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Stangl-Kremser J, Sun M, Ho B, Thomas J, Nauseef JT, Osborne JR, Molina A, Sternberg CN, Nanus DM, Bander NH, Tagawa S. Prognostic value of neutrophil-to-lymphocyte ratio in patients with metastatic castration-resistant prostate cancer receiving prostate-specific membrane antigen targeted radionuclide therapy. Prostate 2023; 83:1351-1357. [PMID: 37424145 DOI: 10.1002/pros.24597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/23/2023] [Accepted: 06/29/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Neutrophil count:lymphocyte count ratio (NLR) may be a prognostic factor for men with advanced prostate cancer. We hypothesized that it is associated with prostate-specific antigen (PSA) response and survival in men treated with prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy (TRT). METHODS Data of 180 men with metastatic castration-resistant prostate cancer (mCRPC) who were treated in sequential prospective radionuclide clinical trials from 2002 to 2021 (utilizing 177Lu-J591, 90Y-J591, 177Lu-PSMA-617, or 225Ac-J591) were retrospectively analyzed. We used a logistic regression to determine the association between NLR and ≥50% PSA decline (PSA50) and a Cox proportional hazards model to investigate the association between NLR and overall survival (OS). RESULTS A total of 94 subjects (52.2%) received 177Lu-J591, 51 (28.3%) 177Lu-PSMA-617, 28 (15.6%) 225Ac-J591, and 7 (3.9%) 90Y-J591. The median NLR of 3.75 was used as cut-off (low vs. high NLR; n = 90, respectively). On univariate analysis, NLR was not associated with PSA50 (HR 1.08; 95% confidence interval [CI] 0.99-1.17, p = 0.067). However, it was associated with worse OS (hazard ratio [HR] 1.06, 95% CI 1.02-1.09, p = 0.002), also after controlling for circulating tumor cell count and cancer and leukemia group B risk group (HR 1.05; 95% CI 1.003-1.11, p = 0.036). Men with high NLR were at a higher hazard of death from all causes (HR 1.43, 95% CI 1.05-1.94, p = 0.024). CONCLUSIONS NLR provides prognostic information in the setting of patients with mCRPC receiving treatment with PSMA-TRT.
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Affiliation(s)
| | - Michael Sun
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Benedict Ho
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Joseph Thomas
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Jones T Nauseef
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
- Meyer Cancer Center, Weill Cornell Medicine, New York, New York, USA
| | - Joseph R Osborne
- Meyer Cancer Center, Weill Cornell Medicine, New York, New York, USA
- Department of Radiology, Division of Molecular Imaging and Therapeutics, Weill Cornell Medicine, New York, New York, USA
| | - Ana Molina
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Cora N Sternberg
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
- Meyer Cancer Center, Weill Cornell Medicine, New York, New York, USA
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York, USA
| | - David M Nanus
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
- Meyer Cancer Center, Weill Cornell Medicine, New York, New York, USA
| | - Neil H Bander
- Department of Urology, Weill Cornell Medicine, New York, New York, USA
- Meyer Cancer Center, Weill Cornell Medicine, New York, New York, USA
| | - Scott Tagawa
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
- Meyer Cancer Center, Weill Cornell Medicine, New York, New York, USA
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Cegla P, Currie G, Wróblewska JP, Cholewiński W, Kaźmierska J, Marszałek A, Kubiak A, Golusinski P, Golusiński W, Majchrzak E. Influence of Semiquantitative [18F]FDG PET and Hematological Parameters on Survival in HNSCC Patients Using Neural Network Analysis. Pharmaceuticals (Basel) 2022; 15:ph15020224. [PMID: 35215335 PMCID: PMC8875232 DOI: 10.3390/ph15020224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 02/08/2023] Open
Abstract
The aim of this study is to assess the influence of semiquantitative PET-derived parameters as well as hematological parameters in overall survival in HNSCC patients using neural network analysis. Retrospective analysis was performed on 106 previously untreated HNSCC patients. Several PET-derived parameters (SUVmax, SUVmean, TotalSUV, MTV, TLG, TLRmax, TLRmean, TLRTLG, and HI) for primary tumor and lymph node with highest activity were assessed. Additionally, hematological parameters (LEU, LEU%, NEU, NEU%, MON, MON%, PLT, PLT%, NRL, and LMR) were also assessed. Patients were divided according to the diagnosis into the good and bad group. The data were evaluated using an artificial neural network (Neural Analyzer version 2.9.5) and conventional statistic. Statistically significant differences in PET-derived parameters in 5-year survival rate between group of patients with worse prognosis and good prognosis were shown in primary tumor SUVmax (10.0 vs. 7.7; p = 0.040), SUVmean (5.4 vs. 4.4; p = 0.047), MTV (23.2 vs. 14.5; p = 0.010), and TLG (155.0 vs. 87.5; p = 0.05), and mean liver TLG (27.8 vs. 30.4; p = 0.031), TLRmax (3.8 vs. 2.6; p = 0.019), TLRmean (2.8 vs. 1.9; p = 0.018), and in TLRTLG (5.6 vs. 2.3; p = 0.042). From hematological parameters, only LMR showed significant differences (2.5 vs. 3.2; p = 0.009). Final neural network showed that for ages above 60, primary tumors SUVmax, TotalSUV, MTV, TLG, TLRmax, and TLRmean over (9.7, 2255, 20.6, 145, 3.6, 2.6, respectively) are associated with worse survival. Our study shows that the neural network could serve as a supplement to PET-derived parameters and is helpful in finding prognostic parameters for overall survival in HNSCC.
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Affiliation(s)
- Paulina Cegla
- Department of Nuclear Medicine, Greater Poland Cancer Center, 61-866 Poznan, Poland;
- Correspondence:
| | - Geoffrey Currie
- School of Dentistry and Health Science, Charles Sturt University, Wagga Wagga 2678, Australia;
| | - Joanna P. Wróblewska
- Department of Oncologic Pathology and Prophylaxis, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (J.P.W.); (A.M.)
- Department of Tumor Pathology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Witold Cholewiński
- Department of Nuclear Medicine, Greater Poland Cancer Center, 61-866 Poznan, Poland;
- Department of Electroradiology, Poznan University of Medical Science, 61-701 Poznan, Poland;
| | - Joanna Kaźmierska
- Department of Electroradiology, Poznan University of Medical Science, 61-701 Poznan, Poland;
- 2nd Radiotherapy Department, Greater Poland Cancer Center, 61-866 Poznan, Poland
| | - Andrzej Marszałek
- Department of Oncologic Pathology and Prophylaxis, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (J.P.W.); (A.M.)
- Department of Tumor Pathology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Anna Kubiak
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Pawel Golusinski
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, 65-046 Zielona Góra, Poland;
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Center, 61-866 Poznan, Poland; (W.G.); (E.M.)
| | - Ewa Majchrzak
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Center, 61-866 Poznan, Poland; (W.G.); (E.M.)
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Arman T, Nelson PS. Endocrine and paracrine characteristics of neuroendocrine prostate cancer. Front Endocrinol (Lausanne) 2022; 13:1012005. [PMID: 36440195 PMCID: PMC9691667 DOI: 10.3389/fendo.2022.1012005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Prostate cancer is a common malignancy affecting men worldwide. While the vast majority of newly diagnosed prostate cancers are categorized as adenocarcinomas, a spectrum of uncommon tumor types occur including those with small cell and neuroendocrine cell features. Benign neuroendocrine cells exist in the normal prostate microenvironment, and these cells may give rise to primary neuroendocrine carcinomas. However, the more common development of neuroendocrine prostate cancer is observed after therapeutics designed to repress the signaling program regulated by the androgen receptor which is active in the majority of localized and metastatic adenocarcinomas. Neuroendocrine tumors are identified through immunohistochemical staining for common markers including chromogranin A/B, synaptophysin and neuron specific enolase (NSE). These markers are also common to neuroendocrine tumors that arise in other tissues and organs such as the gastrointestinal tract, pancreas, lung and skin. Notably, neuroendocrine prostate cancer shares biochemical features with nerve cells, particularly functions involving the secretion of a variety of peptides and proteins. These secreted factors have the potential to exert local paracrine effects, and distant endocrine effects that may modulate tumor progression, invasion, and resistance to therapy. This review discusses the spectrum of factors derived from neuroendocrine prostate cancers and their potential to influence the pathophysiology of localized and metastatic prostate cancer.
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Affiliation(s)
- Tarana Arman
- Division of Human Biology, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Peter S. Nelson
- Division of Human Biology, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA, United States
- *Correspondence: Peter S. Nelson,
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Meisel A, de Wit R, Oudard S, Sartor O, Stenner-Liewen F, Shun Z, Foster M, Ozatilgan A, Eisenberger M, de Bono JS. Neutropenia, neutrophilia, and neutrophil-lymphocyte ratio as prognostic markers in patients with metastatic castration-resistant prostate cancer. Ther Adv Med Oncol 2022; 14:17588359221100022. [PMID: 35677318 PMCID: PMC9168856 DOI: 10.1177/17588359221100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/25/2022] [Indexed: 12/24/2022] Open
Abstract
Background and purpose Chemotherapy-induced neutropenia and neutrophil-to-lymphocyte ratio (NLR) are potentially useful prognostic markers in patients with metastatic castration-resistant prostate cancer (mCRPC). This post hoc analysis investigated whether these markers can be utilized for dose considerations and evaluated the prognostic impact of leukocyte subtypes. Patients and methods PROSELICA assessed the non-inferiority of cabazitaxel 20 mg/m2 (C20; n = 598) versus 25 mg/m2 (C25; n = 602) for overall survival (OS) in patients with mCRPC previously treated with docetaxel. The association of grade ⩾ 3 neutropenia, NLR, baseline neutrophilia and lymphopenia with OS, progression-free survival (PFS), and prostate-specific antigen response rate (PSArr) was investigated by an unplanned uni- and multivariate analyses. Results PROSELICA confirmed the negative prognostic value of increased baseline NLR [⩾3, hazard ratio (HR) 1.40; p < 0.0001], but did not identify a subgroup of patients benefiting more from C20 or C25. In this post hoc analysis, patients who developed grade ⩾3 neutropenia (n = 673) had a significantly improved OS [∆OS = 2.7 months, HR = 0.78 (95% CI 0.68-0.89)] with the greatest advantage observed in patients with baseline neutrophilia [n = 85; 5.3 months, 0.60 (0.42-0.84)]. After adjustment for the Halabi criteria, neutropenia grade ⩾ 3 was the only biomarker that remained significantly associated with OS [ (HR 0.86 (0.75-0.98)], PFS [HR 0.78 (0.68-0.88)], and PSArr [odds ratio (OR) 1.82 (1.37-2.41)] while neutrophilia showed the strongest association with OS [1.53 (1.29-1.81)]. Conclusions Grade ⩾ 3 neutropenia was the only leukocyte-based biomarker associated with all key outcome parameters in mCRPC patients receiving cabazitaxel and might be able to overcome the negative prognostic effect of baseline neutrophilia. NCT number NCT01308580.
