell carcinoma of the oral cavity who were treated with curative intent from January to December 2016. Three hundred sixty-one patients met the eligibility criteria and were included in the study. The median age of our patient cohort was 45 years; the male-to-female ratio was 3.7:1. All of the patients underwent curative treatments after a multi-disciplinary board concurrence. Advanced T stage, patients with buccal mucosal cancers and patients who received upfront non-surgical treatments have poorer survival outcomes. The clinicopathological variables that predicted a poorer overall survival in the cohort of patients treated with upfront surgery were advanced T Stage, higher grade, presence of perineural invasion, a higher inflammatory maker, and combination of platelet and neutrophil lymphocyte ratio (COP-NLR). Our unique study of oral cavity cancer patients with a primary aim of exploring the prognostic significance of the pre-treatment inflammatory markers gave very interesting results. The prognostic significance of COP-NLR and other inflammatory markers in oral cancers need to be further explored. More importantly, our study has clearly reiterated that meaningful long-term survival outcomes in oral cavity cancers can only be achieved with the incorporation of upfront surgery.

The Utility of Pre-Treatment Inflammation Markers as Associative Factors to the Adverse Outcomes of Vulvar Cancer: A Study on Staging, Nodal Involvement, and Metastasis Models

Given the role of inflammation in carcinogenesis, this study investigated the utility of pre-treatment inflammatory markers as associative indicators for advanced-stage disease, lymph node metastasis (LNM), and distant metastasis (DM) in vulvar cancer (VC). A cross-sectional study was conducted on 86 women with VC in a single centre in Jakarta, Indonesia. The laboratory data was based on C-reactive protein (CRP), procalcitonin, the erythrocyte sedimentation rate (ESR) and fourteen derived, recorded and calculated ratios: leukocyte-to-platelet (LPR), neutrophil-to-lymphocyte (NLR), derived neutrophil-to-lymphocyte (dNLR), neutrophil-to-monocyte (NMR), platelet-to-monocyte (PLR), lymphocyte-to-monocyte (LMR), basophil-to-monocyte (BLR), systemic immune-inflammation index (SII), body mass index, albumin, and NLR (BAN) score, haemoglobin-to-platelet (HPR), prognostic nutritional index (PNI), modified Glasgow Prognostic Score (mGPS), CRP-to-albumin, and CRP-to-procalcitonin. The optimal cut-off for each marker was determined using receiver operating characteristic (ROC) curve analysis, and their diagnostic indicator performances were assessed. The utility of these ratios as associative factors for three endpoints was further evaluated in multivariate regression models. Investigated inflammatory markers exhibited specific performances for individual adverse outcomes, proving a fair to excellent ability in case finding and screening. After adjustment, the BAN score ≤ 334.89 (OR 9.20, p = 0.001) and ESR ≥ 104 (OR 4.18, p = 0.048) become two advanced-stage associative factors with AUC: 0.769. LNM was solely determined by higher NLR ≥ 2.83 (OR 4.15, p = 0.014) with AUC: 0.615. Meanwhile, BLR ≥ 0.035 (OR 5.67, p = 0.001) and ESR ≥ 84 (OR 6.01, p = 0.003) were contributing factors for DM, with AUC: 0.765. Inflammatory markers are crucial for identifying the deleterious outcomes of VC. Accordingly, yielded models require external validation.

PO-1104 Impact of pre-treatment inflammatory markers in head and neck cancer treated with chemoradiotherapy

PO-1104 Impact of pre-treatment inflammatory markers in head and neck cancer treated with chemoradiotherapy

Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer.

We aimed to review whether pretreatment inflammatory markers reflect the short- and long-term outcomes of patients with colon cancer, rectal cancer, colon and rectal cancers, and metastatic colorectal cancer (CRC). We found that pretreatment complete blood count and blood chemistry tests reflect short-term and long-term oncological outcomes in patients with CRC. Specifically, in patients with colon cancer, hypoalbuminemia was associated with worse postoperative morbidity, mortality, and inferior survival. In patients with rectal cancer, elevated neutrophil-lymphocyte ratio (NLR) and thrombocytosis were associated with postoperative complications, poor overall survival (OS), and disease-free survival (DFS). A high C-reactive protein/albumin ratio (CAR) was associated with poor OS and DFS. In patients with metastatic CRC, increased NLR and platelet-lymphocyte ratio (PLR) were associated with poor OS, DFS, and progression-free survival (PFS). In addition, high CAR and a low albumin/globulin ratio on blood chemistry tests were associated with poor OS and PFS. Although universal cut-off values were not available, various types of pretreatment laboratory markers could be utilized as adjuncts to predict prognosis in patients with CRC.

