Role of a Modified Urothelium Immune Prognostic Index in Patients With Metastatic Urothelial Carcinoma Treated With Anti–PD-1/PD-L1–Based Therapy
Introduction: The use of antibodies against programmed death receptor-1 (PD-1) and its ligand (PD-L1) has improved survival in metastatic urothelial carcinoma (mUC) patients. However, reliable and convenient biomarkers of early responses and outcomes are still lacking.Materials and Methods: We retro...
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Frontiers Media S.A.
2021-08-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fmolb.2021.621883/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Haifeng Li Haifeng Li Xin An Xin An Riqing Huang Riqing Huang Lu Li Lu Li Chengbiao Chu Chengbiao Chu Wei Yang Wei Yang Zike Qin Zike Qin Zhuowei Liu Zhuowei Liu Fangjian Zhou Fangjian Zhou Cong Xue Cong Xue Yanxia Shi Yanxia Shi |
spellingShingle |
Haifeng Li Haifeng Li Xin An Xin An Riqing Huang Riqing Huang Lu Li Lu Li Chengbiao Chu Chengbiao Chu Wei Yang Wei Yang Zike Qin Zike Qin Zhuowei Liu Zhuowei Liu Fangjian Zhou Fangjian Zhou Cong Xue Cong Xue Yanxia Shi Yanxia Shi Role of a Modified Urothelium Immune Prognostic Index in Patients With Metastatic Urothelial Carcinoma Treated With Anti–PD-1/PD-L1–Based Therapy Frontiers in Molecular Biosciences PD-1 inhibitor LDH NLR urothelial carcinoma mUIPI |
author_facet |
Haifeng Li Haifeng Li Xin An Xin An Riqing Huang Riqing Huang Lu Li Lu Li Chengbiao Chu Chengbiao Chu Wei Yang Wei Yang Zike Qin Zike Qin Zhuowei Liu Zhuowei Liu Fangjian Zhou Fangjian Zhou Cong Xue Cong Xue Yanxia Shi Yanxia Shi |
author_sort |
Haifeng Li |
title |
Role of a Modified Urothelium Immune Prognostic Index in Patients With Metastatic Urothelial Carcinoma Treated With Anti–PD-1/PD-L1–Based Therapy |
title_short |
Role of a Modified Urothelium Immune Prognostic Index in Patients With Metastatic Urothelial Carcinoma Treated With Anti–PD-1/PD-L1–Based Therapy |
title_full |
Role of a Modified Urothelium Immune Prognostic Index in Patients With Metastatic Urothelial Carcinoma Treated With Anti–PD-1/PD-L1–Based Therapy |
title_fullStr |
Role of a Modified Urothelium Immune Prognostic Index in Patients With Metastatic Urothelial Carcinoma Treated With Anti–PD-1/PD-L1–Based Therapy |
title_full_unstemmed |
Role of a Modified Urothelium Immune Prognostic Index in Patients With Metastatic Urothelial Carcinoma Treated With Anti–PD-1/PD-L1–Based Therapy |
title_sort |
role of a modified urothelium immune prognostic index in patients with metastatic urothelial carcinoma treated with anti–pd-1/pd-l1–based therapy |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Molecular Biosciences |
issn |
2296-889X |
publishDate |
2021-08-01 |
description |
Introduction: The use of antibodies against programmed death receptor-1 (PD-1) and its ligand (PD-L1) has improved survival in metastatic urothelial carcinoma (mUC) patients. However, reliable and convenient biomarkers of early responses and outcomes are still lacking.Materials and Methods: We retrospectively screened mUC patients who received anti–PD-1/PD-L1–based therapy at our institute. A modified urothelium immune prognostic index (mUIPI) based on the neutrophil-to-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) was developed to characterize the three groups as good, intermediate, and poor mUIPI. Major observations were progression-free survival (PFS), overall survival (OS), and disease control rate (DCR).Results: We identified 52 mUC patients with a median follow-up time of 29.8 months (95% CI, 26.3–53.2). Low NLR was with improved PFS and OS (hazard ratio [HR], 0.40, 95% CI, 0.18–0.92; HR, 0.27, 95% CI, 0.11–0.69, respectively). Normal LDH was associated with improved PFS but not OS (HR, 0.22, 