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Affiliation(s)
| | - Ronald de Wit
- Medical Oncology, Erasmus University Medical
Center, Rotterdam, The Netherlands
| | - Stephane Oudard
- Service d'Oncologie Médicale, Georges Pompidou
European Hospital, Rene Descartes University, Paris, France
| | - Oliver Sartor
- Medicine and Urology, Tulane Cancer Center, New
Orleans, LA, USA
| | | | | | | | - Ayse Ozatilgan
- Global Medical Affairs Oncology, Sanofi,
Cambridge, MA, USA
| | - Mario Eisenberger
- The Sidney Kimmel Comprehensive Cancer Center,
Johns Hopkins Hospital, Baltimore, MD, USA
| | - Johann S. de Bono
- Division of Clinical Studies, Drug Development
Unit, The Royal Marsden NHS Foundation Trust/The Institute of Cancer
Research, London, UK
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5
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de Wit R, Wülfing C, Castellano D, Kramer G, Eymard JC, Sternberg CN, Fizazi K, Tombal B, Bamias A, Carles J, Iacovelli R, Melichar B, Sverrisdóttir Á, Theodore C, Feyerabend S, Helissey C, Foster MC, Ozatilgan A, Geffriaud-Ricouard C, de Bono J. Baseline neutrophil-to-lymphocyte ratio as a predictive and prognostic biomarker in patients with metastatic castration-resistant prostate cancer treated with cabazitaxel versus abiraterone or enzalutamide in the CARD study. ESMO Open 2021; 6:100241. [PMID: 34450475 PMCID: PMC8390550 DOI: 10.1016/j.esmoop.2021.100241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/05/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023] Open
Abstract
Background There is growing evidence that a high neutrophil-to-lymphocyte ratio (NLR) is associated with poor overall survival (OS) for patients with metastatic castration-resistant prostate cancer (mCRPC). In the CARD study (NCT02485691), cabazitaxel significantly improved radiographic progression-free survival (rPFS) and OS versus abiraterone or enzalutamide in patients with mCRPC previously treated with docetaxel and the alternative androgen-receptor-targeted agent (ARTA). Here, we investigated NLR as a biomarker. Patients and methods CARD was a multicenter, open-label study that randomized patients with mCRPC to receive cabazitaxel (25 mg/m2 every 3 weeks) versus abiraterone (1000 mg/day) or enzalutamide (160 mg/day). The relationships between baseline NLR [< versus ≥ median (3.38)] and rPFS, OS, time to prostate-specific antigen progression, and prostate-specific antigen response to cabazitaxel versus ARTA were evaluated using Kaplan–Meier estimates. Multivariable Cox regression with stepwise selection of covariates was used to investigate the prognostic association between baseline NLR and OS. Results The rPFS benefit with cabazitaxel versus ARTA was particularly marked in patients with high NLR {8.5 versus 2.8 months, respectively; hazard ratio (HR) 0.43 [95% confidence interval (CI) 0.27-0.67]; P < 0.0001}, compared with low NLR [7.5 versus 5.1 months, respectively; HR 0.69 (95% CI 0.45-1.06); P = 0.0860]. Higher NLR (continuous covariate, per 1 unit increase) independently associated with poor OS [HR 1.05 (95% CI 1.02-1.08); P = 0.0003]. For cabazitaxel, there was no OS difference between patients with high versus low NLR (15.3 versus 12.9 months, respectively; P = 0.7465). Patients receiving an ARTA with high NLR, however, had a worse OS versus those with low NLR (9.5 versus 13.3 months, respectively; P = 0.0608). Conclusions High baseline NLR predicts poor outcomes with an ARTA in patients with mCRPC previously treated with docetaxel and the alternative ARTA. Conversely, the activity of cabazitaxel is retained irrespective of NLR. Baseline NLR was evaluated as a biomarker in patients with mCRPC treated with cabazitaxel versus abiraterone or enzalutamide. High baseline NLR predicted poor outcomes with abiraterone or enzalutamide in patients with mCRPC. Clinical benefit from cabazitaxel was retained in higher baseline NLR patients.
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Affiliation(s)
- R de Wit
- Department of Medical Oncology, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - C Wülfing
- Department of Urology, Asklepios Tumorzentrum, Hamburg, Germany
| | - D Castellano
- Department of Medical Oncology, University Hospital 12 de Octubre, Madrid, Spain
| | - G Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - J-C Eymard
- Department of Medical Oncology, Institute Jean Godinot, Reims, France
| | - C N Sternberg
- Division of Hematology and Medical Oncology, Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, USA
| | - K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, Villejuif, France; University of Paris Saclay, Saint-Aubin, France
| | - B Tombal
- Institut de Recherche Clinique, Université Catholique de Louvain, Louvain, Belgium
| | - A Bamias
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - J Carles
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - R Iacovelli
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy; Department of Medical Oncology, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - B Melichar
- Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic
| | - Á Sverrisdóttir
- Department of Oncology, Landspitali University Hospital, Reykjavik, Iceland
| | - C Theodore
- Department of Oncology, Foch Hospital, Suresnes, France
| | | | - C Helissey
- Hôpital d'Instruction des Armées Bégin, Saint Mandé, France
| | - M C Foster
- Global Medical Oncology, Sanofi, Cambridge, USA
| | - A Ozatilgan
- Global Medical Oncology, Sanofi, Cambridge, USA
| | | | - J de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, UK; Prostate Targeted Therapy Group, Royal Marsden Hospital, London, UK
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Mjaess G, Chebel R, Karam A, Moussa I, Pretot D, Abi Tayeh G, Sarkis J, Semaan A, Peltier A, Aoun F, Albisinni S, Roumeguère T. Prognostic role of neutrophil-to-lymphocyte ratio (NLR) in urological tumors: an umbrella review of evidence from systematic reviews and meta-analyses. Acta Oncol 2021; 60:704-713. [PMID: 33586577 DOI: 10.1080/0284186x.2021.1886323] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) has been studied as a biomarker for cancer prognosis, predicting survival in many tumors. The aim of this umbrella review was to combine the results from all systematic reviews and meta-analyses related to the prognostic role of the NLR in patients with urological tumors. METHODS A PubMed, Scopus, Embase and Cochrane search was undergone from inception through September 2020 for systematic reviews and meta-analyses investigating the prognostic value of NLR in urological tumors, subdivided into prostate cancer, renal cell carcinoma, urothelial bladder and upper tract carcinomas PROSPERO (CRD42020216310). RESULTS The results have shown, with a high level of evidence, that an elevated NLR predicts worse overall survival (OS), progression-free survival (PFS) and relapse-free survival (RFS) in prostate cancer, worse OS, PFS and RFS in renal cell carcinoma, worse OS, PFS, RFS and cancer-specific survival (CSS) in muscle invasive bladder cancer, worse PFS and RFS in non-muscle invasive bladder cancer, and worse OS, PFS, RFS and CSS in urothelial upper tract carcinoma. CONCLUSION NLR has a significant prognostic value in urological tumors and should be included in prognostic scores of these cancers.
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Affiliation(s)
- Georges Mjaess
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Hotel-Dieu de France, University of Saint Joseph, Beirut, Lebanon
| | - Roy Chebel
- Hotel-Dieu de France, University of Saint Joseph, Beirut, Lebanon
| | - Aya Karam
- Hotel-Dieu de France, University of Saint Joseph, Beirut, Lebanon
| | - Ilan Moussa
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Dominique Pretot
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Julien Sarkis
- Hotel-Dieu de France, University of Saint Joseph, Beirut, Lebanon
| | - Albert Semaan
- Hotel-Dieu de France, University of Saint Joseph, Beirut, Lebanon
| | | | - Fouad Aoun
- Hotel-Dieu de France, University of Saint Joseph, Beirut, Lebanon
- Department of Urology, Institut Jules Bordet, Brussels, Belgium
| | - Simone Albisinni
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Thierry Roumeguère
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Department of Urology, Institut Jules Bordet, Brussels, Belgium
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7
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Lee YG, Chang H, Keam B, Chun SH, Park J, Park KU, Shin SH, An HJ, Lee KE, Lee KW, Kim HR, Kim SB, Ahn MJ, Hwang IG. Outcomes and Biomarkers of Immune Checkpoint Inhibitor Therapy in Patients with Refractory Head and Neck Squamous Cell Carcinoma: KCSG HN18-12. Cancer Res Treat 2020; 53:671-677. [PMID: 33285051 PMCID: PMC8291197 DOI: 10.4143/crt.2020.824] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 12/04/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose This study was conducted to determine the effectiveness of immune checkpoint inhibitors (ICIs) in recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) after platinum-containing chemotherapy. We also identified clinical biomarkers which may be predictive of patient prognosis. Materials and Methods We analyzed 125 patients with R/M HNSCC who received ICIs, retrospectively. Overall response rate (ORR) was the primary study outcome. Overall survival (OS) and progression-free survival (PFS) were the secondary study outcomes. Results The patients received anti–programmed cell death protein-1 (PD-1) (n=73, 58%), anti–programmed death-ligand 1 (PD-L1) (n=24, 19%), or a combination of anti–PD-1/PD-L1 and anti–cytotoxic T-lymphocyte antigen 4 (n=28, 22%). The median age was 57 years (range, 37 to 87). The location of the primary tumor was in the oral cavity in 28% of the cases, followed by oropharynx (27%), hypopharynx (20%), and larynx (12%). The ORR was 15% (19/125). With 12.3 months of median follow-up, median PFS was 2.7 months. Median OS was 10.8 months. A neutrophil-to-lymphocyte ratio (NLR) > 4 was significantly associated with poor response to ICIs (odds ratio, 0.30; p=0.022). A sum of the target lesions > 40 mm (hazard ratio [HR], 1.53; p=0.046] and a NLR > 4 (HR, 1.75; p=0.009) were considered to be predictive markers of short PFS. A poor performance status (HR, 4.79; p < 0.001), a sum of target lesions > 40 mm (HR, 1.93; p=0.025), and an NLR > 4 (HR, 3.36; p < 0.001) were the significant predictors for poor survival. Conclusion ICIs exhibited favorable antitumor activity in R/M HNSCC. Clinically, our findings can be used to recognize patients benefit from receiving ICI.
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Affiliation(s)
- Yun-Gyoo Lee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Chang
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang Hoon Chun
- Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Jihyun Park
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Keon Uk Park
- Department of Hemato-Oncology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Seong Hoon Shin
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Ho Jung An
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyoung Eun Lee
- Department of Hematology and Oncology, Ewha Womans University Hospital, Seoul, Korea
| | - Keun-Wook Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hye Ryun Kim
- Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myung-Ju Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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8
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Cupp MA, Cariolou M, Tzoulaki I, Aune D, Evangelou E, Berlanga-Taylor AJ. Neutrophil to lymphocyte ratio and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies. BMC Med 2020; 18:360. [PMID: 33213430 PMCID: PMC7678319 DOI: 10.1186/s12916-020-01817-1] [Citation(s) in RCA: 229] [Impact Index Per Article: 57.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although neutrophils have been linked to the progression of cancer, uncertainty exists around their association with cancer outcomes, depending on the site, outcome and treatments considered. We aimed to evaluate the strength and validity of evidence on the association between either the neutrophil to lymphocyte ratio (NLR) or tumour-associated neutrophils (TAN) and cancer prognosis. METHODS We searched MEDLINE, Embase and Cochrane Database of Systematic Reviews from inception to 29 May 2020 for systematic reviews and meta-analyses of observational studies on neutrophil counts (here NLR or TAN) and specific cancer outcomes related to disease progression or survival. The available evidence was graded as strong, highly suggestive, suggestive, weak or uncertain through the application of pre-set GRADE criteria. RESULTS A total of 204 meta-analyses from 86 studies investigating the association between either NLR or TAN and cancer outcomes met the criteria for inclusion. All but one meta-analyses found a hazard ratio (HR) which increased risk (HR > 1). We did not find sufficient meta-analyses to evaluate TAN and cancer outcomes (N = 9). When assessed for magnitude of effect, significance and bias related to heterogeneity and small study effects, 18 (9%) associations between NLR and outcomes in composite cancer endpoints (combined analysis), cancers treated with immunotherapy and some site specific cancers (urinary, nasopharyngeal, gastric, breast, endometrial, soft tissue sarcoma and hepatocellular cancers) were supported by strong evidence. CONCLUSION In total, 60 (29%) meta-analyses presented strong or highly suggestive evidence. Although the NLR and TAN hold clinical promise in their association with poor cancer prognosis, further research is required to provide robust evidence, assess causality and test clinical utility. TRIAL REGISTRATION PROSPERO CRD42017069131 .
