Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolization
Background & Aims: Herein we used data derived from the SORAMIC trial to explore the predictive value of systemic inflammatory markers (neutrophil-to-lymphocyte ratio [NLR] and platelet-to-lymphocyte ratio [PLR]) in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | JHEP Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589555923003269 |
| _version_ | 1827292081179066368 |
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| author | Osman Öcal Melanie Alexandra Kimm Thi Phuong Thao Hoang Maciej Pech Elif Öcal Najib Ben Khaled Bruno Sangro Jens Ricke Max Seidensticker Moritz Wildgruber |
| author_facet | Osman Öcal Melanie Alexandra Kimm Thi Phuong Thao Hoang Maciej Pech Elif Öcal Najib Ben Khaled Bruno Sangro Jens Ricke Max Seidensticker Moritz Wildgruber |
| author_sort | Osman Öcal |
| collection | DOAJ |
| description | Background & Aims: Herein we used data derived from the SORAMIC trial to explore the predictive value of systemic inflammatory markers (neutrophil-to-lymphocyte ratio [NLR] and platelet-to-lymphocyte ratio [PLR]) in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib monotherapy or the combination of selective internal radiation therapy (SIRT)/sorafenib. Methods: Patients randomized to sorafenib monotherapy or SIRT/sorafenib within the per-protocol population of the SORAMIC trial were evaluated in this exploratory post hoc analysis. The median baseline values of NLR and PLR were used as cut-off values to describe subgroups. Kaplan-Meier curves with log-rank tests were used to evaluate median survival in the sorafenib and SIRT/sorafenib arms in each subgroup. Multivariable Cox regression analysis was applied to eliminate the effect of confounding factors. Results: A total of 275 patients with a median overall survival of 12.4 months were included in this analysis. The median NLR value of the cohort was 2.77 and the median PLR was 26.5. There was no significant difference in overall survival between the sorafenib and SIRT/sorafenib arms in patients with low NLR (p = 0.72) and PLR (p = 0.35) values. In patients with high NLR values, there was no statistically significant difference in median overall survival between SIRT/sorafenib and sorafenib cohorts (12.1 vs. 9.2 months, p = 0.21). In patients with high PLR values, overall survival in the SIRT/sorafenib arm was significantly longer than in the sorafenib arm (15.9 vs. 11.0 months, p = 0.029). This significant difference was preserved in the multivariable analysis (SIRT/sorafenib arm: hazard ratio 0.65, 95% CI 0.44-0.96, p = 0.03) incorporating age, Child-Pugh grade, and alpha-fetoprotein levels. Conclusions: PLR is a potential predictive factor of benefit from additional SIRT in patients with HCC receiving sorafenib therapy. The potential predictive value of PLR should be further evaluated in future trials. Impact and implications: Systemic therapies are the mainstay of treatment in patients with hepatocellular carcinoma at advanced stages. However, not all patients respond well to these treatments. In our analysis, using blood test parameters showing systemic inflammation status, we were able to identify patients who would benefit more from combined treatment with a locoregional treatment of radioembolization (or selective internal radiation therapy). |
| first_indexed | 2024-03-07T19:41:39Z |
| format | Article |
| id | doaj.art-820fb76b343f4343ab7f9a3758e6e209 |
| institution | Directory Open Access Journal |
| issn | 2589-5559 |
| language | English |
| last_indexed | 2024-04-24T12:51:13Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHEP Reports |
| spelling | doaj.art-820fb76b343f4343ab7f9a3758e6e2092024-04-06T04:40:22ZengElsevierJHEP Reports2589-55592024-04-0164100995Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolizationOsman Öcal0Melanie Alexandra Kimm1Thi Phuong Thao Hoang2Maciej Pech3Elif Öcal4Najib Ben Khaled5Bruno Sangro6Jens Ricke7Max Seidensticker8Moritz Wildgruber9Department of Radiology, University Hospital, LMU Munich, Munich, Germany; Corresponding author. Address: Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Marchioninistrasse 15, 81377 Munich, Germany; Tel.: +49 4400 72750.Department of Radiology, University Hospital, LMU Munich, Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Munich, GermanyDepartments of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, GermanyDepartment of Radiology, University Hospital, LMU Munich, Munich, GermanyDepartment of Medicine II, University Hospital, LMU Munich, Munich, GermanyLiver Unit, Clínica Universidad de Navarra and CIBEREHD, Pamplona, SpainDepartment of Radiology, University Hospital, LMU Munich, Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Munich, GermanyBackground & Aims: Herein we used data derived from the SORAMIC trial to explore the predictive value of systemic inflammatory markers (neutrophil-to-lymphocyte ratio [NLR] and platelet-to-lymphocyte ratio [PLR]) in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib monotherapy or the combination of selective internal radiation therapy (SIRT)/sorafenib. Methods: Patients randomized to sorafenib monotherapy or SIRT/sorafenib within the per-protocol population of the SORAMIC trial were evaluated in this exploratory post hoc analysis. The median baseline values of NLR and PLR were used as cut-off values to describe subgroups. Kaplan-Meier curves with log-rank tests were used to evaluate median survival in the sorafenib and SIRT/sorafenib arms in each subgroup. Multivariable Cox regression analysis was applied to eliminate the effect of confounding factors. Results: A total of 275 patients with a median overall survival of 12.4 months were included in this analysis. The median NLR value of the cohort was 2.77 and the median PLR was 26.5. There was no significant difference in overall survival between the sorafenib and SIRT/sorafenib arms in patients with low NLR (p = 0.72) and PLR (p = 0.35) values. In patients with high NLR values, there was no statistically significant difference in median overall survival between SIRT/sorafenib and sorafenib cohorts (12.1 vs. 9.2 months, p = 0.21). In patients with high PLR values, overall survival in the SIRT/sorafenib arm was significantly longer than in the sorafenib arm (15.9 vs. 11.0 months, p = 0.029). This significant difference was preserved in the multivariable analysis (SIRT/sorafenib arm: hazard ratio 0.65, 95% CI 0.44-0.96, p = 0.03) incorporating age, Child-Pugh grade, and alpha-fetoprotein levels. Conclusions: PLR is a potential predictive factor of benefit from additional SIRT in patients with HCC receiving sorafenib therapy. The potential predictive value of PLR should be further evaluated in future trials. Impact and implications: Systemic therapies are the mainstay of treatment in patients with hepatocellular carcinoma at advanced stages. However, not all patients respond well to these treatments. In our analysis, using blood test parameters showing systemic inflammation status, we were able to identify patients who would benefit more from combined treatment with a locoregional treatment of radioembolization (or selective internal radiation therapy).http://www.sciencedirect.com/science/article/pii/S2589555923003269Hepatocellular carcinomaSorafenibRadioembolizationPlatelet-to-lymphocyte ratio |
| spellingShingle | Osman Öcal Melanie Alexandra Kimm Thi Phuong Thao Hoang Maciej Pech Elif Öcal Najib Ben Khaled Bruno Sangro Jens Ricke Max Seidensticker Moritz Wildgruber Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolization JHEP Reports Hepatocellular carcinoma Sorafenib Radioembolization Platelet-to-lymphocyte ratio |
| title | Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolization |
| title_full | Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolization |
| title_fullStr | Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolization |
| title_full_unstemmed | Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolization |
| title_short | Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolization |
| title_sort | predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in hcc treated with sorafenib and radioembolization |
| topic | Hepatocellular carcinoma Sorafenib Radioembolization Platelet-to-lymphocyte ratio |
| url | http://www.sciencedirect.com/science/article/pii/S2589555923003269 |
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