A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitors

BackgroundThere are currently no established biomarkers that can predict whether advanced pancreatic carcinoma (PC) patients would benefit from immune checkpoint inhibitors (ICIs). Our study investigated whether the pretreatment composite biomarker of derived neutrophil–lymphocyte ratio (dNLR) and l...

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Main Authors: Shiyun Chen, Shiyuan Guo, Miaomiao Gou, Yuting Pan, Mengjiao Fan, Nan Zhang, Zhaoli Tan, Guanghai Dai
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-10-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.951985/full
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author Shiyun Chen
Shiyun Chen
Shiyuan Guo
Miaomiao Gou
Yuting Pan
Mengjiao Fan
Nan Zhang
Zhaoli Tan
Guanghai Dai
author_facet Shiyun Chen
Shiyun Chen
Shiyuan Guo
Miaomiao Gou
Yuting Pan
Mengjiao Fan
Nan Zhang
Zhaoli Tan
Guanghai Dai
author_sort Shiyun Chen
collection DOAJ
description BackgroundThere are currently no established biomarkers that can predict whether advanced pancreatic carcinoma (PC) patients would benefit from immune checkpoint inhibitors (ICIs). Our study investigated whether the pretreatment composite biomarker of derived neutrophil–lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) can be used as a reliable prognostic factor for the survival of PC patients receiving PD-1 inhibitor therapy.MethodsPatients with advanced PC treated with PD-1 inhibitors at a single center from September 2015 to September 2020 were included. The high levels of dNLR (≥3) and LDH (≥250 U/L) were considered to be risk factors. Based on these two risk factors, patients in this study were categorized into two risk groups: the good dNLR-LDH group, without risk factors, and the intermediate/poor dNLR-LDH group, with one to two risk factors. Overall survival (OS) and progression-free survival (PFS) served as this study’s primary and secondary endpoints. Cox regression models were used to identify independent prognostic factors for survival benefit.ResultsThere were 98 patients in our study. The good group included 61 (62.2%) patients and the intermediate/poor group included 37 (37.8%). The overall patients with PC who received immunotherapy had a median OS of 12.1 months, and the good dNLR-LDH group had a significantly longer OS compared with the intermediate/poor dNLR-LDH group (44.2 vs. 6.4 months; p < 0.010); median PFS was 3.7 and 2.5 months (p = 0.010). The number of metastatic sites >2 and immunotherapy as third-line or later was associated with worse PFS, and the line of immunotherapy and the dNLR-LDH indicator were independent prognostic factors for OS, according to multivariate analysis.ConclusionThe pretreatment composite biomarker of dNLR and LDH can be used as a prognostic biomarker in patients with advanced PC treated with PD-1 inhibitors.
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spelling doaj.art-2f813b8883c043c2be95fba0a249c26d2022-12-22T04:37:06ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-10-011210.3389/fonc.2022.951985951985A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitorsShiyun Chen0Shiyun Chen1Shiyuan Guo2Miaomiao Gou3Yuting Pan4Mengjiao Fan5Nan Zhang6Zhaoli Tan7Guanghai Dai8Medical School of Chinese People’s Liberation Army, Beijing, ChinaDepartment of Oncology, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Beijing, ChinaMedical School of Chinese People’s Liberation Army, Beijing, ChinaDepartment of Oncology, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Beijing, ChinaMedical School of Chinese People’s Liberation Army, Beijing, ChinaDepartment of Oncology, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Beijing, ChinaMedical School of Chinese People’s Liberation Army, Beijing, ChinaDepartment of Oncology, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Oncology, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Beijing, ChinaBackgroundThere are currently no established biomarkers that can predict whether advanced pancreatic carcinoma (PC) patients would benefit from immune checkpoint inhibitors (ICIs). Our study investigated whether the pretreatment composite biomarker of derived neutrophil–lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) can be used as a reliable prognostic factor for the survival of PC patients receiving PD-1 inhibitor therapy.MethodsPatients with advanced PC treated with PD-1 inhibitors at a single center from September 2015 to September 2020 were included. The high levels of dNLR (≥3) and LDH (≥250 U/L) were considered to be risk factors. Based on these two risk factors, patients in this study were categorized into two risk groups: the good dNLR-LDH group, without risk factors, and the intermediate/poor dNLR-LDH group, with one to two risk factors. Overall survival (OS) and progression-free survival (PFS) served as this study’s primary and secondary endpoints. Cox regression models were used to identify independent prognostic factors for survival benefit.ResultsThere were 98 patients in our study. The good group included 61 (62.2%) patients and the intermediate/poor group included 37 (37.8%). The overall patients with PC who received immunotherapy had a median OS of 12.1 months, and the good dNLR-LDH group had a significantly longer OS compared with the intermediate/poor dNLR-LDH group (44.2 vs. 6.4 months; p < 0.010); median PFS was 3.7 and 2.5 months (p = 0.010). The number of metastatic sites >2 and immunotherapy as third-line or later was associated with worse PFS, and the line of immunotherapy and the dNLR-LDH indicator were independent prognostic factors for OS, according to multivariate analysis.ConclusionThe pretreatment composite biomarker of dNLR and LDH can be used as a prognostic biomarker in patients with advanced PC treated with PD-1 inhibitors.https://www.frontiersin.org/articles/10.3389/fonc.2022.951985/fullpancreatic cancerimmune checkpoint inhibitorsoverall survivalprogression-free survivalderived neutrophil–lymphocyte ratiolactate dehydrogenase
spellingShingle Shiyun Chen
Shiyun Chen
Shiyuan Guo
Miaomiao Gou
Yuting Pan
Mengjiao Fan
Nan Zhang
Zhaoli Tan
Guanghai Dai
A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitors
Frontiers in Oncology
pancreatic cancer
immune checkpoint inhibitors
overall survival
progression-free survival
derived neutrophil–lymphocyte ratio
lactate dehydrogenase
title A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitors
title_full A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitors
title_fullStr A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitors
title_full_unstemmed A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitors
title_short A composite indicator of derived neutrophil–lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with PD-1 inhibitors
title_sort composite indicator of derived neutrophil lymphocyte ratio and lactate dehydrogenase correlates with outcomes in pancreatic carcinoma patients treated with pd 1 inhibitors
topic pancreatic cancer
immune checkpoint inhibitors
overall survival
progression-free survival
derived neutrophil–lymphocyte ratio
lactate dehydrogenase
url https://www.frontiersin.org/articles/10.3389/fonc.2022.951985/full
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