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Fay M, Clavijo PE, Allen CT. Heterogeneous characterization of neutrophilic cells in head and neck cancers. Head Neck 2024. [PMID: 38622975 DOI: 10.1002/hed.27774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/14/2024] [Accepted: 04/07/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Neutrophilic cells are among the most abundant immune populations within the head and neck tumor microenvironment (TME) and harbor multiple mechanisms of immunosuppression. Despite these important features, neutrophilic cells may be underrepresented in contemporary studies that aim to comprehensively characterize the immune landscape of the TME due to discrepancies in tissue processing and analysis techniques. Here, we review the role of pathologically activated neutrophilic cells within the TME and pitfalls of various approaches used to study their frequency and function in clinical samples. METHODS The literature was identified by searching PubMed for "immune landscape" and "tumor immune microenvironment" in combination with keywords describing solid tumor malignancies. Key publications that assessed the immune composition of solid tumors derived from human specimens were included. The tumor and blood processing methodologies in each study were reviewed in depth and correlated with the reported abundance of neutrophilic cells. RESULTS Neutrophilic cells do not survive cryopreservation, and many studies fail to identify and study neutrophilic cell populations due to cryopreservation of clinical samples for practical reasons. Additional single-cell transcriptomic studies filter out neutrophilic cells due to low transcriptional counts. CONCLUSIONS This report can help readers critically interpret studies aiming to comprehensively study the immune TME that fail to identify and characterize neutrophilic cells.
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Affiliation(s)
- Magdalena Fay
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Paul E Clavijo
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Clint T Allen
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
- Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Khaled C, El Asmar A, Raisi O, Moreau M, Polastro L, Veys I, Pop FC, Donckier V, Liberale G. Prognostic value of preoperative serological biomarkers in patients undergoing cytoreductive surgery for ovarian cancer peritoneal metastases. Pleura Peritoneum 2023; 8:133-138. [PMID: 37662604 PMCID: PMC10469179 DOI: 10.1515/pp-2022-0199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 05/03/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives Peritoneal metastases of ovarian cancer (PMOC) are common at initial presentation. Cytoreductive surgery (CRS) of curative intent has been proven to be efficient in increasing the overall survival (OS) and the disease-free survival (DFS) of these patients. Nevertheless, CRS is associated with high postoperative morbidity, which makes patient selection a major concern. Appropriate prognostic factors that can predict patient outcomes after surgery are still lacking. Preoperative biomarkers and their ratios have been shown to be predictive of patient prognosis for various solid tumors. We aimed to study their correlation with the prognosis of patients undergoing CRS for PMOC. Methods This retrospective study included patients with PMOC operated by CRS. Preoperative biomarkers and other clinicopathological characteristics were studied to determine their prognostic value in terms OS and DFS. Results 216 patients were included. Patients with preoperative hemoglobin (Hb) <11.7 g/dL had a poorer prognosis in terms of OS (p=0.0062) and DFS (p=0.0077). Additionally, increased neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) >0.32, and platelet-to-lymphocyte ratio (PLR) >214.5 were associated with worse OS (p=0.022, p=0.0028, and p=0.0018, respectively) and worse DFS (p=0.028, p=0.003, and p=0.019, respectively). Multivariate analysis showed that the variables mentioned above were independent predictive factors for OS and DFS. Conclusions Preoperative Hb level, NLR, MLR, and PLR are prognostic factors for OS and DFS in PMOC patients operated by curative CRS.
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Affiliation(s)
- Charif Khaled
- Department of Surgical Oncology, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Antoine El Asmar
- Department of Surgical Oncology, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Omar Raisi
- Department of Surgical Oncology, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Michel Moreau
- Department of Statistics, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Laura Polastro
- Department of Medical Oncology, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Isabelle Veys
- Department of Surgical Oncology, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Florin C. Pop
- Department of Surgical Oncology, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Vincent Donckier
- Department of Surgical Oncology, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Gabriel Liberale
- Department of Surgical Oncology, Jules Bordet Institute - The Brussels University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
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3
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Plaja A, Teruel I, Ochoa-de-Olza M, Cucurull M, Arroyo ÁJ, Pardo B, Ortiz I, Gil-Martin M, Piulats JM, Pla H, Fina C, Carbó A, Barretina-Ginesta MP, Martínez-Román S, Carballas E, González A, Esteve A, Romeo M. Prognostic Role of Neutrophil, Monocyte and Platelet to Lymphocyte Ratios in Advanced Ovarian Cancer According to the Time of Debulking Surgery. Int J Mol Sci 2023; 24:11420. [PMID: 37511180 PMCID: PMC10380459 DOI: 10.3390/ijms241411420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Despite a multimodal radical treatment, mortality of advanced epithelial ovarian cancer (AEOC) remains high. Host-related factors, such as systemic inflammatory response and its interplay with the immune system, remain underexplored. We hypothesized that the prognostic impact of this response could vary between patients undergoing primary debulking surgery (PDS) and those undergoing interval debulking surgery (IDS). Therefore, we evaluated the outcomes of two surgical groups of newly diagnosed AEOC patients according to the neutrophil, monocyte and platelet to lymphocyte ratios (NLR, MLR, PLR), taking median ratio values as cutoffs. In the PDS group (n = 61), low NLR and PLR subgroups showed significantly better overall survival (not reached (NR) vs. 72.7 months, 95% confidence interval [CI]: 40.9-95.2, p = 0.019; and NR vs. 56.1 months, 95% CI: 40.9-95.2, p = 0.004, respectively) than those with high values. Similar results were observed in progression free survival. NLR and PLR-high values resulted in negative prognostic factors, adjusting for residual disease, BRCA1/2 status and stage (HR 2.48, 95% CI: 1.03-5.99, p = 0.043, and HR 2.91, 95% CI: 1.11-7.64, p = 0.03, respectively). In the IDS group (n = 85), ratios were not significant prognostic factors. We conclude that NLR and PLR may have prognostic value in the PDS setting, but none in IDS, suggesting that time of surgery can modulate the prognostic impact of baseline complete blood count (CBC).
