Immune inflammation indicators and implication for immune modulation strategies in advanced hepatocellular carcinoma patients receiving sorafenib
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Andrea Casadei Gardini1, Emanuela Scarpi2, Luca Faloppi3,4, Mario Scartozzi4, Nicola Silvestris5, Daniele Santini6, Giorgio de Stefano7, Giorgia Marisi8, Francesca V. Negri9, Francesco Giuseppe Foschi10, Martina Valgiusti1, Giorgio Ercolani11,12, Giovanni Luca Frassineti1
1Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e Cura dei Tumori (IRST) IRCCS, Meldola, Italy
2Unit of Biostatistics and Clinical Trials, IRST IRCCS, Meldola, Italy
3Department of Medical Oncology, Ospedale Generale Provinciale di Macerata ASUR Marche AV3, Macerata, Italy
4Department of Medical Oncology, University Hospital Cagliari, Cagliari, Italy
5Medical Oncology Unit, Cancer Institute “Giovanni Paolo II”, Bari, Italy
6Medical Oncology Department, University Campus Bio-Medico, Via Álvaro del Portillo, Rome, Italy
7Infectious Diseases and Interventional Ultrasound Unit, D. Cotugno Hospital, Naples, Italy
8Biosciences Laboratory, IRST IRCCS, Meldola, Italy
9Medical Oncology Unit, University Hospital, Parma, Italy
10DPT Internal Medicine, Faenza Hospital, Faenza, AUSL Romagna, Forli, Italy
11Department of General Surgery, Morgagni-Pierantoni Hospiatal, AUSL Romagna, Forli, Italy
12Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Andrea Casadei Gardini, email: [email protected]
Keywords: systemic immune-inflammation index, inflammation, biomarker, hepatocellular carcinoma, neutrophil-to-lymphocyte ratio
Received: June 21, 2016 Accepted: August 15, 2016 Published: August 24, 2016
We evalueted a systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) with the aim to explored their prognostic value in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib. 56 advanced HCC patients receiving sorafenib were available for our analysis. Lymphocyte, neutrophil and platelet were measured before beginning of treatment and after one month. Patient with SII ≥ 360 showed lower median PFS (2.6 vs. 3.9 months, P < 0.026) and OS (5.6 vs. 13.9 months, P = 0.027) with respect to patients with SII < 360.
NLR ≥ 3 had a lower median PFS (2.6 vs. 3.3 months, P < 0.049) but not OS (5.6 vs. 13.9 months, P = 0.062) than those with NLR < 3. After adjusting for clinical covariates SII and NLR remained an independent prognostic factor for OS. The SII and NLR represent potential prognostic indicator in patients with advanced HCC treated with sorafenib.
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