Pan-Immune-Inflammation Value (PIV) has been recently proposed as a new blood-based prognostic biomarker in metastatic colorectal cancer (mCRC). Herein we aimed to validate its prognostic significance and to evaluate its utility for disease monitoring in patients with mCRC receiving first-line chemotherapy. We conducted a single-centre retrospective study involving 130 previously untreated mCRC patients under first-line standard chemotherapy in a real-world scenario. PIV was calculated as (neutrophil count × platelet count × monocyte count)/lymphocyte count at three different time-points: baseline, week 4 after therapy initiation, and at disease progression. We analyzed the influence of baseline PIV on overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and overall response rate (ORR). We also explored the utility of PIV dynamics for disease monitoring. Baseline PIV high was significantly associated with worse OS in univariate [hazard ratio (HR) = 2.10, 95% CI, 1.41–3.15; p = 0.000299] and multivariate (HR = 1.82, 95% CI, 1.15–2.90; p = 0.011) analyses. Baseline PIV was also associated with worse PFS in univariate (HR = 2.04, 95% CI, 1.40–2.97; p = 0.000187) and multivariate (HR = 1.56, 95% CI, 1.05–2.31; p = 0.026) analyses. Baseline PIV was not correlated either with DCR or ORR. Regarding PIV dynamics, there was a statistically significant increase from week 4 to disease progression (p = 0.0003), which was at the expense of cases with disease control as best response (p < 0.0001). In conclusion, this study validates the prognostic significance of baseline PIV in patients with mCRC receiving first-line standard chemotherapy in a real-world scenario. Moreover, it suggests the potential utility of PIV monitoring to anticipate the disease progression among those patients who achieve initial disease control.
Background: In the advanced urothelial carcinoma (aUC) scenario there are no consistent biomarkers to predict the benefit patients derived from immune checkpoint blockade. Recently a novel pan-tumor molecular tissue-based biomarker, the Immunotherapy Response Score (IRS), has been proposed. Herein we conducted a retrospective study to validate the prognostic and predictive utility of the IRS in aUC patients under atezolizumab monotherapy and to characterize its underline molecular and immune features in the context of the IMvigor210 phase 2 clinical trial. Methods: This is a retrospective study of 261 patients with available clinical, molecular, and immune tumor data treated with atezolizumab monotherapy in the IMvigor210 phase 2 clinical trial. Efficacy endpoints were overall survival (OS), disease control rate (DCR), and overall response rate (ORR). Survival estimates were calculated by the Kaplan Meier method, and groups were compared with the log-rank test. The Cox proportional hazards regression model was used to evaluate factors independently associated with OS. Factors associated with disease control (DC) and response were tested with logistic regression in univariable and multivariable analyses. Comparisons between patient and disease characteristics were carried out using Chi-squared or Fisher exact tests. All p values were 2-sided, and those less than 0.05 were considered statistically significant. Results: High IRS was significantly associated with a better OS in univariable [hazard ratio (HR)=0.49, 95% CI 0.33-0.74, p<0.001] and multivariable (HR=0.57, 95% CI 0.37-0.86, p=0.007) analyses. DCR and ORR were significantly higher among high IRS patients (DCR for high IRS vs low IRS patients: 57% vs 32%, p<0.001; ORR for high IRS vs low IRS patients: 42% vs 10%, p<0.001). High IRS patients presented a higher probability of DC and response in univariable [DC: odds ratio (OR)=2.72, 95% CI 1.54-4.81, p<0.001; Response: OR=3.92, 95% CI 2.11-7.31; p<0.001] and multivariable (DC: OR=2.38, 95% CI 1.28-4.44, p=0.006; Response: OR=3.36, 95% CI 1.68-6.69, p<0.001) analyses. Conclusions: This study validates IRS as a strong independent prognostic and predictive biomarker for OS and DC/response in aUC patients treated with atezolizumab monotherapy in the IMvigor210 phase 2 clinical trial. Clinical Trial Registration:NCT02108652,NCT02951767.
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