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Affiliation(s)
- Andrea Plaja
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Iris Teruel
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Maria Ochoa-de-Olza
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Álvaro Javier Arroyo
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Beatriz Pardo
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Irene Ortiz
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Marta Gil-Martin
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Josep María Piulats
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Helena Pla
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Girona, Girona Biomedical Research Institut d'Investigació Biomèdica de Girona (IDIBGi), 17007 Girona, Spain
| | - Claudia Fina
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Girona, Girona Biomedical Research Institut d'Investigació Biomèdica de Girona (IDIBGi), 17007 Girona, Spain
| | - Anna Carbó
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Girona, Girona Biomedical Research Institut d'Investigació Biomèdica de Girona (IDIBGi), 17007 Girona, Spain
| | - Maria-Pilar Barretina-Ginesta
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Girona, Girona Biomedical Research Institut d'Investigació Biomèdica de Girona (IDIBGi), 17007 Girona, Spain
| | - Sergio Martínez-Román
- Obstetrics and Gynecologycal Department, Hospital Germans Trias i Pujol, 08916 Badalona, Spain
| | - Elvira Carballas
- Obstetrics and Gynecologycal Department, Hospital Germans Trias i Pujol, 08916 Badalona, Spain
| | - Andrea González
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Anna Esteve
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Margarita Romeo
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
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Tomás-Pérez S, Oto J, Aghababyan C, Herranz R, Cuadros-Lozano A, González-Cantó E, Mc Cormack B, Arrés J, Castaño M, Cana F, Martínez-Fernández L, Santonja N, Ramírez R, Herreros-Pomares A, Cañete-Mota S, Llueca A, Marí-Alexandre J, Medina P, Gilabert-Estellés J. Increased levels of NETosis biomarkers in high-grade serous ovarian cancer patients' biofluids: Potential role in disease diagnosis and management. Front Immunol 2023; 14:1111344. [PMID: 36817483 PMCID: PMC9936152 DOI: 10.3389/fimmu.2023.1111344] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction High-grade serous ovarian cancer (HGSOC) is the second most frequent gynecological malignancy but the most lethal, partially due to the spread of the disease through the peritoneal cavity. Recent evidence has shown that, apart from their role in immune defense through phagocytosis and degranulation, neutrophils are able to participate in cancer progression through the release of neutrophil extracellular traps (NETs) in a process called NETosis. NETs are composed of DNA, histones, calprotectin, myeloperoxidase (MPO) and elastase and the NETosis process has been proposed as a pre-requisite for the establishment of omental metastases in early stages of HGSOC. Nevertheless, its role in advanced stages remains to be elucidated. Therefore, our principal aim is to characterize a NETosis biomarker profile in biofluids from patients with advanced HGSOC and control women. Methods Specifically, five biomarkers of NETosis (cell-free DNA (cfDNA), nucleosomes, citrullinated histone 3 (citH3), calprotectin and MPO) were quantified in plasma and peritoneal fluid (PF) samples from patients (n=45) and control women (n=40). Results Our results showed that HGSOC patients presented a higher concentration of cfDNA, citH3 and calprotectin in plasma and of all five NETosis biomarkers in PF than control women. Moreover, these biomarkers showed a strong ability to differentiate the two clinical groups. Interestingly, neoadjuvant treatment (NT) seemed to reduce NETosis biomarkers mainly systemically (plasma) compared to the tumor environment (PF). Discussion In conclusion, NETosis biomarkers are present in the tumor environment of patients with advanced HGSOC, which might contribute to the progression of the disease. Besides, plasma cfDNA and calprotectin could represent minimally invasive surrogate biomarkers for HGSOC. Finally, NT modifies NETosis biomarkers levels mainly at the systemic level.
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Affiliation(s)
- Sarai Tomás-Pérez
- Research Laboratory in Biomarkers in Reproduction, Obstetrics and Gynecology, Research Foundation of the General University Hospital of Valencia, Valencia, Spain
| | - Julia Oto
- Hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Cristina Aghababyan
- Research Laboratory in Biomarkers in Reproduction, Obstetrics and Gynecology, Research Foundation of the General University Hospital of Valencia, Valencia, Spain,Department of Obstetrics and Gynecology, General University Hospital of Valencia Consortium, Valencia, Spain
| | - Raquel Herranz
- Hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Aitor Cuadros-Lozano
- Research Laboratory in Biomarkers in Reproduction, Obstetrics and Gynecology, Research Foundation of the General University Hospital of Valencia, Valencia, Spain,Department of Obstetrics and Gynecology, General University Hospital of Valencia Consortium, Valencia, Spain
| | - Eva González-Cantó
- Research Laboratory in Biomarkers in Reproduction, Obstetrics and Gynecology, Research Foundation of the General University Hospital of Valencia, Valencia, Spain
| | - Bárbara Mc Cormack
- Research Laboratory in Biomarkers in Reproduction, Obstetrics and Gynecology, Research Foundation of the General University Hospital of Valencia, Valencia, Spain
| | - Judith Arrés
- Department of Statistics and Operational Research, University of Valencia, Valencia, Spain
| | - María Castaño
- Hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Fernando Cana
- Hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain
| | - Laura Martínez-Fernández
- Research Laboratory in Biomarkers in Reproduction, Obstetrics and Gynecology, Research Foundation of the General University Hospital of Valencia, Valencia, Spain,Department of Obstetrics and Gynecology, General University Hospital of Valencia Consortium, Valencia, Spain
| | - Núria Santonja
- Department of Pathology, General University Hospital of Valencia Consortium, Valencia, Spain
| | - Rocío Ramírez
- Department of Medical Oncology, General University Hospital of Valencia Consortium, Valencia, Spain
| | - Alejandro Herreros-Pomares
- Department of Biotechnology, Polytechnic University of Valencia, Valencia, Spain,Cancer Biomedical Research Network Center, CIBERONC, Madrid, Spain
| | - Sarai Cañete-Mota
- Department of Obstetrics and Gynecology, General University Hospital of Castellon, Castellón, Spain
| | - Antoni Llueca
- Department of Obstetrics and Gynecology, General University Hospital of Castellon, Castellón, Spain,Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), General University Hospital of Castellon, Castellón, Spain,Department of Medicine, University Jaume I, Castellón, Spain
| | - Josep Marí-Alexandre
- Research Laboratory in Biomarkers in Reproduction, Obstetrics and Gynecology, Research Foundation of the General University Hospital of Valencia, Valencia, Spain,Department of Pathology, General University Hospital of Valencia Consortium, Valencia, Spain,*Correspondence: Josep Marí-Alexandre, ; Pilar Medina,
| | - Pilar Medina
- Hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Valencia, Spain,*Correspondence: Josep Marí-Alexandre, ; Pilar Medina,
| | - Juan Gilabert-Estellés
- Research Laboratory in Biomarkers in Reproduction, Obstetrics and Gynecology, Research Foundation of the General University Hospital of Valencia, Valencia, Spain,Department of Obstetrics and Gynecology, General University Hospital of Valencia Consortium, Valencia, Spain,Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
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5
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Escobar-Munguía I, Berea-Baltierra R, Morales-González Á, Madrigal-Santillán E, Anguiano-Robledo L, Morales-González JA. Prognostic impact of the preoperatory neutrophil/lymphocyte index on early surgical complications of patients with colorectal cancer. Am J Cancer Res 2022; 12:3294-3302. [PMID: 35968336 PMCID: PMC9360242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023] Open
Abstract
Colorectal cancer (CRC) is found among those with greatest frequency and exponential increase worldwide, with high mortality rates, which are observed as increasing due to the postsurgical complications that come to present. Systemic inflammation participates in the development and progression of cancer; therefore, inflammatory and/or immunological response markers such as the neutrophil/lymphocyte index (NLI) can aid us in predicting the poor results of our interventions. The purpose of our study was to determine the impact of an NLI of ≥2.6 as a predictor of early postsurgical complications. By means of a prospective cohort, we analyzed 158 patients with CRC who were submitted to elective surgery with a later 30-day follow-up. We found that the preoperatory NLI of ≥2.6 obtained an odds ratio (OR) = 2.24 (95% confidence interval [CI], 1.15-4.36) as a prognostic factor of early postsurgical complications according to the Clavien-Dindo classification scale, which represents a low prognostic impact due to its predictive yield with low accuracy, which is the opposite of what other reports have previously published. The use of chemotherapy before the surgical procedure was also determined to be a risk factor for post-surgical complications.