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Affiliation(s)
- Meghan A Cupp
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
| | - Margarita Cariolou
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
| | - Ioanna Tzoulaki
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Dagfinn Aune
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Evangelos Evangelou
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Antonio J Berlanga-Taylor
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK.
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9
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Petersen CL, Chen JQ, Salas LA, Christensen BC. Altered immune phenotype and DNA methylation in panic disorder. Clin Epigenetics 2020; 12:177. [PMID: 33208194 PMCID: PMC7672933 DOI: 10.1186/s13148-020-00972-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background Multiple studies have related psychiatric disorders and immune alterations. Panic disorder (PD) has been linked with changes in leukocytes distributions in several small studies using different methods for immune characterization. Additionally, alterations in the methylation of repetitive DNA elements, such as LINE-1, have been associated with mental disorders. Here, we use peripheral blood DNA methylation data from two studies and an updated DNA methylation deconvolution library to investigate the relation of leukocyte proportions and methylation status of repetitive elements in 133 patients with panic disorder compared with 118 controls. Methods and results We used DNA methylation data to deconvolute leukocyte cell-type proportions and to infer LINE-1 element methylation comparing PD cases and controls. We also identified differentially methylated CpGs associated with PD using an epigenome-wide association study approach (EWAS), with models adjusting for sex, age, and cell-type proportions. Individuals with PD had a lower proportion of CD8T cells (OR: 0.86, 95% CI: 0.78–0.96, P-adj = 0.030) when adjusting for age, sex, and study compared with controls. Also, PD cases had significantly lower LINE-1 repetitive element methylation than controls (P < 0.001). The EWAS identified 61 differentially methylated CpGs (58 hypo- and 3 hypermethylated) in PD (Bonferroni adjusted P < 1.33 × 10–7). Conclusions These results suggest that those with panic disorder have changes to their immune system and dysregulation of repeat elements relative to controls.
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Affiliation(s)
- Curtis L Petersen
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, 03766, USA.,Quantitative Biomedical Science Program, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03766, USA
| | - Ji-Qing Chen
- Program for Experimental and Molecular Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03766, USA
| | - Lucas A Salas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03766, USA
| | - Brock C Christensen
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03766, USA. .,Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03766, USA. .,Dartmouth Hitchcock Medical Center, 1 Medical Center Dr, 660 Williamson Translation Research Building, Lebanon, NH, 03756, USA.
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10
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Rulando M, Siregar GP, Warli SM. Correlation between neutrophil-to-lymphocyte ratio with Gleason score in patients with prostate cancer at Adam Malik Hospital Medan 2013 - 2015. Urol Ann 2020; 13:53-55. [PMID: 33897165 PMCID: PMC8052910 DOI: 10.4103/ua.ua_1_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 06/19/2020] [Indexed: 11/15/2022] Open
Abstract
Context: A grading system was created by Donald F. Gleason for prostate cancer as prognostic indicators. The neutrophil-to-lymphocyte ratio (NLR) was found that it could be a prognostic factor in solid tumors. Aims: This study aims to assess whether there is a correlation between NLR with the results of the Gleason score of patients with prostate adenocarcinoma biopsy at Haji Adam Malik Hospital Medan. Settings and Design: A total of 121 patients underwent a prostate biopsy from early January 2013 to December 2015 at Adam Malik Hospital. Subjects and Methods: Of the 121 patients, thirty were not included in the study because of incomplete baseline data and a history of hematological abnormalities. Data from 91 patients were then taken, including age, hematologic data prebiopsy, prostate-specific antigen (PSA) on initial examination, prostate weight estimation, and Gleason scores from biopsy results. Statistical Analysis Used: The data are processed with SPSS version 22. Results: A significant moderate strength correlation was found between NLR and Gleason Score (r = 0.572; P = 0.001). However, no statistically significant correlation found between NLR and prostate weight estimation (r = 0.077; P = 0.469) and NLR with PSA (r = 0.072; P = 0.496). Conclusions: A significant correlation between the neutrophil-to-lymphocyte ratio and the Gleason score was noted. Further studies are needed to confirm these findings.
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Affiliation(s)
- Michael Rulando
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik Hospital, Medan, Indonesia
| | - Ginanda Putra Siregar
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik Hospital, Medan, Indonesia
| | - Syah Mirsya Warli
- Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia
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11
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Nkengurutse G, Tian F, Jiang S, Wang Q, Wang Y, Sun W. Preoperative Predictors of Biochemical Recurrence-Free Survival in High-Risk Prostate Cancer Following Radical Prostatectomy. Front Oncol 2020; 10:1761. [PMID: 33014867 PMCID: PMC7511762 DOI: 10.3389/fonc.2020.01761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/06/2020] [Indexed: 12/31/2022] Open
Abstract
Background: D'Amico high-risk prostate cancer (Pca) patients experience poor and heterogeneous oncological outcomes. This heterogeneity highlights a need to extensively explore factors associated with poor outcomes to guide decision-making. Objective: To assess predictors of biochemical recurrence (BCR)-free survival in high-risk patients following radical prostatectomy (RP), and subsequently establish a model predicting outcomes. Methods: We retrospectively identified D'Amico high-risk non-metastatic Pca patients who underwent RP between 2013 and 2019 in our hospital. We collected data including PSA level, clinical stage, biopsy Gleason score (GS), number of D'Amico high-risk factors (RF), the inflammatory status (Neutrophil-to-lymphocyte ratio [NLR], derived NLR [dNLR], platelet-to-lymphocyte ratio [PLR] and LDH). Kaplan-Meier methods were used to analyze BCR-free survival. Univariate and multivariate analyses were performed using Cox proportional hazards model to evaluate the association between clinicopathological parameters and BCR-free survival. Results: The median follow-up time for the 101 patients' cohort was 26 months (range: 3-81 months). The number of RF (1RF vs. ≥2RF), biopsy GS (<8 vs. ≥8), clinical stage (≤cT2c vs. >cT2c), pathological stage, and the presence of adverse pathological features were significant predictors of BCR (P < 0.05). Other parameters including inflammatory status (dNLR, NLR, PLR, and LDH) were not of predictive value. On multivariable analysis, biopsy GS (<8 vs. ≥8; HR 2.439) and clinical stage (≤cT2c vs. >cT2c; HR 3.271) were the independent predictors of BCR. Based on these two independent predictors, patients were stratified into three risk subgroups: favorable (0 risk factor; 47% of patients), intermediate (1 risk factor; 42 %), unfavorable (2 risk factors; 11%). The intermediate and unfavorable subgroups have a significantly shorter median BCR-free survival compared to the favorable subgroup (P < 0.001). Conclusion: Several factors are associated with BCR. Clinical stage (≤cT2c vs. >cT2c) and biopsy GS (<8 vs. ≥8) are the independent predictors of BCR. The stratification of high-risk patients into risk subgroups based on these two predictors shows that the intermediate and unfavorable subgroups have a significantly shorter median BCR-free survival compared to the favorable subgroup. The preoperative stratification model may help urologists and patients during decision-making. In non-metastatic high-risk patients, preoperative inflammatory markers (NLR, dNLR, PLR, and LDH) are not of prognostic value.
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Affiliation(s)
- Gerard Nkengurutse
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Feng Tian
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Sixiong Jiang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qi Wang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ying Wang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Weibing Sun
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
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12
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Li H, Wang W, Yang X, Lian J, Zhang S, Cao J, Zhang X, Song X, Jia S, Xue R. The Clinical Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Brain Metastases from Non-Small Cell Lung Cancer-Harboring EGFR Mutations. Cancer Manag Res 2020; 12:5659-5665. [PMID: 32765069 PMCID: PMC7367746 DOI: 10.2147/cmar.s250688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/26/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose Several studies have explored the correlation between the neutrophil-to-lymphocyte ratio (NLR) and the prognosis of patients with lung cancer. However, little is known about the correlation between the pretreatment NLR and the prognosis of patients with brain metastases from non-small cell lung cancer (NSCLC)-harboring mutations in the epidermal growth factor receptor (EGFR) gene. We sought to evaluate the predictive values in brain metastasis from lung adenocarcinoma with EGFR mutations. Methods We retrospectively examined 133 patients with brain metastases (BMs) from lung adenocarcinoma with EGFR mutations. NLR was calculated using N/L, where N and L, respectively, refer to peripheral blood neutrophil (N) and lymphocyte (L) counts. The cut-off value of NLR was assessed by the area under the curve (AUC). The Log rank test and Cox proportional hazard model were used to confirm the impact of NLR and other variables on survival. Results An NLR value equal to or less than 2.99 was associated with prolonged survival in this cohort of patients in both variable and multivariable analysis. Conclusion We concluded that NLR is an independent prognostic factor in BMs from lung adenocarcinoma with EGFR mutations. This could serve as a useful prognostic biomarker and could be incorporated in the clinical prognostic index specific to patients with BMs.
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Affiliation(s)
- Hongwei Li
- Department of Radiotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Weili Wang
- Department of Radiotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Xiaotang Yang
- Department of Radiotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Jianhong Lian
- Department of Chemotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Shuangping Zhang
- Department of Surgery, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Jianzhong Cao
- Department of Radiotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Xiaqin Zhang
- Department of Radiotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Xin Song
- Department of Radiotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Sufang Jia
- Department of Radiotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Ruiqi Xue
- Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
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13
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Inflammation-Based Scores Increase the Prognostic Value of Circulating Tumor Cells in Primary Breast Cancer. Cancers (Basel) 2020; 12:cancers12051134. [PMID: 32369910 PMCID: PMC7281016 DOI: 10.3390/cancers12051134] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 12/26/2022] Open
Abstract
A correlation between circulating tumor cells (CTCs) and monocytes in metastatic breast cancer (BC), where CTCs and monocyte-to-lymphocyte ratio (MLR) were predictors of overall survival (OS), was recently shown. Herein, we aimed to assess the association between CTCs and the complete blood count (CBC)-derived inflammation-based scores in 284 primary BC patients. CTCs were determined in CD45-depleted peripheral blood mononuclear cells by real time-PCR. This method allowed us to detect a subset of CTCs with an epithelial-to-mesenchymal transition phenotype (CTC EMT), previously associated with inferior outcomes in primary BC. In the present study, CTC EMT positivity (hazard ratio (HR) = 2.4; 95% CI 1.20–4.66, p = 0.013) and elevated neutrophil-to-lymphocyte ratio (NLR) (HR = 2.20; 95% CI 1.07–4.55; p = 0.033) were associated with shorter progression-free survival (PFS) in primary BC patients. Multivariate analysis showed that CTC EMT-positive patients with NLR ≥ 3 had 8.6 times increased risk of disease recurrence (95% CI 2.35–31.48, p = 0.001) compared with CTC EMT-negative patients with NLR < 3. Similarly, disease recurrence was 13.14 times more likely in CTC EMT-positive patients with MLR ≥ 0.34 (95% CI 4.35–39.67, p < 0.001). Given its low methodological and financial demands, the CBC-derived inflammation-based score determination could, after broader validation, significantly improve the prognostication of BC patients.