Abstract P1-08-29: The influence of pre-treatment peripheral blood inflammatory markers on post-treatment response in patients with locally advanced breast cancer (LABC) from Saudi Arabia

Abstract Background: Inflammation is a recognized factor in cancer progression and resistance to treatment. Several studies correlated inflammation-related peripheral blood indices (PBI) to disease progression and poor survival in various cancers and different populations. Nonetheless, inflammation is affected by the distinctive characteristics and environmental exposure of each population. There is no prior study addressing the association of pre-treatment inflammatory markers with outcomes in patients with BC from Saudi Arabia. In this study, we evaluated post-treatment response of LABC in relation to inflammation-related PBI. Methods: We retrospectively analyzed the data of female patients with LABC undergoing neoadjuvant chemotherapy (NACT). Demographics, BMI, clinicopathologic characteristics and stage of the tumor, follow-up status and response to treatment were collected. Outcomes were evaluated in relation to pre-treatment PBI that were grouped based on the local laboratory cutoff values. Response rate (RR) and type was assessed according to post-NACT radiologic evaluation of the breast and subcategorized into complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Results: A total of 172 female patients with BC met the eligibility criteria from January 2014 to December 2019. The mean age at diagnosis was 53±11, and BMI was 31±6. Left BC accounted for 55% and the majority was invasive ductal carcinoma in 85.5%, moderately differentiated in 51%, stage III (AJCC 8th edition) in 73%, and HR-positive tumor in 79%. HER2-positive BC was reported in 32% and TNBC in 10%. Radiologic (CR) accounted for the majority of RR (71.5%). A higher percentage of patients with normal red cell distribution width (RDW) and low neutrophil to lymphocyte ratio (NLR) had radiologic CR with a significant P-value of (0.003) and (0.014), respectively (Table 1). Conclusion: Among several peripheral blood indices, only RDW and NLR significantly influenced post-treatment response in this cohort. They can be explored further to potentially predict response after systemic therapy in patients with LABC. The great advantage of these biomarkers stems from their availability and affordability in routine clinical practice. Table 1.Post-treatment response type &amp; distribution according to inflammation-related peripheral blood indicesVariablesCR(N=123)PR(N=20)SD(N=23)PD(N=6)P valueN=172N(%)N(%)N(%)N(%)NLR High &amp;gt;322(81%)2(7%)0(0%)3(11%)0.014Low ≤3101(70%)18(12%)23(15%)3(2%)RDW High &amp;gt;14.122(92%)2(8%)0(0%)0(0%)0.003Normal 11-14.1100(69%)18(12%)23(16%)5(3%)Low &amp;lt;111(50%)0(0%)0(0%)1(50%) Citation Format: Atlal Abusanad, Abdullah M Alghamdi, Ahmed M Saggaf, Tala Gazzaz, Rival Brika. The influence of pre-treatment peripheral blood inflammatory markers on post-treatment response in patients with locally advanced breast cancer (LABC) from Saudi Arabia [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-08-29.

Prognostic Value of Pretreatment Inflammatory Markers in Patients Receiving Radical Cystectomy for Urothelial Bladder Cancer: Does Age Matter?

Introduction: Biomarkers are known predictors for survival after radical cystectomy (RC) and can improve patient stratification. Yet, it remains unclear how age influences their prognostic value. The current study aimed to assess the impact of age on standard prognostic biomarkers in different age-groups. Materials and Methods: Overall, 1,014 patients undergoing RC for bladder cancer were included. Patients were divided into age-groups (I – <60, II – 60–69, III – 70–79, and IV – ≥80). C-reactive protein (CRP), hemoglobin (Hb), thrombocytes, and leucocytes prior to RC were used as biomarkers. The Kaplan-Meier method and log-rank test were used to compare overall survival (OS) and cancer-specific survival (CSS). For independent predictors of survival, multivariate models were applied. Results: Absolute levels of biomarkers except CRP revealed a significant decrease with increasing age. We found low Hb to be associated with impaired CSS in groups II (2.05 [1.32–3.17]; p = 0.001), III (2.83 [2.01–4.00]; p < 0.001), and IV (1.79 [1.12–2.84]; p = 0.014). Thrombocytes above the cutoff were associated with impaired CSS and OS in groups II, III, and IV for CSS and OS. Leukocytes were associated with impaired CSS and OS in group II (2.11 [1.38–3.23]; p < 0.001 and 1.99 [1.36–2.90]; p < 0.001) and III (1.70 [1.08–2.67]; p = 0.021 and 1.80 [1.25–2.58]; p = 0.002). Elevated CRP was associated with impaired CSS and OS across all groups. Conclusion: Biomarkers are predictors for survival after RC. Yet, their impact on survival is less in the oldest patient group. Therefore, careful patient stratification and treatment administration should be considered in elderly patients. Further investigations are needed to fully understand the underlying mechanisms.