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Affiliation(s)
- Ignacio Escobar-Munguía
- Jefe del Departamento de Medicina Interna y Apoyo Nutricio, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS)México
| | | | | | - Eduardo Madrigal-Santillán
- Laboratorio de Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico NacionalPlan de San Luis y Díaz Mirón, Col. Casco de Santo Tomás, Del. Miguel Hidalgo, Ciudad de México 11340, Mexico
| | - Liliana Anguiano-Robledo
- Escuela Superior de Medicina, Laboratorio de Farmacología Molecular, Instituto Politécnico NacionalDel. Miguel Hidalgo, Ciudad de México 11340, Mexico
| | - José A Morales-González
- Laboratorio de Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico NacionalPlan de San Luis y Díaz Mirón, Col. Casco de Santo Tomás, Del. Miguel Hidalgo, Ciudad de México 11340, Mexico
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6
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Pre-diagnosis and post-diagnosis dietary patterns and survival in women with ovarian cancer. Br J Cancer 2022; 127:1097-1105. [DOI: 10.1038/s41416-022-01901-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/08/2022] Open
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7
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Raskov H, Orhan A, Gaggar S, Gögenur I. Neutrophils and polymorphonuclear myeloid-derived suppressor cells: an emerging battleground in cancer therapy. Oncogenesis 2022; 11:22. [PMID: 35504900 PMCID: PMC9065109 DOI: 10.1038/s41389-022-00398-3] [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: 01/10/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 12/12/2022] Open
Abstract
Neutrophils are central mediators of innate and adaptive immunity and first responders to tissue damage. Although vital to our health, their activation, function, and resolution are critical to preventing chronic inflammation that may contribute to carcinogenesis. Cancers are associated with the expansion of the neutrophil compartment with an escalation in the number of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSC) in the peripheral circulation and tumor microenvironment. Although phenotypically similar to classically activated neutrophils, PMN-MDSC is pathologically activated and immunosuppressive in nature. They dynamically interact with other cell populations and tissue components and convey resistance to anticancer therapies while accelerating disease progression and metastatic spread. Cancer-associated neutrophilia and tumor infiltration of neutrophils are significant markers of poor outcomes in many cancers. Recently, there has been significant progress in the identification of molecular markers of PMN-MDSC providing insights into the central role of PMN-MDSC in the local tumor microenvironment as well as the systemic immune response in cancer. Further advances in sequencing and proteomics techniques will improve our understanding of their diverse functionalities and the complex molecular mechanisms at play. Targeting PMN-MDSC is currently one of the major focus areas in cancer research and several signaling pathways representing possible treatment targets have been identified. Positive results from preclinical studies clearly justify the current investigation in drug development and thus novel therapeutic strategies are being evaluated in clinical trials. In this review, we discuss the involvement of PMN-MDSC in cancer initiation and progression and their potential as therapeutic targets and clinical biomarkers in different cancers.
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Affiliation(s)
- Hans Raskov
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark.
| | - Adile Orhan
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Shruti Gaggar
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark
| | - Ismail Gögenur
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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8
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Liontos M, Andrikopoulou A, Koutsoukos K, Markellos C, Skafida E, Fiste O, Kaparelou M, Thomakos N, Haidopoulos D, Rodolakis A, Dimopoulos MA, Zagouri F. Neutrophil-to-lymphocyte ratio and chemotherapy response score as prognostic markers in ovarian cancer patients treated with neoadjuvant chemotherapy. J Ovarian Res 2021; 14:148. [PMID: 34724958 PMCID: PMC8561989 DOI: 10.1186/s13048-021-00902-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/13/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is the recommended approach in patients with advanced epithelial ovarian cancer (EOC). However, most patients eventually relapse despite the initial high response rate to chemotherapy. Neutrophil-to-lymphocyte ratio is a well-known biomarker that reflects severe inflammation, critical illness, and mortality in various diseases. Chemotherapy response score (CRS) and neutrophil-to-lymphocyte ratio (NLR) have been identified as potential biomarkers of platinum resistance and disease prognosis. We retrospectively evaluated 132 patients with stage IIIc or IV ovarian/fallopian tube/primary peritoneal cancer who had received NACT followed by IDS from 01/01/2003 to 31/12/2018. CRS was assessed on omental specimens collected from IDS according to ICCR guidelines. RESULTS Median age was 64.57 years (SD: 9.72; range 39.2-87.1). Most ovarian tumors were serous epithelial (90.9%; 120/132). An elevated NLR (defined as > 3) was observed in 72% (95/132) of patients in contrast with 28% (37/132) of patients characterized by low NLR status. Median PFS (mPFS) and median overall survival (mOS) were 13.05 months (95% CI: 11.42-14.67)) and 34.69 months (95% CI: 23.26-46.12) respectively. In univariate analysis, CRS3 score was significantly associated with prolonged mPFS (CRS1/2: 12.79 months vs CRS3: 17.7 months; P = 0.008). CRS score was not associated with mOS (P = 0.876). High NLR was not significantly associated with mPFS (P = 0.128), however it was significantly associated with poor mOS (P = 0.012). In multivariate analysis, only performance of surgery maintained its statistical significance with both PFS (P = 0.001) and OS (P = 0.008). CONCLUSION NLR could serve as a useful predictor of OS but not PFS in ovarian cancer patients receiving NACT. In accordance with our previous study, CRS score at omentum was found to be associated with PFS but not OS in ovarian cancer patients treated with NACT and IDS.
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Affiliation(s)
- M Liontos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - A Andrikopoulou
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - K Koutsoukos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - C Markellos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - E Skafida
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - O Fiste
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - M Kaparelou
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - N Thomakos
- Department of Obstetrics and Gynecology, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - D Haidopoulos
- Department of Obstetrics and Gynecology, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Rodolakis
- Department of Obstetrics and Gynecology, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - M A Dimopoulos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - F Zagouri
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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9
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Role of neutrophil extracellular traps in radiation resistance of invasive bladder cancer. Nat Commun 2021; 12:2776. [PMID: 33986291 PMCID: PMC8119713 DOI: 10.1038/s41467-021-23086-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 04/14/2021] [Indexed: 12/24/2022] Open
Abstract
Radiation therapy (RT) is used in the management of several cancers; however, tumor radioresistance remains a challenge. Polymorphonuclear neutrophils (PMNs) are recruited to the tumor immune microenvironment (TIME) post-RT and can facilitate tumor progression by forming neutrophil extracellular traps (NETs). Here, we demonstrate a role for NETs as players in tumor radioresistance. Using a syngeneic bladder cancer model, increased NET deposition is observed in the TIME of mice treated with RT and inhibition of NETs improves overall radiation response. In vitro, the protein HMGB1 promotes NET formation through a TLR4-dependent manner and in vivo, inhibition of both HMGB1 and NETs significantly delays tumor growth. Finally, NETs are observed in bladder tumors of patients who did not respond to RT and had persistent disease post-RT, wherein a high tumoral PMN-to-CD8 ratio is associated with worse overall survival. Together, these findings identify NETs as a potential therapeutic target to increase radiation efficacy. Radioresistance remains a challenge in the treatment of bladder cancer. In this study, the authors show in mice that radiation increases deposits of neutrophil extracellular traps (NETs) via a TLR4-dependent mechanism and that NETs-targeting strategies can improve the response to radiotherapy.
