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Elevated peripheral blood neutrophil-to-lymphocyte ratio is associated with an immunosuppressive tumour microenvironment and decreased benefit of pd-1 antibody in advanced gastric cancer

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Gastroenterology Report 2021年第6期9卷 560-570页

作者： Dan-Yun Ruan Yan-Xing Chen Xiao-Li Wei Ying-Nan Wang Zi-Xian Wang Hao-Xiang Wu Rui-Hua Xu Shu-Qiang Yuan Feng-Hua Wang State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicineSun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Department of Medical Oncology the Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China Department of Medical Oncology Sun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Department of Gastric Surgery Sun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China

Background Due to its limited efficacy and potential toxicity,anti-pd-1 monoclonal antibody is not suitable for all advanced gastric cancer(AGC)patients and predictive biomarkers identifying patients who can benefit from it are urgently *** study aimed to evaluate the predictive and prognostic value of inflammatory markers in the context of the systemic inflammatory status and tumour *** The study included 58 patients from a prospective study investigating the safety and efficacy of toripalimab in chemorefractory AGC *** characteristics,treatment outcomes,and haematological parameters were ***-cell infiltration and gene expression in tumour tissue were examined using transcriptome *** In this cohort,the median follow-up time was 4.5 months,the median progression-free survival was 1.9 months,and the median overall survival(OS)was 4.8 *** objective response rate was 12.1%and th disease control rate(DCR)was 39.7%.Both the baseline blood neutrophil-to-lymphocyte ratio(bNLR)with a cut-point of 2.7 and the early elevated dynamic change of the bNLR(dNLR)with a cut-point of 1.5 were prognostic factors of *** in the high bNLR or dNLR group had remarkably poor DCR(25.8%vs 59.1%,P=0.023;15.8%vs 54.6%,P=0.008).In multivariate analysis,bNLR and tumour mutational burden were independent prognostic factors of *** RNA-seq analysis revealed enriched neutrophil infiltration and a higher tumour NLR in the bNLR-high *** tumour gene-expression profiles were associated with neutrophil recruitment and inflammatory cytokine *** Our study demonstrated the potential clinical utility of NLR as a biomarker for patient selection and clinical management in predicting the prognosis of AGC patients as well as response to anti-pd-1 *** addition,high bNLR reflected the imbalance of tumour-tissue-infiltrating neutrophils and lymphocytes,and was associated with an

关键词： advanced gastric cancer neutrophil-to-lymphocyte ratio anti-pd-1 monoclonal antibody tumour microenvironment

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