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14
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Hu J, Chen J, Li H, He T, Deng H, Gong G, Cui Y, Liu P, Ren W, Zhou X, Li C, Zu X. A preoperative nomogram predicting the pseudocapsule status in localized renal cell carcinoma. Transl Androl Urol 2020; 9:462-472. [PMID: 32420152 PMCID: PMC7214989 DOI: 10.21037/tau.2020.01.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Tumor enucleation (TE) surgery for localized renal cell carcinoma (RCC) relies on a complete peritumoral pseudocapsule (PC). Study objective was to develop a preoperative model to predict PC status. Methods The prediction model was developed in a cohort that consisted of 170 patients with localized RCC, and data was gathered from 2010 to 2015. Multivariable logistic regression analysis and R were used to generate this prediction model. The statistical performance was assessed with respect to the calibration, discrimination, and clinical usefulness. Results The prediction model incorporated the systemic inflammatory markers [neutrophil-lymphocyte ratio (NLR); albumin-globulin ratio (AGR)], CT imaging features (tumor size and necrosis), and clinical risk factors (BMI). The model showed good discrimination, with a C-index of 0.85 (0.78–0.91), and good calibration (P=0.60). The sensitivity and specificity were 62% and 94% respectively. Decision curves and clinical impact curve demonstrated that the current model was clinically useful. Conclusions We constructed a model that incorporated both the systematic inflammatory markers and clinical risk factors. It can be conveniently used to preoperatively predict the individualized risk of PC invasion and identify the best candidates to receive TE surgery.
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Affiliation(s)
- Jiao Hu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Huihuang Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Tongchen He
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Hao Deng
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Guanghui Gong
- Department of Pathology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yu Cui
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Peihua Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Wenbiao Ren
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xu Zhou
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Chao Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
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15
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Bravi CA, Rosiello G, Fallara G, Vertosick E, Tin A, Sjoberg D, Bianchi M, Mazzone E, Martini A, Dell'oglio P, Stabile A, Gandaglia G, Fossati N, Briganti A, Montorsi F, Vickers A. Predictive value of preoperative neutrophil-to-lymphocyte ratio in localized prostate cancer: results from a surgical series at a high-volume institution. Minerva Urol Nephrol 2020; 73:481-488. [PMID: 32083416 DOI: 10.23736/s2724-6051.20.03662-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND To examine the predictive value of neutrophil-to-lymphocyte ratio in localized prostate cancer for surgical pathology and recurrence in patients treated by radical prostatectomy. METHODS We evaluated 1258 patients treated by radical prostatectomy at San Raffaele Hospital between 2011 and 2017 and assessed the association between preoperative neutrophil-to-lymphocyte ratio and surgical pathology (advanced stage, grade group ≥4, nodal involvement, grade discordance between biopsy and surgical pathology) and biochemical recurrence. RESULTS The preoperative neutrophil-to-lymphocyte ratio was not significantly associated with advanced stage (≥T3), International Society of Urological Pathology (ISUP) grade (≥4) or discordance. At multivariable analysis, patients with higher neutrophil-to-lymphocyte ratio had lower risk of nodal involvement at final pathology (odds ratio [OR]: 0.77; 95% confidence interval [CI]: 0.64, 0.92; P=0.005). The preoperative level of neutrophil-to-lymphocyte ratio was associated with biochemical recurrence on univariate analysis (OR: 0.81, 95% CI: 0.68, 0.96; P=0.017). Such a relationship was not significant at multivariable analysis adjusting for tumor severity (OR: 0.93, 95% CI: 0.79, 1.09; P=0.4). CONCLUSIONS Neutrophil-to-lymphocyte ratio does not have clinical utility for the prediction of adverse pathology and biochemical recurrence. Further research should focus on its value for predicting regional lymph node metastasis.
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Affiliation(s)
- Carlo A Bravi
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy - .,Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA -
| | - Giuseppe Rosiello
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Giuseppe Fallara
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Emily Vertosick
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amy Tin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniel Sjoberg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marco Bianchi
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Elio Mazzone
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Martini
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo Dell'oglio
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Armando Stabile
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Giorgio Gandaglia
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola Fossati
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Briganti
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Montorsi
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Onishi K, Miyake M, Hori S, Onishi S, Iida K, Morizawa Y, Tatsumi Y, Nakai Y, Tanaka N, Fujimoto K. γ-Klotho is correlated with resistance to docetaxel in castration-resistant prostate cancer. Oncol Lett 2020; 19:2306-2316. [PMID: 32194730 PMCID: PMC7039116 DOI: 10.3892/ol.2020.11308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 10/16/2019] [Indexed: 01/09/2023] Open
Abstract
The Klotho (KL) gene was first identified as a potent aging suppressor. The KL family currently comprises of three proteins: α-Klotho (KLA), β-Klotho (KLB), and γ-Klotho (KLG). Many studies have shown that KLA and KLB participate in tumor progression or suppression, depending on the type of cancer; however, the relationship between KLG and prostate cancer has not yet been studied. Some studies have claimed that KL is correlated to sensitivity to chemotherapy. Here, we investigated the oncogenic potential of KLG in castration-resistant prostate cancer (CRPC). Immunohistochemical analysis using prostate biopsy specimens revealed that patients with high KLG expression in primary prostate cancer tissue had a significantly poor prognosis for overall survival. In addition, the prostate-specific antigen response rate after docetaxel (DTX) therapy in patients with high KLG expression was lower than that in patients with low KLG expression. To evaluate the potential of KLG as a therapeutic target in human prostate cancer, we generated a xenograft model of human CRPC cell line (PC-3) in male athymic mice. The animals were randomly divided into four groups as follows: i) control group (vehicle only); ii) DTX group (intraperitoneal administration); iii) small interfering RNA targeting KLG (KLG siRNA) group (intratumoral administration); and iv) a combination group (DTX plus KLG siRNA). After 3 weeks of treatment, the tumor weight and tumor Ki-67 labeling index were significantly lower in the KLG siRNA group and the combination group than in the control group. Sensitivity to DTX was increased upon treatment with KLG siRNA. These findings suggest that KLG expression in primary prostate cancer lesions is associated with resistance to DTX in CRPC and has potential as a diagnostic and therapeutic target for patients with CRPC.
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Affiliation(s)
- Kenta Onishi
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Sayuri Onishi
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Kota Iida
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Yoshihiro Tatsumi
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara 634-8521, Japan
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Wu L, Xiang S, Hu X, Mo M, Zhao C, Cai Y, Tong S, Jiang H, Chen L, Wang Z, Xiong W, Ou Z. Prostate-specific antigen modulates the osteogenic differentiation of MSCs via the cadherin 11-Akt axis. Clin Transl Med 2020; 10:363-373. [PMID: 32508049 PMCID: PMC7240859 DOI: 10.1002/ctm2.27] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND A high prevalence of osteoblastic bone metastases is characteristic of prostate cancer. Prostate-specific antigen (PSA) is a serine protease uniquely produced by prostate cancer cells and is an important serological marker for prostate cancer. However, whether PSA modulates the osteogenic process remains largely unknown. In this study, we explored the effect of PSA on modulating the osteoblastic differentiation of mesenchymal stem cells (MSCs). In this study, we used flow cytometry, CCK-8 assay, Alizarin red S (ARS) staining and quantification, alkaline phosphatase (ALP) activity and staining, Western blotting, and quantitative real-time PCR (qRT-PCR) to explore the effect of PSA on osteogenic differentiation of MSCs. RESULTS We first demonstrated that although PSA did not affect the proliferation, morphology, or phenotype of MSCs, it significantly promoted the osteogenic differentiation of MSCs in a concentration-dependent manner. Furthermore, we demonstrated that PSA promoted the osteogenic differentiation of MSCs by elevating the expression of Cadherin 11 in MSCs and, thus, activating the Akt signaling pathway. CONCLUSIONS In conclusion, we demonstrated that PSA could promote the osteogenesis of MSCs through Akt signaling pathway activation by elevating the expression of cadherin-11 in MSCs. These findings imply a possible role of PSA in osteoblastic bone metastases in prostate cancer.
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Affiliation(s)
- Longxiang Wu
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Shiqi Xiang
- Department of OrthopedicsThe Second Xiangya Hospital of Central South UniversityChangshaP.R. China
| | - Xiheng Hu
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Miao Mo
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Cheng Zhao
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Yi Cai
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Shiyu Tong
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Huichuan Jiang
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Linxiao Chen
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Zhi Wang
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Wei Xiong
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
| | - Zhenyu Ou
- Department of UrologyXiangya Hospital of Central South UniversityChangshaP.R. China
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Huszno J, Kolosza Z. Prognostic value of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratio in breast cancer patients. Oncol Lett 2019; 18:6275-6283. [PMID: 31788105 DOI: 10.3892/ol.2019.10966] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 05/29/2019] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to assess the blood the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) as prognostic factors in breast cancer (BC) patients. A retrospective analysis of 436 BC patients who were treated at COI (Gliwice, Poland) between January 2005 and June 2018 was performed. The prognostic value [overall survival (OS)] of the pre-treatment PLR, NLR and MLR was assessed by univariate and multivariate analysis. The 5-year OS was lower in the NLR >2.65 compared with that in the NLR≤2.65 group (82.5 vs. 89.6%; P=0.053), and significantly lower in the subgroup of triple-negative breast cancer (TNBC; 70.3 vs. 89.3%; P=0.034) and in patients whose tumors had an estrogen receptor-negative [ER(-)] status (66.6 vs. 83.6%; P=0.018). The 5-year OS was lower in patients with PLR >190.9 compared with that in the PLR≤190.9 group (78.7 vs. 89.4%; P=0.020). A poor OS rate associated with an elevated PLR was also observed in the subgroups with TNBC (68.2 vs. 88.5%; P=0.032) and with ER(-) status tumors (57.7 vs. 83.6%, P=0.002). An elevated MLR (>0.28) was not associated with OS time (P=0.830). Multivariate analysis revealed that the NLR and PLR were insignificant negative prognostic factors, except for the subgroup of patients with ER(-) tumors, where an elevated NLR [hazard ratio (HR)=2.40; 95% confidence interval (CI): 1.20-4.80; P=0.013] and a higher PLR (HR=2.51; 95%CI: 1.23-5.14; P=0.012) were independent prognostic factors for poor OS together with lymph node metastasis ((HR=5.47; 95%CI: 2.46-12.15; P=0.0001 and HR=4.82; 95% CI: 2.15-10.78; P=0.0001), respectively. The present results revealed that an elevated NLR (>2.65) and PLR (>190.9) are associated with poor OS in BC patients. In the ER(-) subgroup of patients, an elevated NLR and PLR were significant independent prognostic factors. However, the MLR did not affect OS.
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Affiliation(s)
- Joanna Huszno
- I Radiation and Clinic Oncology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland.,Genetic Outpatient Clinic, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland
| | - Zofia Kolosza
- Department of Medical Physics, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland
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Huszno J, Kolosza Z, Mrochem-Kwarciak J, Rutkowski T, Skladowski K. The Role of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, and Platelets in the Prognosis of Metastatic Renal Cell Carcinoma. Oncology 2019; 97:7-17. [PMID: 31048577 DOI: 10.1159/000498943] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 02/13/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE(S) The aim of this analysis was to evaluate the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), platelets (PLT), and neutrophil level for their prognostic value in patients with metastatic renal cell carcinoma (mRCC). MATERIALS We retrospectively reviewed medical records of 141 patients with mRCC (2006-2016). Univariate and multivariate analyses were performed with the Cox proportional hazards regression model. The cutoff value of NLR was "elevated" as >3.68 and the PLR cutoff value was "elevated" as >144.4. RESULTS The median PFS and OS were shorter in elevated NLR and PLR. A higher value of PLT was associated with worse median OS and higher neutrophil level with worse OS and PFS. In multivariate analysis, higher NLR (p = 0.007) and PLR (p = 0.006) were independent prognostic factors for shorter OS together with BMI ≤30 (p = 0.004), higher Fuhrman grade (p = 0.0002), lower level of hemoglobin (p= 0.010), and ZUBROD 2 (p = 0.0002). Higher PLR (p = 0.0002) was an independent negative prognostic factor for PFS together with higher Fuhrman grade (p = 0.001), higher neutrophil level (p = 0.001), and lower lymphocyte level (p = 0.013). CONCLUSION Elevated pretreatment NLR, PLR, PLT, and neutrophil count are associated with shorter OS and PFS in patients with mRCC. NLR and PLR are independent prognostic factors for OS. However, PLR and neutrophil count are independent prognostic factors for PFS.