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10
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HAFIZOĞLU M, KOROGLU R, DEMİR H, BOZKURT E, HAFIZOĞLU E. The correlation of tumor markers, neutrophil/lymphocyte ratio and FDG PET/CT measures in pancreatic cancer. TURKISH JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.46310/tjim.839545] [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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11
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El Bairi K, Al Jarroudi O, Afqir S. Inexpensive Systemic Inflammatory Biomarkers in Ovarian Cancer: An Umbrella Systematic Review of 17 Prognostic Meta-Analyses. Front Oncol 2021; 11:694821. [PMID: 34631526 PMCID: PMC8495411 DOI: 10.3389/fonc.2021.694821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/03/2021] [Indexed: 02/05/2023] Open
Abstract
UNLABELLED The association of several inflammation-based biomarkers [lymphocyte-to-monocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios (LMR, NLR, and PLR, respectively)] with the survival of epithelial ovarian cancer (EOC) patients has been extensively investigated in several systematic reviews and meta-analyses (MAs) of observational studies. The aim of this umbrella systematic review is to appraise all available results in published MAs that explored the association between these biomarkers and EOC outcomes. An umbrella systematic review of the current evidence for systemic inflammatory biomarkers in the peripheral blood of EOC patients was performed by searching several databases including PubMed/Medline and Web of Science. The quality of the MAs was appraised using the AMSTAR-2 tool as well as other qualitative criteria. The evidence was graded from convincing (Class I) to weak (Class IV). Our umbrella review appraised 17 MAs of retrospective studies (range: 7-16) with a number of enrolled patients ranging from 1,636 to 4,910 patients in each MA. All these MAs demonstrated that pretreatment high NLR and PLR, as well as low LMR, were independent predictors of poor overall survival and progression-free survival in EOC. Nearly all published MAs were conducted by Chinese researchers (16/17) and were redundant in their character. Another issue in these MAs is the absence of prior PROSPERO database registration as well as the earlier exclusion of the gray literature. On the other hand, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses Of Observational Studies in Epidemiology (MOOSE)-based reporting guidelines were used in nine out of the 17 MAs. A good number of MAs have transparently provided funding acknowledgment. The AMSTAR-2-based assessment showed low quality in 11 out of the 17 reviewed MAs. This negative rating was largely due to the absence of critical domains. Finally, all evaluated MAs were rated as Class III or IV (suggestive and weak, respectively). Despite the power of MAs in increasing sampling and precision, the quality of the current non-randomized evidence on this topic is still weak. SYSTEMATIC REVIEW REGISTRATION PROSPERO, identifier CRD42020201493.
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Affiliation(s)
- Khalid El Bairi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
- *Correspondence: Khalid El Bairi,
| | - Ouissam Al Jarroudi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| | - Said Afqir
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
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12
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Increased Expression of LYNX1 in Ovarian Serous Cystadenocarcinoma Predicts Poor Prognosis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1392674. [PMID: 33299855 PMCID: PMC7710416 DOI: 10.1155/2020/1392674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/15/2020] [Accepted: 11/16/2020] [Indexed: 12/31/2022]
Abstract
Few studies have reported the function of LYNX1 in ovarian cancer. We retrieved LYNX1 gene expression data and clinical information of 376 patients with ovarian cancer from The Cancer Genome Atlas (TCGA) project website. Wilcoxon signed-rank test and logistic regression were used to analyze the relationship between clinical pathologic features and LYNX1 expression. The Kaplan–Meier method was used to draw survival curves of patients, and Cox regression was used to calculate the relationship between LYNX1 expression and survival rate or the clinicopathological characteristics of the patients. Gene set enrichment analysis (GSEA) was performed, and the correlation between LYNX1 expression and cancer immune infiltrates was investigated via single sample gene set enrichment analysis (ssGSEA). High LYNX1 expression in ovarian serous cystadenocarcinoma (OVs) was associated with tumor residual disease (RD). In Kaplan–Meier survival analysis, patients with OVs who also displayed high LYNX1 expression had decreased overall survival (OS) and disease-specific survival (DSS) than those with low LYNX1 expression. Univariate analysis also supported that patients with high LYNX1 expression had lower OS than those with low LYNX1 expression. LYNX1 expression has the potential to be a prognostic molecular marker of poor survival in OVs.
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13
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Chen W, Zhong S, Shan B, Zhou S, Wu X, Yang H, Ye S. Serum D-dimer, albumin and systemic inflammatory response markers in ovarian clear cell carcinoma and their prognostic implications. J Ovarian Res 2020; 13:89. [PMID: 32771026 PMCID: PMC7415177 DOI: 10.1186/s13048-020-00693-w] [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: 03/01/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022] Open
Abstract
Background This study attempts to evaluate whether preoperative systemic inflammatory response (SIR) markers or other hematological variables, such as albumin, D-dimer, and carbohydrate antigen 125, play roles in predicting chemotherapy response and survival outcome in patients with ovarian clear cell carcinoma (OCCC). Methods Preoperative leukocyte differential counts, as well as platelet, serum albumin, plasma D-dimer and CA-125 levels, were measured in patients with FIGO IC-IV ovarian clear cell cancer. The correlations of these hematological biomarkers with clinicopathological features, chemotherapy response, and survival outcomes were further analyzed. Survival time was estimated using the Kaplan-Meier model, whereas Cox regression was conducted for multivariate analysis. Results Among the 84 patients, 28.6% were classified as platinum resistant, and 69.0% were platinum sensitive. Preoperative CA125, albumin, and D-dimer levels; neutrophil to lymphocyte ratios (NLR); and monocyte to lymphocyte ratios were significantly correlated with FIGO stage, residual tumor, and platinum response. Platelet to lymphocyte ratio was not related to platinum response (P = 0.060). The median follow-up time was 28 months (range, 1 to 128 months). Preoperative CA125, albumin, and D-dimer levels were significant prognostic factors for overall survival (OS) and progression-free survival (PFS). In the univariate analysis, only NLR exhibited prognostic significance for PFS (P = 0.007). Multivariate analysis indicated that D-dimer > 3.27 (P = 0.001 for OS; P = 0.040 for PFS) and albumin < 39.6 (P = 0.005 for OS and P = 0.041 for PFS) retained significance. Conclusions Preoperative NLR has some predictive value for platinum resistance in patients with IC-IV stage OCCC but has little predictive effect on prognosis. Elevated D-dimer and reduced albumin might be potential biomarkers for worse response to first-line platinum-based chemotherapy and poor clinical outcomes.
