Immune-inflammatory biomarkers as prognostic factors for immunotherapy in pretreated advanced urinary tract cancer patients: an analysis of the Italian SAUL cohort

ESMO Open

article

G. Fornarini¹  S.E. Rebuzzi¹  G.L. Banna³  F. Calabrò⁴  G. Scandurra⁵  U. De Giorgi⁶  C. Masini⁷  C. Baldessari⁸  E. Naglieri⁹  C. Caserta^1,10  S. Manacorda^1,11  M. Maruzzo^1,12  M. Milella^1,13  C. Buttigliero^1,14  R. Tambaro^1,15  P. Ermacora^1,16  F. Morelli^1,17  F. Nolè^1,18  C. Astolfi^1,19  C.N. Sternberg^2,20 

[1] Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino;Department of Internal Medicine and Medical Specialties, University of Genoa;Department of Oncology, Portsmouth Hospitals University NHS Trust;Medical Oncology, Azienda Ospedaliera S. Camillo-Forlanini;Medical Oncology, Azienda Ospedaliera Cannizzaro di Catania;Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori;Medical Oncology;Oncology, Azienda Ospedaliero - Universitaria di Modena;Division of Medical Oncology, IRCCS Istituto Tumori Bari Giovanni Paolo II - IRCCS;Medical Oncology Unit, Azienda Ospedaliera S. Maria;Medical Oncology, Azienda Ospedaliero-Universitaria Pisana;Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto;Dipartimento di Oncologia, Policlinico Universitario G.B. Rossi Borgo Roma;Medical Oncology, Università degli Studi di Torino;U.O.C di Oncologia Sperimentale Uroginecologica;Dipartimento di Oncologia, Azienda Ospedaliero Universitaria di Udine;Casa Sollievo della Sofferenza;IEO, Istituto Europeo di Oncologia IRCCS;Medical Affairs & Clinical Operation;Hematology and Oncology, Englander Institute for Precision Medicine Weill Cornell Medicine

关键词: biomarker;    immunotherapy;    PD-1;    PD-L1;    LDH;    neutrophil-to-lymphocyte ratio (NLR);    systemic immune-inflammation index (SII);    immune-checkpoint inhibitor;    prognostic;    urothelial carcinoma;   

DOI  :  10.1016/j.esmoop.2021.100118

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background Reliable and affordable prognostic and predictive biomarkers for urothelial carcinoma treated with immunotherapy may allow patients' outcome stratification and drive therapeutic options. The SAUL trial investigated the safety and efficacy of atezolizumab in a real-world setting on 1004 patients with locally advanced or metastatic urothelial carcinoma who progressed to one to three prior systemic therapies.Patients and methods 1375) in addition to study-defined ones derived from receiver operating characteristic (ROC) analysis were used.Results The cut-off values for NLR and SII by the ROC analysis were 3.65 (sensitivity 60.4; specificity 63.0) and 884 (sensitivity 64.4; specificity 67.5), respectively. The median overall survival (OS) was 14.7 months for NLR <3.65 [95% confidence interval (CI) 9.9-not reached (NR)] versus 6.0 months for NLR ≥3.65 (95% CI 3.9-9.4); 14.7 months for SII <884 (95% CI 10.6-NR) versus 6.0 months for SII ≥884 (95% CI 3.7-8.6). The combination of SII, PD-L1, and LDH stratified OS better than SII plus PD-L1 through better identification of patients with intermediate prognosis (77% versus 48%, respectively). Multivariate analyses confirmed significant correlations with OS and progression-free survival for both the SII + PD-L1 + LDH and SII + PD-L1 combinations.Conclusion The combination of immune-inflammatory biomarkers based on SII, PD-L1, with or without LDH is a potentially useful and easy-to-assess prognostic tool deserving validation to identify patients who may benefit from immunotherapy alone or alternative therapies.

【 授权许可】

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