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Affiliation(s)
- Joanna Huszno
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland,
| | - Zofia Kolosza
- Department of Medical Physics, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jolanta Mrochem-Kwarciak
- Analytics and Clinical Biochemistry Department, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Tomasz Rutkowski
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Krzysztof Skladowski
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
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20
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Prognostic Value of Systemic Inflammatory Indices, NLR, PLR, and MPV, for Predicting 1-Year Survival of Patients Undergoing Cytoreductive Surgery with HIPEC. J Clin Med 2019; 8:jcm8050589. [PMID: 31035703 PMCID: PMC6571647 DOI: 10.3390/jcm8050589] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/08/2019] [Accepted: 04/25/2019] [Indexed: 12/21/2022] Open
Abstract
The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV) have been reported to be associated with the prognosis of various types of tumors. This study evaluated the prognostic value and clinical use of inflammatory markers for predicting 1-year survival in patients undergoing cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). This retrospective study included 160 patients who underwent CRS with HIPEC between July 2014 and April 2017. Data on NLR, PLR, and MPV were collected preoperatively and on postoperative days (POD) 1, 2, 3, 4, and 5. In a multivariate analysis using a cox proportional hazard regression model, higher values of preoperative NLR and MPV, PLR, and MPV on POD 2, 3, and 5 were associated with reduced 1-year survival after CRS with HIPEC. Patients with increased MPV showed lower rates of 1-year survival following CRS with HIPEC. In addition, elevated preoperative NLR and postoperative PLR were correlated with poor survival. These markers are able to stratify patients by risk profile, which may ultimately improve perioperative management and be helpful in improving outcomes following CRS with HIPEC.
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McAllister MJ, Underwood MA, Leung HY, Edwards J. A review on the interactions between the tumor microenvironment and androgen receptor signaling in prostate cancer. Transl Res 2019; 206:91-106. [PMID: 30528321 DOI: 10.1016/j.trsl.2018.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/23/2018] [Accepted: 11/19/2018] [Indexed: 12/29/2022]
Abstract
Prostate cancer growth is controlled by androgen receptor signaling via both androgen-dependent and androgen-independent pathways. Furthermore, the prostate is an immune competent organ with inflammatory changes both within the systemic and local environment contributing to the reprogramming of the prostatic epithelium with consistently elevated lymphocyte infiltration and proinflammatory cytokines being found in prostate cancer. The crosstalk between the tumor microenvironment and androgen receptor signaling is complex with both protumorigenic and antitumorigenic roles observed. However, despite an increase in immune checkpoint inhibitors and inflammatory signaling blockades available for a range of cancer types, we are yet to see substantial progress in the treatment of prostate cancer. Therefore, this review aims to summarize the tumor microenvironment and its impact on androgen receptor signaling in prostate cancer.
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Affiliation(s)
- Milly J McAllister
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
| | - Mark A Underwood
- Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Hing Y Leung
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, United Kingdom; Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom; Cancer Research UK Beatson Institute, Glasgow, United Kingdom
| | - Joanne Edwards
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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22
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Peng H, Luo X. Prognostic significance of elevated pretreatment systemic inflammatory markers for patients with prostate cancer: a meta-analysis. Cancer Cell Int 2019; 19:70. [PMID: 30962764 PMCID: PMC6434630 DOI: 10.1186/s12935-019-0785-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/15/2019] [Indexed: 02/06/2023] Open
Abstract
Background Pretreatment inflammatory factors, including neutrophil, lymphocyte, platelet and monocyte counts as well as the ratios between them such as neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) and lymphocyte–monocyte ratio (LMR) have been suggested as potential prognostic predictors for patients with prostate cancer (PCa). However, the prognostic effects remain controversial. Therefore, the goal of this study was evaluate the prognostic values of these markers for PCa patients using a meta-analysis. Methods Potentially relevant publications in PubMed and Cochrane Library were searched. Pooled hazard ratio (HR) with 95% confidence interval (CI) for overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), recurrence free survival (RFS) and distant metastases-free survival (DMFS) were determined using a fixed or random effects model by STATA 13.0 software. Results Thirty-two studies involving 21,949 participants were included. Our pooled results demonstrated that a high pretreatment NLR (HR = 1.55, 95% CI 1.37–1.76), PLR (HR = 1.72; 95% CI 1.36–2.18), neutrophil (HR = 1.10; 95% CI 1.03–1.18 and monocyte counts (HR = 2.25; 95% CI 1.67–3.05) predicted inferior OS, while elevated pretreatment LMR (HR = 2.27; 95% CI 1.76–2.94) was correlated with favorable OS. Furthermore, the higher NLR (HR = 1.62; 95% CI 1.29–2.04) and monocyte counts (HR = 1.75; 95% CI 1.36–2.25), but lower LMR predicted worse PFS (HR = 2.18; 95% CI 1.58–3.02); poor RFS was only associated with NLR (HR = 1.12; 95% CI 1.04–1.20). The subgroup analysis showed that the higher NLR may be a predictive factor for OS only in patients with mCRPC and undergoing chemotherapy; while the higher PLR was only significantly associated with OS in localized PCa regardless of treatment. Conclusion This meta-analysis reveals that pretreatment NLR, PLR, LMR, neutrophil, and monocyte counts may be effective predictive biomarkers for prognosis in patients with PCa.
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Affiliation(s)
- Hao Peng
- Department of Urological Surgery, Zhoukou Central Hospital of Henan Province, No. 26 Renmin East Road, Chuanhui District, Zhoukou, 466000 China
| | - Xiaogang Luo
- 2State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai, 201620 China
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Loubersac T, Nguile-Makao M, Pouliot F, Fradet V, Toren P. Neutrophil-to-lymphocyte Ratio as a Predictive Marker of Response to Abiraterone Acetate: A Retrospective Analysis of the COU302 Study. Eur Urol Oncol 2019; 3:298-305. [PMID: 31411963 DOI: 10.1016/j.euo.2019.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/27/2018] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The neutrophil-lymphocyte ratio (NLR) is an inexpensive and accessible prognostic marker for many cancers, including metastatic castration-resistant prostate cancer (mCRPC). OBJECTIVE In this study, we assess the role of NLR as a predictive biomarker through a retrospective analysis of the pivotal COU302 study of abiraterone acetate (AA) as first-line therapy for men with asymptomatic or minimally symptomatic mCRPC. DESIGN, SETTING, AND PARTICIPANTS The COU302 study randomized asymptomatic or minimally symptomatic men with mCRPC to receive AA plus prednisone or prednisone as first-line treatment. Baseline NLR, overall survival, radiographic progression-free survival, and prostate-specific antigen (PSA) progression-free survival were evaluated. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Descriptive statistics, as well as Kaplan-Meier and Cox survival models were used to assess the effect of baseline NLR and changes in NLR on response to AA plus prednisone versus prednisone, with adjustment for important covariates. RESULTS AND LIMITATIONS Among the 1082 patients who received treatment, baseline NLR values showed no significant differences according to baseline covariates except for albumin. Baseline variables were similar between dichotomous groups with an NLR cutoff of 2.5, except for a lower proportion of patients with >10 bone metastases in the NLR <2.5 group. Our survival results demonstrate that higher NLR values corresponded to poorer overall survival and PSA response to AA but not to placebo, which was confirmed in our adjusted regression models. No significant differences were seen in time to radiographic progression. In separate analyses, an increase or decrease in NLR by 2 from treatment baseline did not clearly signal subsequent lack of benefit with continued AA. CONCLUSIONS Our results suggest that baseline NLR may be able to predict response to AA in men with asymptomatic mCRPC but that changes in NLR during treatment are insufficient to guide treatment. Further validation studies are warranted. PATIENT SUMMARY In this report, we look at the ratio of circulating immune cells as a predictor of response to abiraterone acetate (AA), using data from a large trial. Our results suggest that this ratio derived from routinely obtained bloodwork can predict which patients respond better to AA.
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Affiliation(s)
| | - Molière Nguile-Makao
- Oncology Division, Department of Surgery, Faculty of Medicine, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Université Laval, Québec, QC, Canada
| | - Frédéric Pouliot
- Oncology Division, Department of Surgery, Faculty of Medicine, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Université Laval, Québec, QC, Canada
| | - Vincent Fradet
- Oncology Division, Department of Surgery, Faculty of Medicine, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Université Laval, Québec, QC, Canada
| | - Paul Toren
- Oncology Division, Department of Surgery, Faculty of Medicine, Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Université Laval, Québec, QC, Canada.
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Dong Y, Cheng Y, Wang J. The Ratio of Neutrophil to Lymphocyte is a Predictor in Endometrial Cancer. Open Life Sci 2019; 14:110-118. [PMID: 33817142 PMCID: PMC7874757 DOI: 10.1515/biol-2019-0012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/21/2019] [Indexed: 01/29/2023] Open
Abstract
Objective: The aim of our study was to assess the prognostic value of the ratio of neutrophil to lymphocyte (NLR) for patients with surgically treated endometrial cancer (EC). Methods: We retrospectively reviewed 510 EC patients who were surgically treated between January 2010 and December 2016. We used receiver-operating characteristic (ROC) curve analysis to identify an optimal cut-off for NLR in predicting overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS). Nonparametric tests were used to determine the associations between NLR and clinicopathologic characteristics. The Kaplan–Meier method and Cox proportional-hazards regression were used for survival analysis. Results: With a cut-off of 2.47, the 510 patients were divided into low NLR (NLR <2.47) and high NLR (NLR ≥2.47). Elevated NLR was associated with advanced stage (P=0.039), increased histology grade (P=0.005) and lymph node metastasis (P=0.041). Multivariable analysis suggested that NLR was an independent prognostic marker for OS (hazard ratio [HR] 4.7; 95% confidence interval [CI], 1.5-14.1; P =0.006), CSS (HR 3.6; 95% CI, 1.1-11.5; P =0.028) and DFS (HR 2.3; 95% CI, 1.0-5.2; P =0.044). Conclusion: NLR may be an independent prognostic indicator for OS, CSS and DFS. It could help clinicians with preoperative risk stratification and treatment strategy tailoring.