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Affiliation(s)
- Wei Chen
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, the Central Hospital of Minhang District, Shanghai, China
| | - Siyuan Zhong
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Boer Shan
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Shuling Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xiaohua Wu
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Huijuan Yang
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Shuang Ye
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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14
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Gülseren V, Çakır İ, Özdemir İA, Sancı M, Gökçü M, Güngördük K. The role of changes in systemic inflammatory response markers during neoadjuvant chemotherapy in predicting suboptimal surgery in ovarian cancer. Curr Probl Cancer 2020; 44:100536. [PMID: 31980146 DOI: 10.1016/j.currproblcancer.2020.100536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/15/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
Abstract
AIM The aim of this study was to investigate the possibility of using the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and platelet count and their dynamic changes during chemotherapy to predict suboptimal interval debulking surgery (IDS) in stage IIIC-IVA serous ovarian cancer (OC). METHOD Patients who underwent IDS after neoadjuvant chemotherapy (NAC) for stage IIIC-IVA serous OC at 3 centers between January 2008 and March 2018 were analyzed retrospectively. All women with complete blood counts both at diagnosis (T0) and after the completion of NAC but prior to IDS (T1) were included. An average of 3 weeks passed between IDS and the last cycle of NAC. RESULTS A total of 214 patients were found suitable for the study. Suboptimal surgery was performed in 25.2% of the patients and optimal surgery was performed in 74.8%. The rate of change in NLR was calculated as [(NLR T0 - NLR T1)/NLR T0] × 100. A higher rate of change in NLR was found in the optimal surgery group. Recovery of thrombocytosis (When platelet count before NAC was >400,000/mm3, recovery of thrombocytosis was defined as ≤400,000/mm3 after NAC.) was found to have 85.7% sensitivity and 64.8% specificity in predicting suboptimal surgery (P < 0.001). According to both multivariate and univariate regression analysis, a large change in NLR (>17%) and recovery of thrombocytosis significantly predicted suboptimal surgery. CONCLUSION To identify the likelihood of suboptimal surgery in advanced stage OC patients who undergo IDS after NAC, the dynamic change in NLR values can be examined.
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Affiliation(s)
- Varol Gülseren
- Mersin State Hospital, Department of Obstetrics and Gynecology, Mersin, Turkey.
| | - İlker Çakır
- Tepecik Education and Research Hospital, Department of Gynecologic Oncology, Izmir, Turkey
| | - İsa Aykut Özdemir
- Bakirkoy Sadi Konuk Research and Training Hospital, Department of Gynecologic Oncology, Istanbul, Turkey
| | - Muzaffer Sancı
- Tepecik Education and Research Hospital, Department of Gynecologic Oncology, Izmir, Turkey
| | - Mehmet Gökçü
- Tepecik Education and Research Hospital, Department of Gynecologic Oncology, Izmir, Turkey
| | - Kemal Güngördük
- Muğla Sitki Koçman University Education and Research Hospital, Department of Gynecologic Oncology, Muğla, Turkey
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Salman L, Sabah G, Jakobson-Setton A, Raban O, Yeoshoua E, Eitan R. Neutrophil-to-lymphocyte ratio as a prognostic factor in advanced stage ovarian carcinoma treated with neoadjuvant chemotherapy. Int J Gynaecol Obstet 2019; 148:102-106. [PMID: 31571212 DOI: 10.1002/ijgo.12986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 06/29/2019] [Accepted: 09/27/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To evaluate the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) upon diagnosis, and its impact on surgical outcome, among patients with advanced stage ovarian carcinoma treated with neoadjuvant chemotherapy (NACT). METHODS A retrospective cohort study included all women with stage IIIC and IV ovarian carcinoma receiving NACT in Rabin Medical Center, Petah-Tikva, Israel; January 1, 2005, to June 30, 2017. Demographics and treatment outcome were compared between patients with NLR at diagnosis ≥6.0 and those with NLR <6.0. Primary outcome was optimal debulking (<1 cm largest residual disease). Overall survival was compared between groups using Kaplan-Meier survival analysis. RESULTS Of 111 patients, 33 (29.7%) had NLR ≥6.0 at diagnosis, and 78 (70.3%) had NLR <6.0. No difference was found in rates of optimal debulking between the group with NLR ≥6.0 and that with NLR <6.0 (78.9% vs 84.7%, respectively, P=0.555). Using Kaplan-Meier survival analysis, NLR ≥6.0 was associated with significantly worse overall survival (P<0.05). In a multivariate Cox proportional hazard model, elevated NLR was not statistically associated with poor overall survival (P=0.080). CONCLUSIONS In advanced stage ovarian carcinoma, NLR ≥6.0 at diagnosis did not predict surgical outcome, however it was a predictive factor for poor overall survival.
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Affiliation(s)
- Lina Salman
- Gynecologic Oncology Division, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gad Sabah
- Gynecologic Oncology Division, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ariella Jakobson-Setton
- Gynecologic Oncology Division, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oded Raban
- Gynecologic Oncology Division, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Effi Yeoshoua
- Gynecologic Oncology Division, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ram Eitan
- Gynecologic Oncology Division, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Farolfi A, Gurioli G, Fugazzola P, Burgio SL, Casanova C, Ravaglia G, Altavilla A, Costantini M, Amadori A, Framarini M, Ansaloni L, De Giorgi U. Immune System and DNA Repair Defects in Ovarian Cancer: Implications for Locoregional Approaches. Int J Mol Sci 2019; 20:E2569. [PMID: 31130614 PMCID: PMC6566239 DOI: 10.3390/ijms20102569] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/07/2019] [Accepted: 05/23/2019] [Indexed: 01/26/2023] Open
Abstract
In the last few years, substantial progress has been made in the treatment of ovarian cancer, with increased knowledge about the biology of the disease. Ovarian cancer is a neoplasm strongly linked to defects in DNA repair mechanisms, where deficiency in the homologous recombination (HR) system results in a better response of ovarian cancers to therapy, whether platinum-based chemotherapy, anthracyclines, or poly (ADP-ribose) polymerase (PARP) inhibitors. More recently, it has been demonstrated that different ovarian cancer histotypes may have different immunogenicity. Interestingly, defects in HR systems are associated more frequently with higher tumor infiltrating lymphocytes, providing a rationale for developing combination therapy with immune-modulating agents and PARP inhibitors. Again, locoregional therapies combining heat shock and chemotherapy delivery have been shown to induce an anticancer immune response in vitro. Thus, the potential for locoregional therapeutic approaches that may impact the immune system, perhaps in combination with immune-modulating agents or PARP inhibitors, needs to be further explored. With this premise, we reviewed the main biological and clinical data demonstrating a strict interplay between the immune system, DNA repair mechanisms, and intraperitoneal therapies in ovarian cancer, with a focus on potential future therapeutic implications.
