Baseline neutrophil-to-lymphocyte ratio is associated with outcome of ipilimumab-treated metastatic melanoma patients.
Baseline neutrophil-to-lymphocyte ratio is associated with outcome of ipilimumab-treated metastatic melanoma patients.
复制标题
基线嗜中性粒细胞与淋巴细胞比率与经ipilmimab治疗的转移性黑色素瘤患者的结果有关。
DOI：
10.1038/bjc.2015.180
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发表时间：
2015-06-09
影响因子：
8.8
通讯作者：
Martinoli C
中科院分区：
文献类型：
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作者：
Ferrucci PF;Gandini S;Battaglia A;Alfieri S;Di Giacomo AM;Giannarelli D;Cappellini GC;De Galitiis F;Marchetti P;Amato G;Lazzeri A;Pala L;Cocorocchio E;Martinoli C
伊匹单抗可提高转移性黑色素瘤患者的生存率。尽管有记录的、持久的客观反应，但仍有大量患者未能从治疗中受益。本研究的目的是确定治疗益处的前期标记。共有 187 名转移性黑色素瘤患者在三个意大利机构接受 3 mg kg−1 ipilimumab 治疗，以及 27 名患者接受 10mg kg−1 ipilimumab 治疗，接受了评估。根据治疗前全血细胞计数计算中性粒细胞与淋巴细胞比率（NLR）。使用 Kaplan-Meier 方法评估无进展生存期 (PFS) 和总生存期 (OS)，并应用多变量 Cox 模型，调整混杂因素和其他预后因素。在欧洲肿瘤研究所治疗的 69 名患者的训练队列中，多变量分析中，治疗前 NLR 被确定为治疗获益的最强且独立的标志物。与 NLR≥5 的患者相比，基线 NLR<5 的患者的 PFS（HR=0.38；95% CI：0.22-0.66；P=0.0006）和 OS（HR=0.24；95% CI：0.13-0.46；P<0.0001）显着改善。三个验证患者队列证实了低 NLR 与生存率改善之间的关联。我们的研究结果表明，基线 NLR 与伊匹单抗治疗患者的结局密切相关且独立相关，并且可能有助于识别最有可能从该治疗中受益的患者。
Ipilimumab improves the survival of metastatic melanoma patients. Despite documented, durable objective responses, a significant number of patients fails to benefit from treatment. The aim of this study was to identify an upfront marker for treatment benefit. A total of 187 metastatic melanoma patients treated in three Italian Institutions with 3 mg kg−1 ipilimumab, and 27 patients treated with 10 mg kg−1 ipilimumab, were evaluated. Neutrophil-to-lymphocyte ratio (NLR) was calculated from pre-therapy full blood counts. Progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan–Meier method, and multivariate Cox models were applied, adjusting for confounders and other prognostic factors. In the training cohort of 69 patients treated at European Institute of Oncology, pre-therapy NLR was identified as the strongest and independent marker for treatment benefit in multivariate analyses. Patients with baseline NLR<5 had a significantly improved PFS (HR=0.38; 95% CI: 0.22–0.66; P=0.0006) and OS (HR=0.24; 95% CI: 0.13–0.46; P<0.0001) compared with those with a NLR⩾5. Associations of low NLR with improved survival were confirmed in three validation cohorts of patients. Our findings show that baseline NLR is strongly and independently associated with outcome of patients treated with ipilimumab, and may serve to identify patients most likely to benefit from this therapy.