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Affiliation(s)
| | - Yuan Cheng
- Peking University People's Hospital, Beijing, China
| | - Jianliu Wang
- Peking University People's Hospital, Beijing, China
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25
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Gevariya N, Besançon M, Robitaille K, Picard V, Diabaté L, Alesawi A, Julien P, Fradet Y, Bergeron A, Fradet V. Omega-3 fatty acids decrease prostate cancer progression associated with an anti-tumor immune response in eugonadal and castrated mice. Prostate 2019; 79:9-20. [PMID: 30073695 DOI: 10.1002/pros.23706] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 07/13/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Several lines of evidence suggest effects of dietary fat on prostate cancer (PCa) development and progression. Targeting omega (ω)-3:ω6 fatty acids (FA) ratio could be beneficial against PCa by favorably modulating inflammation. Here, we studied the effects of ω3- and ω6-enriched diets on prostate tumor growth and inflammatory response in androgen-deprived and non-deprived conditions. METHODS Immune-competent eugonadal and castrated C57BL/6 mice were injected with TRAMP-C2 prostate tumor cells and daily fed with ω3- or ω6-enriched diet. FA and cytokine profiles were measured in blood and tumors using gas chromatography and multiplex immunoassay, respectively. Immune cell infiltration in tumors was profiled by multicolor flow cytometry. RESULTS ω3-enriched diet decreased prostate TRAMP-C2 tumor growth in immune-competent eugonadal and castrated mice. Cytokines associated with Th1 immune response (IL-12 [p70], IFN-γ, GM-CSF) and eosinophil recruitment (eotaxin-1, IL-5, and IL-13) were significantly elevated in tumors of ω3-fed mice. Using in vitro experiments, we confirmed ω3 FA-induced eotaxin-1 secretion by tumor cells and that eotaxin-1 secretion was regulated by androgens. Analysis of immune cell infiltrating tumors showed no major difference of immune cells' abundance between ω3- and ω6-enriched diets. CONCLUSIONS ω3-enriched diet reduces prostate tumor growth independently of androgen levels. ω3 FA can inhibit tumor cell growth and induce a local anti-tumor inflammatory response. These findings warrant further examination of dietary ω3's potential to slow down the progression of androgen-sensitive and castrate-resistant PCa by modulating immune cell function in tumors.
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Affiliation(s)
- Nikunj Gevariya
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Marjorie Besançon
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Karine Robitaille
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
| | - Valérie Picard
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
| | - Lamoussa Diabaté
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Anwar Alesawi
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
| | - Pierre Julien
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
- Endocrinology and Nephrology Axis, Centre de recherche du CHU de Québec-Université Laval-CHUL, Québec, Quebec, Canada
| | - Yves Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Alain Bergeron
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Vincent Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
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26
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Wang Z, Peng S, Xie H, Guo L, Jiang N, Shang Z, Niu Y. Neutrophil-lymphocyte ratio is a predictor of prognosis in patients with castration-resistant prostate cancer: a meta-analysis. Cancer Manag Res 2018; 10:3599-3610. [PMID: 30271208 PMCID: PMC6149871 DOI: 10.2147/cmar.s159105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background The prognostic value of neutrophil–lymphocyte ratio (NLR) in patients with castration-resistant prostate cancer (CRPC) had been investigated in previous studies; however, the results remain inconsistent. This study was aimed to investigate the prognostic value of NLR in CRPC patients. Materials and methods Literature was identified from PubMed, Embase, Web of Science, and Cochrane, which investigated the relationship between pretreatment NLR and prognosis in CRPC patients. HRs for overall survival (OS) and progression-free survival (PFS) were extracted from eligible studies. Heterogeneity was assessed using the I2 value. The fixed-effects model was used if there was no evidence of heterogeneity; otherwise, the random-effects model was used. Publication bias was evaluated using Begg’s funnel plot test. Results A total of 5,705 patients from 16 studies were included in this analysis. The pooled results showed that an elevated NLR predict poor OS (pooled HR = 1.52, 95% CI: 1.41–1.63, P<0.001) and PFS (pooled HR = 1.50, 95% CI: 1.21–1.85, P<0.001) in patients with CRPC. Subgroup analysis revealed that an elevated NLR significantly predicted poor OS in Asian studies group (HR = 2.43, 95% CI: 1.47–4.01, P=0.001). The elevated NLR also significantly predicted poor PFS in Asian studies group (HR = 1.99, 95% CI: 1.30–3.06, P=0.002). Conclusion This study suggests that an elevated NLR predict poor prognosis in patients with CRPC.
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Affiliation(s)
- Zhun Wang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Shuanghe Peng
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Hui Xie
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Linpei Guo
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Ning Jiang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Zhiqun Shang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Yuanjie Niu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
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Cioni B, Zwart W, Bergman AM. Androgen receptor moonlighting in the prostate cancer microenvironment. Endocr Relat Cancer 2018; 25:R331-R349. [PMID: 29618577 DOI: 10.1530/erc-18-0042] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/04/2018] [Indexed: 01/03/2023]
Abstract
Androgen receptor (AR) signaling is vital for the normal development of the prostate and is critically involved in prostate cancer (PCa). AR is not only found in epithelial prostate cells but is also expressed in various cells in the PCa-associated stroma, which constitute the tumor microenvironment (TME). In the TME, AR is expressed in fibroblasts, macrophages, lymphocytes and neutrophils. AR expression in the TME was shown to be decreased in higher-grade and metastatic PCa, suggesting that stromal AR plays a protective role against PCa progression. With that, the functionality of AR in stromal cells appears to deviate from the receptor's classical function as described in PCa cells. However, the biological action of AR in these cells and its effect on cancer progression remains to be fully understood. Here, we systematically review the pathological, genomic and biological literature on AR actions in various subsets of prostate stromal cells and aim to better understand the consequences of AR signaling in the TME in relation to PCa development and progression.
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Affiliation(s)
- B Cioni
- Division of OncogenomicsThe Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - W Zwart
- Division of OncogenomicsThe Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode InstituteThe Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - A M Bergman
- Division of OncogenomicsThe Netherlands Cancer Institute, Amsterdam, the Netherlands
- Division of Medical OncologyThe Netherlands Cancer Institute, Amsterdam, the Netherlands
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Jiang CH, Sun TL, Xiang DX, Wei SS, Li WQ. Anticancer Activity and Mechanism of Xanthohumol: A Prenylated Flavonoid From Hops ( Humulus lupulus L.). Front Pharmacol 2018; 9:530. [PMID: 29872398 PMCID: PMC5972274 DOI: 10.3389/fphar.2018.00530] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/02/2018] [Indexed: 12/17/2022] Open
Abstract
It has been observed that many phytochemicals, frequently present in foods or beverages, show potent chemopreventive or therapeutic properties that selectively affect cancer cells. Numerous studies have demonstrated the anticancer activity of xanthohumol (Xn), a prenylated flavonoid isolated from hops (Humulus lupulus L.), with a concentration up to 0.96 mg/L in beer. This review aims to summarize the existing studies focusing on the anticancer activity of Xn and its effects on key signaling molecules. Furthermore, the limitations of current studies and challenges for the clinical use of Xn are discussed.
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Affiliation(s)
- Chuan-Hao Jiang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tao-Li Sun
- Key Laboratory Breeding Base of Hu'nan Oriented Fundamental and Applied Research of Innovative Pharmaceutics, College of Pharmacy, Changsha Medical University, Changsha, China
| | - Da-Xiong Xiang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China.,Hunan Provincial Engineering Research Center of Translational Medicine and Innovative Drug, Changsha, China
| | - Shan-Shan Wei
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Wen-Qun Li
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China.,Institute of Clinical Pharmacy, Central South University, Changsha, China.,Hunan Provincial Engineering Research Center of Translational Medicine and Innovative Drug, Changsha, China
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Thein MS, Kohli A, Ram R, Ingaramo MC, Jain A, Fedarko NS. Chitotriosidase, a marker of innate immunity, is elevated in patients with primary breast cancer. Cancer Biomark 2018; 19:383-391. [PMID: 28582842 DOI: 10.3233/cbm-160101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Cancer progression has been associated with altered immune cell function and activation. Neopterin, which is secreted by interferon-γ stimulated macrophages, exhibits an association with multiple cancer types and metastatic disease. Chitotriosidase, which is secreted by chronically activated macrophages and granulocyte-macrophage colony-stimulating factor stimulated neutrophils has not been studied in the setting of cancer. OBJECTIVE The goal of this discovery study was to screen chitotriosidase for diagnostic capacity in detecting cancer and compare its operating characteristics with those of neopterin. METHODS Serum from subjects with breast (n= 66) or prostate (n= 70) cancer, and from 204 subjects free of malignant disease were studied. Chitotriosidase was measured by enzyme activity assay, while neopterin was measured by a competitive enzyme immunoassay. Statistical analyses included group comparisons by Mann Whitney U test, diagnostic capacity by receiver operating characteristics (ROC) curve analysis and biomarker associations with physiologic and clinical measures by Spearman correlation. RESULTS Chitotriosidase activity was significantly higher in both cancer types compared with gender matched controls, though only in breast cancer was the diagnostic capacity significant (area under the ROC curve of 0.97 ± 0.01). In contrast, neopterin was significantly elevated in prostate cancer and exhibited discriminatory capacity (area under the ROC curve of 0.76 ± 0.05). Age, BMI, % body fat and metastasis were variables that correlated with neopterin, but not chitotriosidase levels. CONCLUSIONS The operating characteristics of serum chitotriosidase were different from neopterin and further analysis of chitotriosidase as a biomarker for breast cancer is warranted.
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Affiliation(s)
- Mya Sanda Thein
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.,University of Maryland Community Oncology Group, Glen Burnie, MD, USA
| | - Anita Kohli
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Scheie Eye Institute at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rohit Ram
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Maria Clara Ingaramo
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Instituto de Agrobiotecnología del Litoral, Santa Fe, Argentina
| | - Alka Jain
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Neal S Fedarko
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Takenaka Y, Oya R, Kitamiura T, Ashida N, Shimizu K, Takemura K, Yamamoto Y, Uno A. Prognostic role of neutrophil-to-lymphocyte ratio in head and neck cancer: A meta-analysis. Head Neck 2018; 40:647-655. [PMID: 29076207 DOI: 10.1002/hed.24986] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/03/2017] [Accepted: 09/15/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Neutrophils play substantial roles in cancer progression. Previous reports demonstrated the prognostic impact of the pretreatment neutrophil-to-lymphocyte ratio (NLR) in various types of solid cancers. The purpose of this study was to quantify the prognostic impact of NLR on head and neck squamous cell carcinoma (HNSCC). METHODS We systematically searched electronic databases, identified articles regarding NLR and HNSCC mortality, and extracted hazard ratios (HRs) and 95% confidence intervals (CIs). Pooled HRs for overall survival (OS) and disease-specific survival (DSS) were estimated using random effect models. RESULTS Nineteen studies enrolling 3770 patients were included in the analyses. Overall, NLR greater than the cutoff value was associated with poorer OS and DSS (HR 1.69; 95% CI 1.47-1.93; P < .001 and HR 1.88; 95% CI 1.20-2.95; P = .006, respectively). CONCLUSION Elevated NLR predicts worse outcomes in patients with HNSCC.