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Affiliation(s)
- Alberto Farolfi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy.
| | - Giorgia Gurioli
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy.
| | - Paola Fugazzola
- General and Emergency Surgery, Maurizio Bufalini Hospital, Cesena 47521, Italy.
| | - Salvatore Luca Burgio
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy.
| | - Claudia Casanova
- Oncology Department, Santa Maria delle Croci Hospital, Ravenna 48121, Italy.
| | - Giorgia Ravaglia
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy.
| | - Amelia Altavilla
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy.
| | | | - Andrea Amadori
- Department of Gynecological, Morgagni-Pierantoni Hospital, Forlì 47121, Italy.
| | - Massimo Framarini
- Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì 47121, Italy.
| | - Luca Ansaloni
- General and Emergency Surgery, Maurizio Bufalini Hospital, Cesena 47521, Italy.
| | - Ugo De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy.
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Siristatidis C, Christoforaki V, Zafeiriou Z, Mastorakos G, Vrantza T, Daskalakis G. First trimester neutrophil-to-lymphocyte ratio (NLR) and pregnancy outcomes in medically assisted reproduction (MAR): a case control study. Gynecol Endocrinol 2019; 35:434-438. [PMID: 30614314 DOI: 10.1080/09513590.2018.1534949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
As success rates after medically assisted reproduction (MAR) technologies have remained constantly limited during the last years, there has been a systematic effort to predict clinical outcomes. There is currently weak evidence to name the neutrophil-to-lymphocyte ratio (NLR), as an accurate predictor in MAR. Through a case control study, and by setting strict eligibility criteria, we enrolled 66 women (35 with negative outcome and 31 cycles with live birth), in terms of NLR at the time of oocyte retrieval. Clinical and IVF cycle characteristics were comparable in a normalized population. There was a positive correlation between NLR and the age of the woman (r = 0.310, p=.011 and rs =0.363, p=.033). Higher odds ratios (ORs) of MAR positive outcome were detected only at higher NLR values, when NLR was divided into quartiles, but only in the 4th quartile [OR =4.33 (95%CI: 1.02-10.79)]. ROC curve resulted on an AUC equal to 0.660 (95%CI: 0.529-0.791) and p value .025. The estimated specificity, sensitivity and cutoff point were 0.57, 0.548, and 1.98, respectively, while PPV and NPV values were 70.6% and 59.3%, respectively. In conclusion, NLR was positively correlated with maternal age; in our study cohort, MAR failure was associated with lower NLR values.
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Affiliation(s)
- Charalampos Siristatidis
- a Third Department Department of Obstetrics and Gynaecology, Assisted Reproduction Unit , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Viktoria Christoforaki
- b Department of Obstetrics and Gynaecology , University Hospital of Heraklion , Heraklion , Greece
| | - Zafeiris Zafeiriou
- c "Theagenio" Anticancer Hospital of Thessaloniki , Thessaloniki , Greece
| | - George Mastorakos
- d Second Department of Obstetrics and Gynaecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Tereza Vrantza
- a Third Department Department of Obstetrics and Gynaecology, Assisted Reproduction Unit , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - George Daskalakis
- e First Department of Obstetrics and Gynaecology , Alexandra Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
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Yalon M, Toren A, Jabarin D, Fadida E, Constantini S, Mehrian-Shai R. Elevated NLR May Be a Feature of Pediatric Brain Cancer Patients. Front Oncol 2019; 9:327. [PMID: 31114757 PMCID: PMC6502986 DOI: 10.3389/fonc.2019.00327] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/11/2019] [Indexed: 12/17/2022] Open
Abstract
Pediatric brain tumors are the most common solid tumor type and the leading cause of cancer-related death in children. The immune system plays an important role in cancer pathogenesis and in the response to immunotherapy treatments. T lymphocytes are key elements for the response of the immune system to cancer cells and have been associated with prognosis of different cancers. Neutrophils on the other hand, which secrete pro-angiogenic and anti-apoptotic factors, enhance the ability of tumor cells to grow and develop into metastases. We conducted a retrospective study of 120 pediatric brain cancer patients and 171 elective pediatric patients hospitalized in Dana Children's Hospital and Sheba Medical Center. Data on age, sex, treatment, lymphocyte, neutrophil, and monocyte count were collected from routinely performed preoperative blood tests. Neutrophil-to-lymphocyte ratio (NLR), and the lymphocyte-to-monocyte ratio (LMR) were calculated and significance was determined by paired T test. p < 0.05 was considered as statistically significant. NLR was significantly higher in the pediatric brain cancer patients. The high NLR in pediatric brain cancer patients is the result of a combination of low lymphocytes and high neutrophils. Both of these factors can have a role in cancer development and propagation and also in response to therapy.
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Affiliation(s)
- Michal Yalon
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Ramat Gan, Israel
| | - Amos Toren
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Ramat Gan, Israel.,The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Dina Jabarin
- The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Edna Fadida
- Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv-Sourasky Medical Center, Tel Aviv, Israel
| | - Shlomi Constantini
- Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv-Sourasky Medical Center, Tel Aviv, Israel
| | - Ruty Mehrian-Shai
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Ramat Gan, Israel
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Li H, Zhao Y, Zheng F. Prognostic significance of elevated preoperative neutrophil-to-lymphocyte ratio for patients with colorectal cancer undergoing curative surgery: A meta-analysis. Medicine (Baltimore) 2019; 98:e14126. [PMID: 30653142 PMCID: PMC6370071 DOI: 10.1097/md.0000000000014126] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Preoperative neutrophil-to-lymphocyte ratio (NLR) has been suggested as a useful predictive factor for prognosis in patients with various cancers. However, the prognostic value of NLR in patients with colorectal cancer (CRC) remains controversial. Therefore, the goal of this study was to perform a meta-analysis to evaluate the prognostic value of NLR in patients with CRC undergoing curative surgery. METHODS PubMed, EMBASE and Cochrane Library databases were searched to screen the relevant studies. Pooled hazard ratio (HR) with 95% confidence interval (CI) was used to assess the associations of preoperative NLR and overall survival (OS), disease-free survival (DFS), recurrence free survival (RFS) and disease specific survival (DSS) by STATA 13.0 software. RESULTS Sixteen studies involving 5897 patients were included in our meta-analysis. Our pooled results demonstrated that high NLR was associated with poor OS (HR: 1.66, 95%CI: 1.36-2.02, P < .001), DFS (HR = 1.54, 95%CI: 1.18-2.02, P = .002), RFS (HR = 2.31, 95%CI: 1.68-3.17, P < .001) and DSS (HR = 2.27; 95% CI: 1.75-2.96, P < .001). When the patients were stratified according to country, sample size, NLR cut-off, follow up and postoperative chemotherapy, high NLR was still significantly correlated with OS. The limitation was that the majority of enrolled studies were retrospective. CONCLUSION Preoperative NLR may be an effective predictive biomarker for prognosis in patients with CRC. Detection of NLR may be beneficial to identify the high-risk patients who need other antitumor therapies in addition to surgery.
