■在不同肿瘤中,血小板-淋巴细胞比率(PLR)和中性粒细胞-淋巴细胞比率(NLR)作为独立的预后标志物的作用已得到充分确立。然而,对于NLR和PLR作为免疫检查点抑制剂(ICIs)治疗结局的预测因子的潜力,目前评价有限.
■建立NLR和PLR之间的相关性以及ICI的临床获益潜力。
■对报道NLR,PLR,以及使用ICIs治疗的癌症患者的治疗结果。感兴趣的结果是客观反应率(ORR),疾病控制率(DCR),和进行性疾病(PD)。ORR是获得完全反应和部分反应的患者的总和。DCR包括病情稳定的患者。PD是进展的患者比例,复发,或停止治疗。使用STATA12.0软件包进行统计分析。异质性由I2值确定。使用纽卡斯尔-渥太华量表进行质量评估。采用Egger检验建立发表偏倚和敏感性分析。
■系统综述共纳入40篇符合纳入标准的论文。然而,只有17项研究用于荟萃分析来确定NLR之间的相关性,PLR,和治疗反应。我们发现,在不同的肿瘤中研究了使用ICI治疗以及使用PLR和NLR参数监测结果和不良事件。我们的分析表明,低NLR与较高的ORR(OR=0.62(95%CI0.47-0.81,p=0.001)和较高的DCR(OR=0.23,95%CI0.14-0.36,p<0.001)相关。较高的NLR预测PD的概率较高(OR=3.12,95%CI1.44,6.77,p=0.004)。同样,低PLR与高ORR相关(OR=0.69,95%CI0.5,0.95,p=0.025)。一般来说,NLR和PLR较低的患者更有可能获得临床获益和更好的缓解(p值<0.001).同时,高比率的患者更有可能进展(p值<0.005),尽管研究之间存在显著的异质性。没有观察到显著的发表偏倚。
■研究表明,基线或治疗期间的高NLR和PLR与较差的治疗结果相关。因此,这些比率可以在临床实践中与其他标志物一起使用,以确定免疫疗法的治疗功效。
UNASSIGNED: 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).
UNASSIGNED: To establish a correlation between NLR and PLR and the potential of clinical benefit from ICIs.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.