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Affiliation(s)
- Yukinori Takenaka
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Ryohei Oya
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Takahiro Kitamiura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Naoki Ashida
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kotaro Shimizu
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kazuya Takemura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Yoshifumi Yamamoto
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Atsuhiko Uno
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
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Sacdalan DB, Lucero JA, Sacdalan DL. Prognostic utility of baseline neutrophil-to-lymphocyte ratio in patients receiving immune checkpoint inhibitors: a review and meta-analysis. Onco Targets Ther 2018; 11:955-965. [PMID: 29503570 PMCID: PMC5827677 DOI: 10.2147/ott.s153290] [Citation(s) in RCA: 210] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Systemic inflammation is associated with prognosis in solid tumors. The neutrophil-to-lymphocyte ratio (NLR) is a marker for the general immune response to various stress stimuli. Studies have shown correlation of NLR to outcomes in immune checkpoint blockade, peripheral neutrophil count to intratumor neutrophil population, and NLR to intratumoral levels of myeloid-derived suppressor cells. Studies have shown elevated peripheral blood regulator T cells accompanied by elevated NLR are associated with poor outcomes further highlighting the importance of inflammation in the prognosis of cancer patients. METHODS We performed a meta-analysis of published articles on the utility of baseline NLR in predicting outcomes in patients treated with immune checkpoint inhibitors (ICIs) using Review Manager, version 5.3. Seven studies on the prognostic utility of NLR in ICI treatment were included in this analysis. For outcomes of interest, the hazard ratios (HRs) were computed. Subgroup analyses were planned based on type of malignancy and type of immune checkpoint inhibitor. RESULTS/DISCUSSION A high NLR resulted in worse overall survival (OS) (HR, 1.92; 95% CI, 1.29-2.87; p=0.001) and progression-free survival (PFS; HR, 1.66; 95% CI, 1.38-2.01; p<0.00001) across types of malignancies studied (melanoma, non-small-cell lung cancer, and genitourinary cancer). Subgroup analysis across different types of malignancies treated with ICI showed similar results for OS and PFS. The single study on genitourinary cancers also showed worse OS and PFS (OS: HR, 1.82; 95% CI, 1.29-2.87; p=0.001 and PFS: HR, 1.83; 95% CI, 0.97-3.44; p=0.06). A high NLR also showed worse OS and PFS across all ICIs (ipilimumab, nivolumab, and unspecified or pooled pembrolizumab and nivolumab; OS: HR, 1.92; 95% CI, 1.29-2.87; p=0.001 and PFS: HR, 1.66; 95% CI, 1.38-2.01; p<0.00001). Subgroup analysis by type of ICI showed similar results. CONCLUSION A high NLR is associated with poorer outcomes across studies. This shows that NLR has the potential as a readily available prognostic indicator for patients receiving ICI based on available studies. Studies utilizing more stringent design may serve to better determine the utility of this tool.
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Affiliation(s)
- Danielle Benedict Sacdalan
- Section of Medical Oncology, Department of Medicine, University of the Philippines Manila and Philippine General Hospital, Manila, Philippines
| | - Josephine Anne Lucero
- Department of Medicine, University of the Philippines Manila and Philippine General Hospital, Manila, Philippines
| | - Dennis Lee Sacdalan
- Section of Medical Oncology, Department of Medicine, University of the Philippines Manila and Philippine General Hospital, Manila, Philippines
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Murata H, Koyama K, Takezawa Y, Nishigaki Y. Baseline neutrophil-to-lymphocyte ratio predicts the prognosis of castration-resistant prostate cancer treated with abiraterone acetate. Mol Clin Oncol 2018; 8:592-594. [PMID: 29541468 DOI: 10.3892/mco.2018.1562] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/28/2017] [Indexed: 02/03/2023] Open
Abstract
Abiraterone acetate (AA), a CYP17 inhibitor, now has a crucial role in the treatment of castration-resistant prostate cancer (CRPC), and previous studies have reported several prognostic clinical factors for AA treatment. The neutrophil-to-lymphocyte ratio (NLR) has also been investigated for a CRPC treatments in a few reports, however it has not been identified to be a prognostic factor for AA treatment in Japanese patients. The present study aimed to assess the association of the baseline NLR with the overall survival (OS) in CPRC patients treated by AA. The present study retrospectively reviewed a total of 90 consecutive patients with CRPC treated with AA from 2011 to 2016 at Yokohama City University Medical Center and National Cancer Center Hospital East. The primary endpoint of the study was the OS, which was defined as the survival from the start of AA administration. The secondary endpoint was the prostate-specific antigen (PSA) response. PSA response was defined as a reduction in antigen levels of >50%. Complete blood cell counts were performed, and the NLR was calculated using the neutrophil and lymphocyte counts obtained on the same day or a few days prior to the initiation of AA therapy. The NLR cut-off point was determined to be 3.76 for the OS, and divided into the high NLR group of 34 patients and the low NLR group of 56 patients. A PSA response was obtained in 8 patients (23.5%) in the high NLR group and in 24 (42.9%) in the low NLR group. The difference of PSA response between the two groups was significant (P=0.037). Kaplan-Meier curves demonstrated that a high NLR [NLR ≥3.76; median OS: 8.4 months; 95% confidence interval (CI): 6.325-10.475 months] was correlated with a risk of mortality compared with a low NLR (NLR <3.76; median OS not reached). A multivariate analysis demonstrated that the NLR was an independent predictor for the OS (hazard ratio: 2.682; 95% CI: 1.143-6.293; P=0.023). The findings suggest that the NLR may be a useful novel biomarker for predicting the prognosis of CRPC patients treated with AA.
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Affiliation(s)
- Hiroaki Murata
- Department Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Kenzou Koyama
- Department Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Yasunobu Takezawa
- Department Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
| | - Yasunori Nishigaki
- Department Orthopaedics, Matsushita Memorial Hospital, Moriguchi, Osaka 570-8540, Japan
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Dreussi E, Ecca F, Scarabel L, Gagno S, Toffoli G. Immunogenetics of prostate cancer: a still unexplored field of study. Pharmacogenomics 2018; 19:263-283. [PMID: 29325503 DOI: 10.2217/pgs-2017-0163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The immune system is a double-edged sword with regard to the prostate cancer (PCa) battle. Immunogenetics, the study of the potential role of immune-related polymorphisms, is taking its first steps in the treatment of this malignancy. This review summarizes the most recent papers addressing the potential of immunogenetics in PCa, reporting immune-related polymorphisms associated with tumor aggressiveness, treatment toxicity and patients' prognosis. With some peculiarities, RNASEL, IL-6, IL-10, IL-1β and MMP7 have arisen as the most significant biomarkers in PCa treatment and management, having a potential clinical role. Validation prospective clinical studies are required to translate immunogenetics into precision treatment of PCa.
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Affiliation(s)
- Eva Dreussi
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
| | - Fabrizio Ecca
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
| | - Lucia Scarabel
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
| | - Sara Gagno
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
| | - Giuseppe Toffoli
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
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Plourde G. Case Report #9—Biomarkers of Prostate Cancer. Prostate Cancer 2018. [DOI: 10.1016/b978-0-12-815966-8.00009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Belderbos BPS, de Wit R, Hoop EOD, Nieuweboer A, Hamberg P, van Alphen RJ, Bergman A, van der Meer N, Bins S, Mathijssen RHJ, van Soest RJ. Prognostic factors in men with metastatic castration-resistant prostate cancer treated with cabazitaxel. Oncotarget 2017; 8:106468-106474. [PMID: 29290963 PMCID: PMC5739748 DOI: 10.18632/oncotarget.22474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/27/2017] [Indexed: 01/04/2023] Open
Abstract
Background Treatment selection for men with metastatic castration-resistant prostate cancer (mCRPC) has become increasingly challenging with the introduction of novel therapies at earlier disease stages. The purpose of this study was to identify prognostic factors for overall survival (OS) and PSA response in patients with mCRPC treated with cabazitaxel. Results 224 mCRPC patients were included in the current analysis. In multivariable analysis, WHO performance status, baseline hemoglobin, alkaline phosphatase and albumin were all significantly associated with OS. Hemoglobin and alkaline phosphatase were significantly associated with PSA response. Conclusions This study identified prognostic factors for OS and PSA response of men with mCRPC treated with cabazitaxel. In an increasingly complicated treatment landscape with several treatment options available our findings might serve to estimate the chance of survival of men qualifying for treatment with second-line chemotherapy in daily practice. Furthermore, these data can be used to risk-stratify patients in clinical trials. Methods We performed a post-hoc analysis of a randomized phase II trial of mCRPC patients treated with cabazitaxel. Cox and logistic regression models were used to investigate the influence of clinical and biochemical variables on OS and PSA response. Nomograms were developed to estimate the chance of PSA response and OS.
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Affiliation(s)
- Bodine P S Belderbos
- Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, 3015 CE Rotterdam, The Netherlands
| | - Ronald de Wit
- Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, 3015 CE Rotterdam, The Netherlands
| | - Esther Oomen-de Hoop
- Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, 3015 CE Rotterdam, The Netherlands
| | - Annemieke Nieuweboer
- Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, 3015 CE Rotterdam, The Netherlands
| | - Paul Hamberg
- Department of Internal Medicine, Franciscus Gasthuis and Vlietland, 3045 PM Rotterdam, The Netherlands
| | - Robbert J van Alphen
- Department of Internal Medicine, Elisabeth Tweesteden Ziekenhuis, 5042 AD Tilburg, The Netherlands
| | - André Bergman
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
| | - Nelly van der Meer
- Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, 3015 CE Rotterdam, The Netherlands
| | - Sander Bins
- Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, 3015 CE Rotterdam, The Netherlands
| | - Ron H J Mathijssen
- Department of Medical Oncology, Erasmus University Medical Center and Cancer Institute, 3015 CE Rotterdam, The Netherlands
| | - Robert J van Soest
- Department of Urology, Erasmus University Medical Center and Cancer Institute, 3015 CE Rotterdam, The Netherlands
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Neutrophil to Lymphocyte Ratio as Prognostic Indicator for Patients with Esophageal Squamous Cell Cancer. Int J Biol Markers 2017; 32:e409-e414. [PMID: 28799624 DOI: 10.5301/ijbm.5000294] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2017] [Indexed: 01/13/2023]
Abstract
Background This study aimed to evaluate the correlation between neutrophil to lymphocyte ratio (NLR) with overall survival (OS) of esophageal squamous cell carcinoma (ESCC) patients. Method Records of patients with diagnosed ESCC were reviewed. Leukocyte counts and patients' characteristics were extracted from their clinical records to calculate NLR. Correlation between NLR and baseline characteristics with overall survival (OS) was then analyzed using Cox regression. The patients were then separated into higher and lower NLR groups according to median NLR. OS was further compared between the 2 groups. Results A total of 1281 patients were included in the study. Cox regression analysis showed a significant correlation of NLR with OS of ESCC patients. The median pretreatment NLR was identified as 2.86. Higher NLR was associated with worse prognosis in terms of OS. Conclusions Pretreatment NLR is independently associated with OS of ESCC patients. Therefore, NLR may be used as a predictive indicator for pretreatment evaluation and adjustment of treatment regimen.
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Rangarajan K, Chandrakumaran K, Dayal S, Mohamed F, Moran BJ, Cecil TD. The pre-operative neutrophil-lymphocyte ratio predicts overall and disease-free survival following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with pseudomxyoma peritonei of appendiceal origin. Int J Hyperthermia 2017; 34:559-563. [PMID: 29063804 DOI: 10.1080/02656736.2017.1384073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIM The neutrophil-lymphocyte ratio (NLR) and other inflammation-based scores have been used as a prognostic tool to predict survival in solid tumours including pseudomyxoma peritonei (PMP). The aim was to evaluate the prognostic value of this marker and risk stratify PMP patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS Retrospective analysis was conducted of a prospectively collected database of patients with PMP who underwent CRS and HIPEC between 1994 and 2015. The NLR was calculated by dividing the pre-operative neutrophil count by lymphocyte count. Predicted overall survival (OS) and disease-free interval (DFI) were calculated using a Kaplan-Meier survival model. RESULTS The study included 699 patients, stratified into four groups as defined by their NLR. Group A: 200 (28.6%) patients (NLR = 0.10-2.00), Group B: 160 (22.8%) patients (NLR = 2.10-2.78), Group C: 184 (26.3%) patients (NLR = 2.79-4.31) and Group D: 155 (22.2%) patients (NLR ≥ 4.32). The median follow-up for this cohort was 36 months. The predicted DFI was 132.2, 113.1, 84.4 and 47.9 months and the OS was 141.1, 117.6, 88.7 and 51.2 months for Groups A, B, C and D, respectively. As the NLR increases, there is a reduction in long-term survival. CONCLUSION The pre-operative NLR is cost effective and has equivalent prognostic value to pre-operative tumour markers for patients with PMP treated with CRS and HIPEC. The NLR is a reliable tool that may have a role in predicting outcomes following CRS and HIPEC for patients with PMP of appendiceal origin.
