J. Li1, Q. Q. Chen1, T. Wang1, Z. Liu1, S. Ji1, and R. Zhu2; 1Department of Radiotherapy Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, suzhou, China, 2Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
Purpose/Objective(s): This study aims to assess the prognostic value of inflammatory markers in locally advanced or metastatic cervical cancer patients receiving anti-programmed death 1 (PD-1) treatment. Materials/
Methods: A total of 105 cervical cancer patients treated with immunocheckpoint inhibitor treatment from October 2019 to October 2022 were retrospectively collected. The peripheral blood indexes were neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio (PLR) , lymphocyte-to-monocyte ratio (LMR) , systemic immune-inflammation index (SII) and prognostic nutritional index (PNI). The optimal critical values of inflammatory indexes were determined using receiver operating characteristic curve (ROC) analysis. Kaplan-Meier method was utilized to estimate progression-free survival (PFS). Univariate and multivariate Cox regression analyses were performed to assess the prognostic value of inflammatory markers. Results: Among the 105 patients receiving ICI treatment, median progression-free survival (mPFS) is 19.0 months.The clinical characteristics of the patients, including age, pathological type, therapy regimen, Figo stage, NLR, PLR, LMR, SII and PNI were obtained from the medical records.The optimal cutoff values of NLR, PLR, LMR, SII and PNI were 3.71, 281.1, 3.34, 43.75 and 1104.35 respectively. In the univariate analysis, age, pathological type, therapy regimen, Figo stage,LMR were not associated with PFS, however, higher NLR(mPFS: 41.4 m vs 19.9 m, P < 0.001), higher PLR, (mPFS: 42.1 m vs 22.5 m, P < 0.001),higher SII (mPFS: 40.6 m vs 14.0 m, P < 0.001)and lower PNI(mPFS: 39.9 m vs 19.8m, P < 0.001)were associated with shorter PFS. Multivariate analysis showed that SII (Hazard Ratio, HR=2.754, 95%CI =1.106-6.859 ,P=0.03) were independent risk factors for PFS. Conclusion: In this study, we found that SII could be used as a predictor for PFS in cervical cancer patients treated with immunotherapy.