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Prognostic and clinicopathological significance of neutrophil-to-lymphocyte ratio in patients with oral cancer. Biosci Rep 2018; 38:BSR20181550. [PMID: 30446526 PMCID: PMC6294633 DOI: 10.1042/bsr20181550] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/13/2018] [Accepted: 11/15/2018] [Indexed: 12/18/2022] Open
Abstract
Objectives: Many studies have examined the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR) in oral cancer; however, the results are contradictory. We, therefore, conducted a meta-analysis aiming to clarify the prognostic value of the NLR in oral cancer patients. Methods: A literature search was conducted in the PubMed, Web of Science, and Embase databases. Stata version 12.0 was used for statistical analysis. Results: A total of 14 studies with 3216 patients were finally included. The results indicated that a high NLR was significantly associated with worse DFS (n=10, HR = 1.73, 95% confidence interval [CI] = 1.44–2.07, P<0.001). Similar results were observed for overall survival (OS) (n=9, HR = 1.61, 95% CI = 1.39–1.86, P<0.001). Moreover, a high NLR was also correlated with lymph node metastasis (n=7, odds ratio [OR] = 1.62, 95% CI = 1.32–1.98, P<0.001), advanced tumor stage (n=7, OR = 2.63, 95% CI = 2.12–3.25, P<0.001), T stage (n=6, OR = 3.22, 95% CI = 2.59–4.01, P<0.001), tumor differentiation (n=5, OR = 1.48, 95% CI = 1.03–2.11, P=0.033), and perineural invasion (n=4, OR = 1.83, 95% CI = 1.4–2.39, P<0.001). However, an elevated NLR was not correlated with gender. Conclusion: This meta-analysis showed that the NLR might be a potential independent prognostic factor in patients with oral cancer.
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21
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Boland JL, Zhou Q, Martin M, Callahan MK, Konner J, O'Cearbhaill RE, Friedman CF, Tew W, Makker V, Grisham RN, Hensley ML, Zecca N, Iasonos AE, Snyder A, Hyman DM, Sabbatini P, Aghajanian C, Cadoo KA, Zamarin D. Early disease progression and treatment discontinuation in patients with advanced ovarian cancer receiving immune checkpoint blockade. Gynecol Oncol 2018; 152:251-258. [PMID: 30470581 PMCID: PMC6613945 DOI: 10.1016/j.ygyno.2018.11.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/12/2018] [Accepted: 11/15/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Delayed responses observed with immune checkpoint blockade (ICB) present a challenge for patients with peritoneal malignancies, who risk early symptomatic disease progression requiring treatment discontinuation. While efforts are ongoing to define the biomarkers of response, it is equally important to identify patients at risk for early discontinuation. We sought to investigate the timing of disease progression in epithelial ovarian cancer (EOC) patients treated with ICB and to identify pre-treatment clinical parameters associated with early discontinuation. METHODS Retrospective analysis was performed on EOC patients treated with ICB at MSKCC from January 2013 to May 2017. Cutoffs for early and very early discontinuation due to disease progression were defined at 12 and 8 weeks, respectively. Univariate and multivariate logistic regression models were built based on pre-treatment clinical variables. RESULTS Of 108 identified patients, 89 were included in the analysis. Forty-six (51.7%) patients discontinued therapy early, 30 of which (33.7%) discontinued therapy very early. Eight patients (9.0%) died within 12 weeks of ICB initiation from disease progression. In multivariate analyses, bulky peritoneal disease (p = 0.009, OR: 4.94) and liver parenchymal metastases (p = 0.001, OR: 8.08) were associated with early discontinuation. Liver parenchymal metastases (p = 0.001, OR 6.64), and high neutrophil-to-lymphocyte ratio (p = 0.021, OR: 3.54), were associated with very early discontinuation. CONCLUSIONS Over 50% of EOC patients suffer disease progression requiring early discontinuation of ICB. Pre-treatment prognostic clinical characteristics may identify patients at highest risk for early discontinuation due to disease progression and warrant caution in using these agents in late line patients with advanced disease.
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Affiliation(s)
- Julia L Boland
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Qin Zhou
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Madhuri Martin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Margaret K Callahan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jason Konner
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Roisin E O'Cearbhaill
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Claire F Friedman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - William Tew
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Vicky Makker
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Rachel N Grisham
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Martee L Hensley
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Nicholas Zecca
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexia E Iasonos
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexandra Snyder
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - David M Hyman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Paul Sabbatini
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Carol Aghajanian
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Karen A Cadoo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA
| | - Dmitriy Zamarin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weil Cornell Medical College, New York, NY, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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22
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Yeo B, Redfern AD, Mouchemore KA, Hamilton JA, Anderson RL. The dark side of granulocyte-colony stimulating factor: a supportive therapy with potential to promote tumour progression. Clin Exp Metastasis 2018; 35:255-267. [PMID: 29968171 DOI: 10.1007/s10585-018-9917-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/26/2018] [Indexed: 12/15/2022]
Abstract
Granulocyte-colony stimulating factor (G-CSF) is one of several cytokines that can expand and mobilize haematopoietic precursor cells from bone marrow. In particular, G-CSF mobilizes neutrophils when the host is challenged by infection or tissue damage. Severe neutropenia, or febrile neutropenia is a life-threatening event that can be mitigated by administration of G-CSF. Consequently, G-CSF has been used to support patients undergoing chemotherapy who would otherwise require dose reduction due to neutropenia. Over the past 10-15 years it has become increasingly apparent, in preclinical tumour growth and metastasis models, that G-CSF can support tumour progression by mobilization of tumour-associated neutrophils which consequently promote tumour dissemination and metastasis. With the increasing use of G-CSF in the clinic, it is pertinent to ask if there is any evidence of a similar promotion of tumour progression in patients. Here, we have reviewed the preclinical and clinical data on the potential contribution of G-CSF to tumour progression. We conclude that, whilst the evidence for a promotion of metastasis is strong in preclinical models and that limited data indicate that high serum G-CSF levels in patients are associated with poorer prognosis, no studies published so far have revealed evidence of increased tumour progression associated with supportive G-CSF use during chemotherapy in patients. Analysis of G-CSF receptor positive cohorts within supportive trials, as well as studies of the role of G-CSF blockade in appropriate tumours in the absence of chemotherapy could yield clinically translatable findings.
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Affiliation(s)
- Belinda Yeo
- Olivia Newton-John Cancer Research Institute and La Trobe University School of Cancer Medicine, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,Austin Health, Heidelberg, VIC, 3084, Australia
| | | | - Kellie A Mouchemore
- Peter MacCallum Cancer Centre, Parkville, VIC, Australia.,Department of Biochemistry & Molecular Biology, Monash University, Clayton, VIC, Australia
| | - John A Hamilton
- Arthritis and Inflammation Research Centre, Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC, Australia
| | - Robin L Anderson
- Olivia Newton-John Cancer Research Institute and La Trobe University School of Cancer Medicine, 145 Studley Road, Heidelberg, VIC, 3084, Australia.
