167P - Peripheral blood neutrophil-to-lymphocyte ratio correlated with serum IL-8 level and predict the outcome of hepatocellular carcinoma patients treated with immune-targeted combination therapy

Background

The study aimed to evaluate baseline and dynamic changes of serum neutrophil-to-lymphocyte ratio (NLR) level as biomarkers of response to anti-PD-1/PD-L1 blockade combined with anti-VEGF or tyrosine kinase inhibitors (TKIs) in advanced hepatocellular carcinoma (aHCC) patients and the potential relationship between NLR and serum cytokines.

Methods

We collected NLR level at baseline and week 3 since initial treatment as well as baseline serum cytokines in patients with aHCC treated with immune-targeted combination therapy from October 2018 to November 2021. The cutoff of baseline NLR was defined by median level. We defined both baseline NLR ≤ 2.63 as well as NLR decrease at week 3 as group1 (n = 30), baseline NLR ≤ 2.63 while NLR increase at week 3 as group2 (n = 27), baseline NLR ＞ 2.63 while NLR decrease at week 3 as group3 (n = 38), both baseline NLR＞2.63 as well as NLR increase at week 3 as group4 (n = 14).

Results

A total of 132 patients with aHCC received the immune-targeted combination therapy were included. Baseline high NLR was significantly associated with worse progression-free survival (PFS) (5.4 vs. 14.1 months, p ＜ 0.001) and overall survival (OS) (11.3 vs. 27.7 months, p ＜ 0.001), even after multivariate analysis. NLR level decreased significantly at week 3 in patients with complete response or partial response (CR/PR) (baseline vs. week3: 2.30 vs. 1.96, p = 0.006), no significant difference was shown in patients with progression disease (PD) (n = 18) (baseline vs. week3: 3.80 vs. 2.90, p = 0.157). Patients in group4 showed the worst treatment response, with no patients achieved CR/PR. Cytokines analysis showed that patients with baseline high NLR had significantly higher level of baseline serum IL-8 than those with low NLR (5.66 vs. 2.05 pg/ml, p = 0.001). Patients with baseline high IL-8 showed worse PFS (5.5 vs. 11.4 months, p =0.047) and OS (13.5 vs. 26.4 months, p = 0.001).

Conclusions

NLR is an independent prognostic factor for aHCC, the combination of dynamic change and baseline NLR may assist in screening out patients who are difficult to benefit from immune-targeted therapy. High baseline NLR may correlate with high baseline serum IL-8.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

The CAMS Innovation Fund for Medical Sciences; The Translational Research Project of Medical Oncology Key Foundation of Cancer Hospital Chinese Academy of Medical Sciences; Beijing Natural Science Foundation.

Disclosure

All authors have declared no conflicts of interest.