95% CI, 0.10–0.52; HR, 0.86, 95% CI, 0.34–2.13, respectively). The median PFS for the poor, intermediate, and good mUIPI groups was 1.97 months (95% CI, 1.15 to NR), 3.48 months (95% CI, 1.58 to NR), and 14.52 months (95% CI, 5.75 to NR), respectively (p < 0.001). The median OS for the poor, intermediate, and good mUIPI was 12.82, 18.11, and 34.87 months, respectively (p = 0.28). A good mUIPI was associated with a higher DCR compared to intermediate and poor mUIPI (odds ratio [OR] 7.58, 95% CI, 1.73–43.69; OR, 6.49, 95% CI, 0.14–295.42, respectively). In the subgroup analysis, a good mUIPI was associated with improved PFS in the subgroups of male patients and patients with low urinary tract primary tumors, liver metastases, non–first-line treatment, and monotherapy.Conclusions: mUIPI predicts early responses in mUC patients who received anti–PD-1/PD-L1–based therapy. |
topic |
PD-1 inhibitor LDH NLR urothelial carcinoma mUIPI |
url |
https://www.frontiersin.org/articles/10.3389/fmolb.2021.621883/full |
work_keys_str_mv |
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doaj-960a3d6e3c1248d9820f36ecd8b3bb562021-08-12T06:11:37ZengFrontiers Media S.A.Frontiers in Molecular Biosciences2296-889X2021-08-01810.3389/fmolb.2021.621883621883Role of a Modified Urothelium Immune Prognostic Index in Patients With Metastatic Urothelial Carcinoma Treated With Anti–PD-1/PD-L1–Based TherapyHaifeng Li0Haifeng Li1Xin An2Xin An3Riqing Huang4Riqing Huang5Lu Li6Lu Li7Chengbiao Chu8Chengbiao Chu9Wei Yang10Wei Yang11Zike Qin12Zike Qin13Zhuowei Liu14Zhuowei Liu15Fangjian Zhou16Fangjian Zhou17Cong Xue18Cong Xue19Yanxia Shi20Yanxia Shi21State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Urology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaIntroduction: The use of antibodies against programmed death receptor-1 (PD-1) and its ligand (PD-L1) has improved survival in metastatic urothelial carcinoma (mUC) patients. However, reliable and convenient biomarkers of early responses and outcomes are still lacking.Materials and Methods: We retrospectively screened mUC patients who received anti–PD-1/PD-L1–based therapy at our institute. A modified urothelium immune prognostic index (mUIPI) based on the neutrophil-to-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) was developed to characterize the three groups as good, intermediate, and poor mUIPI. Major observations were progression-free survival (PFS), overall survival (OS), and disease control rate (DCR).Results: We identified 52 mUC patients with a median follow-up time of 29.8 months (95% CI, 26.3–53.2). Low NLR was with improved PFS and OS (hazard ratio [HR], 0.40, 95% CI, 0.18–0.92; HR, 0.27, 95% CI, 0.11–0.69, respectively). Normal LDH was associated with improved PFS but not OS (HR, 0.22, 95% CI, 0.10–0.52; HR, 0.86, 95% CI, 0.34–2.13, respectively). The median PFS for the poor, intermediate, and good mUIPI groups was 1.97 months (95% CI, 1.15 to NR), 3.48 months (95% CI, 1.58 to NR), and 14.52 months (95% CI, 5.75 to NR), respectively (p < 0.001). The median OS for the poor, intermediate, and good mUIPI was 12.82, 18.11, and 34.87 months, respectively (p = 0.28). A good mUIPI was associated with a higher DCR compared to intermediate and poor mUIPI (odds ratio [OR] 7.58, 95% CI, 1.73–43.69; OR, 6.49, 95% CI, 0.14–295.42, respectively). In the subgroup analysis, a good mUIPI was associated with improved PFS in the subgroups of male patients and patients with low urinary tract primary tumors, liver metastases, non–first-line treatment, and monotherapy.Conclusions: mUIPI predicts early responses in mUC patients who received anti–PD-1/PD-L1–based therapy.https://www.frontiersin.org/articles/10.3389/fmolb.2021.621883/fullPD-1 inhibitorLDHNLRurothelial carcinomamUIPI |