Neutrophil-lymphocyte ratio predicts early outcomes in patients with unresectable hepatocellular carcinoma treated with atezolizumab plus bevacizumab: a multicenter analysis
Neutrophil-lymphocyte ratio predicts early outcomes in patients with unresectable hepatocellular carcinoma treated with atezolizumab plus bevacizumab: a multicenter analysis
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DOI：
10.1097/meg.0000000000002356
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发表时间：
2022-06-01
影响因子：
2.1
通讯作者：
Hiasa, Yoichi
中科院分区：
文献类型：
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作者：
Tada, Toshifumi;Kumada, Takashi;Hiasa, Yoichi
目的：探讨中性粒细胞与淋巴细胞比率 (NLR) 是否可以预测接受阿特珠单抗联合贝伐单抗 (Atez/Bev) 治疗的不可切除肝细胞癌 (HCC) 患者的预后。方法：总共纳入了 249 名接受 Atez/Bev 治疗的不可切除 HCC 患者。我们分析了该队列中该疗法的生存率和中止情况。结果：2、4、6和8个月的累积总生存率分别为97.6%、94.9%、88.9%和82.8%。 NLR 低 (= 3.0) 的患者之间的累积总生存率存在显着差异 (P = 0.001)。相反，低 NLR 患者与高 NLR 患者的累积无进展生存期没有差异。缓解分布为：完全缓解为 1.5%，部分缓解为 17.1%，疾病稳定为 60.5%，疾病进展为 21.0%。低 NLR 和高 NLR 患者的反应没有差异。关于不良事件，低NLR患者和高NLR患者之间，任何级别和至少3级的免疫相关肝损伤、任何级别的食欲下降、至少3级的蛋白尿以及任何级别的其他不良事件均存在显着差异。分别有 56 名、18 名和 2 名患者因疾病进展、不良事件和其他原因停止 Atez/Bev 治疗。低 NLR 患者与高 NLR 患者之间因不良事件而导致的 Atez/Bev 治疗累积停药率存在显着差异 (P = 0.022)。采用逆概率加权的 Cox 比例风险模型分析表明，至少 3.0 的 NLR 与总生存率显着相关（风险比，3.369；95% 置信区间，1.024-11.080）。结论：NLR 可以预测接受 Atez/Bev 治疗的不可切除 HCC 患者的预后。
Objective: To investigate whether neutrophil-to-lymphocyte ratio (NLR) can predict outcomes in patients with unresectable hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab (Atez/Bev). Methods: A total of 249 patients with unresectable HCC treated with Atez/Bev were included. We analyzed survival and discontinuation of this therapy in this cohort. Results: Cumulative overall survival at 2, 4, 6, and 8 months was 97.6%, 94.9%, 88.9%, and 82.8%, respectively. Cumulative overall survival differed significantly between patients with low (= 3.0) NLR (P = 0.001). Conversely, cumulative progression-free survival did not differ between patients with low versus high NLR. The distribution of response was 1.5% for complete response, 17.1% for partial response, 60.5% for stable disease, and 21.0% for progressive disease. Responses were not different between patients with low and high NLR. Regarding adverse events, immune-related liver injury of any grade and grade of at least 3, decreased appetite of any grade, grade of at least 3 proteinuria, and other adverse events of any grade differed significantly between patients with low and high NLR. There were 56, 18, and 2 patients who discontinued Atez/Bev therapy due to progression of disease, adverse event, and other reasons, respectively. The cumulative discontinuation rate for Atez/Bev therapy due to adverse events differed significantly between patients with low versus high NLR (P = 0.022). Cox proportional hazards modeling analysis with inverse probability weighting showed that NLR of at least 3.0 was significantly associated with overall survival (hazard ratio, 3.369; 95% confidence interval, 1.024-11.080). Conclusions: NLR can predict outcomes in patients with unresectable HCC treated with Atez/Bev.