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Ding Y, Zhang S, Qiao J. Prognostic value of neutrophil-to-lymphocyte ratio in melanoma: Evidence from a PRISMA-compliant meta-analysis. Medicine (Baltimore) 2018; 97:e11446. [PMID: 30045267 PMCID: PMC6078713 DOI: 10.1097/md.0000000000011446] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND A number of studies have investigated the prognostic impact of the neutrophil-to-lymphocyte ratio (NLR) in patients with melanoma but the results were controversial. Therefore, we conducted a meta-analysis to explore the prognostic value of NLR in melanoma. METHODS The databases of PubMed, Embase, and Web of Science were thoroughly searched. Associations between NLR and overall survival (OS) and progression-free survival (PFS) were investigated by pooling hazard ratio (HR) and 95% confidence interval (CI). RESULTS A total of 12 studies comprising 3207 patients were finally included in the meta-analysis. The results showed that a high NLR was associated with poor OS (HR = 2.23, 95% CI = 1.64-3.04, P < .001, random-effects model) and PFS (HR = 2.19, 95% CI = 1.78-2.69, P < .001, fixed-effects model). Subgroup analyses demonstrated that NLR was still associated with poor OS and PFS for patients in Western countries who were treated with ipilimumab. No significant publication bias was found in this meta-analysis. CONCLUSION This meta-analysis demonstrated that a high NLR was predictive of poor OS and PFS in patients with melanoma.
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24
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Gong W, Zhao L, Dong Z, Dou Y, Liu Y, Ma C, Qu X. After neoadjuvant chemotherapy platelet/lymphocyte ratios negatively correlate with prognosis in gastric cancer patients. J Clin Lab Anal 2018; 32:e22364. [PMID: 29251364 PMCID: PMC6816988 DOI: 10.1002/jcla.22364] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/31/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Circulating predictors prognostic factors of neoadjuvant chemotherapy, which identify the patients who are potential possibly to benefit from it are limited at present. In this research, we aimed to compare the prognostic significance of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in patients with locally advance gastric carcinoma who were treated with neoadjuvant chemotherapy (NAC) followed by D2 gastrectomy. MATERIALS AND METHODS From 2007 to 2015, 91 patients with locally advanced gastric cancer treated with NAC followed by D2 gastrectomy included in this retrospective cohort study. The correlation of clinical data, including tumor regression, response evaluation, tumor location, pathological type, systemic therapy, tumor size (cm), neural invasion, lymphatic-vascular invasion, ypTNM stage, and survival prognosis were analyzed. RESULTS Platelet/lymphocyte ratio and neutrophil/lymphocyte ratio in gastric cancer patients were higher than in matched normal volunteers. PLR levels higher after neoadjuvant chemotherapy are associated with worse OS. Multivariate Cox proportional analysis showed that pre-neoadjuvant chemotherapy PLR was an independent prognostic factor. CONCLUSIONS Pre-neoadjuvant chemotherapy PLR may be a feasible biomarker for survival prognosis in patients with locally advanced gastric cancer. PLR and NLR were reduced after neoadjuvant chemotherapy. After neoadjuvant chemotherapy, PLR level was negatively correlated with survival prognosis.
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Affiliation(s)
- Weipeng Gong
- Key Laboratory of Cardiovascular Remodeling and Function ResearchChinese Ministry of EducationChinese Ministry of HealthQilu Hospital of Shandong UniversityJinanShandongChina
- Department of Surgical OncologyShandong Cancer Hospital Affiliated to Shandong UniversityJinanShandongChina
| | - Lei Zhao
- Key Laboratory of Cardiovascular Remodeling and Function ResearchChinese Ministry of EducationChinese Ministry of HealthQilu Hospital of Shandong UniversityJinanShandongChina
| | - Zhaogang Dong
- Department of Clinical LaboratoryQilu Hospital of Shandong UniversityJinanShandongChina
| | - Yu Dou
- Key Laboratory of Cardiovascular Remodeling and Function ResearchChinese Ministry of EducationChinese Ministry of HealthQilu Hospital of Shandong UniversityJinanShandongChina
| | - Yanguo Liu
- Department of Medical OncologyQilu Hospital of Shandong UniversityJinanShandongChina
| | - Chao Ma
- Key Laboratory of Cardiovascular Remodeling and Function ResearchChinese Ministry of EducationChinese Ministry of HealthQilu Hospital of Shandong UniversityJinanShandongChina
| | - Xun Qu
- Key Laboratory of Cardiovascular Remodeling and Function ResearchChinese Ministry of EducationChinese Ministry of HealthQilu Hospital of Shandong UniversityJinanShandongChina
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Fukuda H, Takagi T, Kondo T, Shimizu S, Tanabe K. Predictive value of inflammation-based prognostic scores in patients with metastatic renal cell carcinoma treated with cytoreductive nephrectomy. Oncotarget 2018; 9:14296-14305. [PMID: 29581844 PMCID: PMC5865670 DOI: 10.18632/oncotarget.24507] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 02/10/2018] [Indexed: 12/20/2022] Open
Abstract
Inflammation-based prognostic scores are useful for predicting survival in various cancers. Here, we aimed to determine the most useful inflammation-based prognostic score for predicting survival in patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy. We retrospectively analyzed the data of 152 patients who underwent cytoreductive nephrectomy for metastatic renal cell carcinoma between 1986 and 2015. In the multivariate stepwise analysis, the combination of age, Memorial Sloan-Kettering Cancer Center score, histology, sarcomatoid change, clinical nodal stage, brain metastasis, and liver metastasis was a significant predictor for survival (Harrell's concordance index [c-index]: 0.638). The c-index of the combination improved with the addition of an inflammation-based prognostic score: C-reactive protein (c-index: 0.672), Glasgow prognostic score (c-index: 0.674), neutrophil-to-lymphocyte ratio (c-index: 0.685), lymphocyte-to-monocyte ratio (c-index: 0.670), platelet-to-lymphocyte ratio (c-index: 0.666), systemic inflammation response index (c-index: 0.652), and systemic immune-inflammation index (c-index: 0.678). The neutrophil-to-lymphocyte ratio provided the greatest improvement in the c-index. Additional multivariate analysis showed that the neutrophil-to-lymphocyte ratio was an independent prognostic factor for survival (P < 0.0001). The neutrophil-to-lymphocyte ratio was the most useful inflammation-based prognostic score for predicting survival in patients with metastatic renal cell carcinoma treated with cytoreductive nephrectomy.
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Affiliation(s)
- Hironori Fukuda
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Toshio Takagi
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Tsunenori Kondo
- Department of Urology, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, Japan
| | - Satoru Shimizu
- Department of Medical Education, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Kazunari Tanabe
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
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