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Affiliation(s)
- Karan Rangarajan
- a Peritoneal Malignancy Department , Basingstoke and North Hampshire Hospitals , Basingstoke , UK
| | - Kandiah Chandrakumaran
- a Peritoneal Malignancy Department , Basingstoke and North Hampshire Hospitals , Basingstoke , UK
| | - Sanjeev Dayal
- a Peritoneal Malignancy Department , Basingstoke and North Hampshire Hospitals , Basingstoke , UK
| | - Faheez Mohamed
- a Peritoneal Malignancy Department , Basingstoke and North Hampshire Hospitals , Basingstoke , UK
| | - Brendan J Moran
- a Peritoneal Malignancy Department , Basingstoke and North Hampshire Hospitals , Basingstoke , UK
| | - Thomas D Cecil
- a Peritoneal Malignancy Department , Basingstoke and North Hampshire Hospitals , Basingstoke , UK
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Prognostic significance of neutrophil to lymphocyte ratio in ovarian cancer: evidence from 4,910 patients. Oncotarget 2017; 8:68938-68949. [PMID: 28978169 PMCID: PMC5620309 DOI: 10.18632/oncotarget.20196] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 07/12/2017] [Indexed: 12/12/2022] Open
Abstract
Increasing evidence indicates that elevated neutrophil to lymphocyte ratio (NLR) are related with poor prognosis in various types of tumors. However, the prognostic role of NLR in patients with ovarian cancer (OC) remains controversial. Thus, the current meta-analysis aimed to investigate the prognostic role of NLR in patients with OC. A total of 16 studies with 4,910 patients were included. By pooling hazard ratios (HRs) with 95% confidence intervals (CIs) and odds ratios (ORs) with 95% CIs from each study. The results demonstrated that elevated pretreatment NLR was significantly related to poor OS (HR: 1.50, 95% CI: 1.27-1.77) and PFS (HR: 1.53, 95% CI: 1.28-1.84) in patients with OC. Subgroup analyses was divided by ethnicity, sample size, histologic types, cut-off value of NLR, analysis method and NOS score, but the results did not showed any significant change the main results. This meta-analysis revealed that elevated pretreatment NLR might be a predicative factor of poor prognosis in OC patients.
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Wang J, Liu Y, Zhang N, Li X, Xin P, Bi J, Kong C. Prognostic role of pretreatment platelet to lymphocyte ratio in urologic cancer. Oncotarget 2017; 8:70874-70882. [PMID: 29050328 PMCID: PMC5642603 DOI: 10.18632/oncotarget.20147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/23/2017] [Indexed: 12/12/2022] Open
Abstract
The prognostic value of platelet to lymphocyte ratio (PLR) in urologic cancer does not reach a consensus. Herein, we performed the meta-analysis to determine the prognostic role of PLR in patients with urologic cancer. A literature search was performed in the PubMed, Embase, and Web of Science databases. Hazard ratios (HRs) were extracted to estimate the association between PLR and prognosis. A total of 20 articles comprising 6079 patients were included in this study. The pooled results showed that a high PLR was significantly associated with worse prognosis of overall survival (OS) in urologic cancer [HR=1.65, 95% confidence interval (CI) =1.37-1.99, P<0.01]. The result also indicated that an elevated PLR was significantly associated with poor OS in renal cancer (HR=1.88, 95% CI=1.39-2.55, P<0.01). In addition, the significant association between poor OS and elevated PLR in renal cancer was consistent regardless of treatment, cut-off value, sample size and study quality. Our result also indicated that an elevated PLR predicted shorter OS (HR=1.78, 95% CI=1.38-2.30, P<0.01) and cancer-specific survival (HR=2.02, 95% CI=1.24-3.29, P<0.01) in prostate cancer. In conclusion, an elevated PLR was a predictive indicator of poor survival in renal cancer and prostate cancer.
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Affiliation(s)
- Jianfeng Wang
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Yang Liu
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Naiwen Zhang
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Xuejie Li
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Peng Xin
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Jianbin Bi
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Chuize Kong
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
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Takenaka Y, Kitamura T, Oya R, Ashida N, Shimizu K, Takemura K, Yamamoto Y, Uno A. Prognostic role of neutrophil-lymphocyte ratio in nasopharyngeal carcinoma: A meta-analysis. PLoS One 2017; 12:e0181478. [PMID: 28715474 PMCID: PMC5513538 DOI: 10.1371/journal.pone.0181478] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 06/30/2017] [Indexed: 12/15/2022] Open
Abstract
Background Inflammatory markers are used to predict prognosis of nasopharyngeal carcinoma (NPC). Previous reports of neutrophil-to-lymphocyte ratio (NLR) and NPC mortality are inconsistent. This study aimed to quantify the prognostic impact of NLR on NPC. Methods The primary outcome was overall survival (OS), and the secondary outcomes were disease-specific survival (DSS), progression-free survival (PFS) and distant metastasis-free survival (DMFS). We systematically searched electronic databases, identified articles reporting an association between NLR and NPC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and pooled HRs for each outcome were estimated using random effect models. Results Nine studies enrolling 5397 patients were included in the analyses. NLR greater than the cutoff value was associated with poor overall survival (HR 1.51, 95% CI 1.27–1.78), disease-specific survival (HR 1.44, 95% CI 1.22–1.71), progression-free survival (HR 1.53, 95% CI 1.22–1.90), and distant metastasis-free survival (HR 1.83, 95% CI 1.14–2.95). Conclusions Elevated NLR predicts worse OS, DSS, PFS and DMFS in patients with NPC.
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Affiliation(s)
- Yukinori Takenaka
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
- * E-mail:
| | - Takahiro Kitamura
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Ryohei Oya
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Naoki Ashida
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kotaro Shimizu
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kazuya Takemura
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Yoshifumi Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Atsuhiko Uno
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
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McSorley ST, Dolan RD, Roxburgh CSD, McMillan DC, Horgan PG. How and why systemic inflammation worsens quality of life in patients with advanced cancer. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23809000.2017.1331705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Stephen T. McSorley
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK
| | - Ross D. Dolan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK
| | | | - Donald C. McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK
| | - Paul G. Horgan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK
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Response to Comment on "Neutrophil to Lymphocyte Ratio as a Predictive Marker of Vestibular Schwannoma Growth". Otol Neurotol 2016; 38:305-306. [PMID: 27941410 DOI: 10.1097/mao.0000000000001305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Faria SS, Fernandes PC, Silva MJB, Lima VC, Fontes W, Freitas-Junior R, Eterovic AK, Forget P. The neutrophil-to-lymphocyte ratio: a narrative review. Ecancermedicalscience 2016. [PMID: 28105073 DOI: 10.3332/ecancer.2016.702can-10-702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cellular-mediated inflammatory response, lymphocytes, neutrophils, and monocytes are increasingly being recognised as having an important role in tumorigenesis and carcinogenesis. In this context, studies have suggested that the neutrophil-to-lymphocyte ratio (NLR) can be used as an independent prognostic factor in a variety of cancers. Particularly in breast cancer, several studies have shown that a high NLR is associated with shorter survival. Because the NLR can be easily determined from the full blood count, it could potentially provide a simple and inexpensive test cancer prognosis. This review addresses the possibilities and limitations of using the NLR as a clinical tool for risk stratification helpful for individual treatment of breast cancer patients. The potential underlying phenomena and some perspectives are discussed.
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Affiliation(s)
- Sara Socorro Faria
- Mastology Program, Federal University of Uberlandia (UFU), Avenida Engenheiro Diniz 1178, Reitoria 3º Andar Uberlândia, Minas Gerais, Brazil
| | - Paulo César Fernandes
- Department of Medical Oncology, AC Camargo Cancer Center, R Professor Antônio Prudente, 211, Liberdade, São Paulo 01509, Brazil
| | - Marcelo José Barbosa Silva
- Department of Medical Oncology, AC Camargo Cancer Center, R Professor Antônio Prudente, 211, Liberdade, São Paulo 01509, Brazil
| | - Vladmir C Lima
- Department of Medical Oncology, AC Camargo Cancer Center, R Professor Antônio Prudente, 211, Liberdade, São Paulo 01509, Brazil
| | - Wagner Fontes
- Laboratory of Biochemistry of Protein Chemistry (Proteomics Research), University of Brasilia (UnB), Campus Universitário Darcy Ribeiro S/N (Asa Norte) 70910-900, Brazil
| | - Ruffo Freitas-Junior
- Mastology Program, Federal University of Goias (UFG), Rodovia Goiania Nerópolis Km 12, Prédio da Reitoria, 74001-970, Goiania/GO, Brazil
| | - Agda Karina Eterovic
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Patrice Forget
- Department of Anesthesiology and Perioperative Medicine, Universitair Ziekenhuis Brussel, laarbeeklaan 101, 1090 Brussels, Belgium
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Faria SS, Fernandes PC, Silva MJB, Lima VC, Fontes W, Freitas-Junior R, Eterovic AK, Forget P. The neutrophil-to-lymphocyte ratio: a narrative review. Ecancermedicalscience 2016; 10:702. [PMID: 28105073 PMCID: PMC5221645 DOI: 10.3332/ecancer.2016.702] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Indexed: 01/06/2023] Open
Abstract
Cellular-mediated inflammatory response, lymphocytes, neutrophils, and monocytes are increasingly being recognised as having an important role in tumorigenesis and carcinogenesis. In this context, studies have suggested that the neutrophil-to-lymphocyte ratio (NLR) can be used as an independent prognostic factor in a variety of cancers. Particularly in breast cancer, several studies have shown that a high NLR is associated with shorter survival. Because the NLR can be easily determined from the full blood count, it could potentially provide a simple and inexpensive test cancer prognosis. This review addresses the possibilities and limitations of using the NLR as a clinical tool for risk stratification helpful for individual treatment of breast cancer patients. The potential underlying phenomena and some perspectives are discussed.
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Affiliation(s)
- Sara Socorro Faria
- Mastology Program, Federal University of Uberlandia (UFU), Avenida Engenheiro Diniz 1178, Reitoria 3º Andar Uberlândia, Minas Gerais, Brazil
| | - Paulo César Fernandes
- Department of Medical Oncology, AC Camargo Cancer Center, R Professor Antônio Prudente, 211, Liberdade, São Paulo 01509, Brazil
| | - Marcelo José Barbosa Silva
- Department of Medical Oncology, AC Camargo Cancer Center, R Professor Antônio Prudente, 211, Liberdade, São Paulo 01509, Brazil
| | - Vladmir C Lima
- Department of Medical Oncology, AC Camargo Cancer Center, R Professor Antônio Prudente, 211, Liberdade, São Paulo 01509, Brazil
| | - Wagner Fontes
- Laboratory of Biochemistry of Protein Chemistry (Proteomics Research), University of Brasilia (UnB), Campus Universitário Darcy Ribeiro S/N (Asa Norte) 70910-900, Brazil
| | - Ruffo Freitas-Junior
- Mastology Program, Federal University of Goias (UFG), Rodovia Goiania Nerópolis Km 12, Prédio da Reitoria, 74001-970, Goiania/GO, Brazil
| | - Agda Karina Eterovic
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Patrice Forget
- Department of Anesthesiology and Perioperative Medicine, Universitair Ziekenhuis Brussel, laarbeeklaan 101, 1090 Brussels, Belgium
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