Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio during immune checkpoint inhibitor treatment in recurrent or metastatic head and neck squamous cell carcinoma patients

Li, Junliang; Hsieh, Tsai-Ling; Ou, Ming-Che; Lin, Fan-ching; Tsai, Stella Chin‐Shaw

doi:10.1016/j.oraloncology.2022.105729

Cited by 3 publications

(2 citation statements)

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“…Tumors were considered platinum‐sensitive if they developed recurrent disease more than 6 months after platinum‐based therapy or had never been treated with platinum chemotherapy. Several studies have demonstrated that elevated neutrophil‐to‐lymphocyte ratio (NLR) is associated with worse survival in patients with R/M HNSCC 31–34 . NLR was calculated from the complete blood count (CBC) at the time of R/M diagnosis.…”

Section: Methodsmentioning

confidence: 99%

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Patterns of recurrence in head and neck squamous cell carcinoma to inform personalized surveillance protocols

Haring

Kana

Dermody

et al. 2023

Cancer

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BackgroundDevelopment of evidence‐based post‐treatment surveillance guidelines in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) is limited by comprehensive documentation of patterns of recurrence and metastatic spread.MethodsA retrospective analysis of patients diagnosed with R/M HNSCC at a National Cancer Institute‐designated cancer center between 1998– 2019 was performed (n = 447). Univariate and multivariate analysis identified patterns of recurrence and predictors of survival.ResultsMedian overall survival (mOS) improved over time (6.7 months in 1998–2007 to 11.8 months in 2008–2019, p = .006). Predictors of worse mOS included human papillomavirus (HPV) negativity (hazard ratio [HR], 1.8; 95% confidence interval [CI], 1.2–2.6), high neutrophil/lymphocyte ratio (HR, 2.1 [1.4–3.0], disease‐free interval (DFI) ≤6 months (HR, 1.4 [1.02–2.0]), and poor performance status (Eastern Cooperative Oncology Group, ≥2; HR, 1.91.1–3.4). In this cohort, 50.6% of recurrences occurred within 6 months of treatment completion, 72.5% occurred within 1 year, and 88.6% occurred within 2 years. Metachronous distant metastases were more likely to occur in patients with HPV‐positive disease (odds ratio [OR], 2.3 [1.4–4.0]), DFI >6 months (OR, 2.4 [1.5–4.0]), and body mass index ≥30 (OR, 2.3 [1.1–4.8]). Oligometastatic disease treated with local ablative therapy was associated with improved survival over polymetastatic disease (HR, 0.36; 95% CI, 0.24–0.55).ConclusionThese data regarding patterns of distant metastasis in HNSCC support the clinical utility of early detection of recurrence. Patterns of recurrence in this population can be used to inform individualized surveillance programs as well as to risk‐stratify eligible patients for clinical trials.Plain Language Summary After treatment for head and neck cancer (HNC), patients are at risk of recurrence at prior sites of disease or at distant sites in the body. This study includes a large group of patients with recurrent or metastatic HNC and examines factors associated with survival outcomes and recurrence patterns. Patients with human papillomavirus (HPV)‐positive HNC have good survival outcomes, but if they recur, this may be in distant regions of the body and may occur later than HPV‐negative patients. These data argue for personalized follow‐up schedules for patients with HNC, perhaps incorporating imaging studies or novel blood tests.

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Section: Methodsmentioning

confidence: 99%

“…Several studies have demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is associated with worse survival in patients with R/M HNSCC. [31][32][33][34] NLR was calculated from the complete blood count (CBC) at the time of R/M diagnosis.…”

Section: Explanatory Variablesmentioning

confidence: 99%

Patterns of recurrence in head and neck squamous cell carcinoma to inform personalized surveillance protocols

Haring

Kana

Dermody

et al. 2023

Cancer

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Exploring long-term responses to immune checkpoint inhibitors in recurrent and metastatic head and neck squamous cell carcinoma

Bila,

Franken,

Van Dessel

et al. 2024

Oral Oncology

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Inflammatory markers as prognostic markers in patients with head and neck squamous cell carcinoma treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Wang,

Yin,

Wang

et al. 2024

Front. Oncol.

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BackgroundVarious inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein-to-albumin ratio (CAR), have been linked to the effectiveness of immunotherapy in multiple types of malignancies. We investigated how these inflammatory markers affect the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) receiving immunotherapy.MethodsThe databases PubMed, Embase, and Cochrane were systematically searched up until March 26, 2024, to identify relevant literature. Hazard ratios (HR) and corresponding 95% confidence intervals (CI) were extracted from the eligible studies. Data analysis was conducted using Review Manager and STATA 17.0 software to assess the impact of each indicator on prognosis. Subgroup analysis was performed to explore potential sources of heterogeneity in the data.ResultsThe analysis included sixteen studies with 1316 patients. A higher baseline NLR was significantly associated with poorer overall survival (OS) (pooled HR: 1.55, 95%CI: 1.14-2.11, P=0.006) and progression-free survival (PFS) (pooled HR: 1.59, 95% CI: 1.21-2.10, P<0.05). Furthermore, a high NLR after immunotherapy was strongly correlated with poor OS (pooled HR: 5.43, 95% CI: 3.63-8.12, P<0.01). Additionally, higher baseline C-reactive CAR was significantly associated with worse OS (pooled HR: 2.58, 95% CI: 1.96-3.40, P<0.01).ConclusionThe inflammatory markers NLR and CAR serve as effective prognostic biomarkers for immunotherapy in patients with HNSCC. However, the practical application of clinical detection requires further validation through large-scale prospective studies to confirm these findings and explore the underlying mechanisms.

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Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio during immune checkpoint inhibitor treatment in recurrent or metastatic head and neck squamous cell carcinoma patients

Cited by 3 publications

References 35 publications

Patterns of recurrence in head and neck squamous cell carcinoma to inform personalized surveillance protocols

Patterns of recurrence in head and neck squamous cell carcinoma to inform personalized surveillance protocols

Exploring long-term responses to immune checkpoint inhibitors in recurrent and metastatic head and neck squamous cell carcinoma

Inflammatory markers as prognostic markers in patients with head and neck squamous cell carcinoma treated with immune checkpoint inhibitors: a systematic review and meta-analysis

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