Combined neutrophil-to-lymphocyte ratio predicts progression-free survival in metastatic cervical cancer patients treated with immune checkpoint inhibitors.
Photo by National Cancer Institute / Unsplash
Key Takeaway
Consider Combined.NLR as an independent prognostic factor for progression-free survival in metastatic cervical cancer patients treated with immune checkpoint inhibitors.
This retrospective cohort analysis included 148 individuals diagnosed with metastatic or recurrent cervical cancer who received immune checkpoint inhibitors. The study was conducted at a single center, and follow-up duration was not reported. The primary exposure was the combined neutrophil-to-lymphocyte ratio (Combined.NLR), which incorporated pre-treatment and post-treatment measurements. Participants were categorized into groups based on median NLR values obtained before and after treatment.
The main outcome assessed was progression-free survival (PFS). Individuals in the poor Combined.NLR group exhibited a notably increased risk of disease progression compared to those in the good group. The hazard ratio for this increased risk was 1.355, with a 95% confidence interval of 1.006–1.824 and a p-value of 0.046. Additionally, a nomogram derived from the data demonstrated a concordance index of 0.70.
Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported in the study. The analysis identified Combined.NLR as an independent prognostic factor for disease progression. However, the study design is observational, meaning the findings suggest association rather than causation. Limitations regarding the single-center setting and lack of reported follow-up duration should be considered when interpreting these results for broader clinical application.
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View Original Abstract ↓
BackgroundThe outlook for individuals dealing with metastatic or recurrent cervical cancer is still unfavorable, and existing biomarkers that assess the effectiveness of immune checkpoint inhibitors (ICIs) have certain drawbacks. Our objective was to assess the predictive importance of the combined neutrophil-to-lymphocyte ratio (Combined.NLR), incorporating both pre-treatment and post-treatment measurements in this patient population.MethodsThis retrospective cohort analysis, performed at one center, encompassed 148 individuals diagnosed with metastatic or recurrent cervical cancer who underwent treatment with ICIs. Patients were categorized into the Combined.NLR groups according to the median neutrophil-to-lymphocyte ratio (NLR) values obtained before and after treatment. The relationship between the Combined.NLR and progression-free survival (PFS) was examined through Cox regression analysis. A prognostic nomogram that includes various factors was created.ResultsThe Combined.NLR was identified as an independent prognostic factor for PFS. Individuals classified in the poor group exhibited a notably increased risk of disease progression in comparison to those in the good group [hazard ratio (HR) = 1.355, 95% confidence interval (CI): 1.006–1.824, p = 0.046]. The nomogram, which integrated the Combined.NLR, histological type, PD-L1 expression, the count of previous treatment lines, and the presence of multi-organ metastasis demonstrated a concordance index of 0.70. Calibration curves showed a strong correlation between the predicted results and the actual outcomes.ConclusionThe Combined.NLR is a dynamic and readily accessible prognostic marker. The developed nomogram provides individualized risk prediction for individuals with metastatic or recurrent cervical cancer, potentially aiding clinical decision-making.
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