Tatsuki Ikoma1,2, Mototsugu Shimokawa3, Toshihiko Matsumoto1,2, Shogen Boku2, Tomoyo Yasuda2, Nobuhiro Shibata2, Yusuke Kurioka4, Masahiro Takatani4, Tetsuji Nobuhisa5, Tsutomu Namikawa6, Hiroyuki Kitagawa6, Kazuhiro Hanazaki6, Keitaro Doi7, Takanobu Shimada7, Takehiko Tsumura7,8, Hiroyuki Marusawa8, Seichiro Kanaya9, Shuko Morita10, Tetsurou Inokuma10, Hiroki Nagai1, Hisateru Yasui1, Hironaga Satake11. 1. Department of Medical Oncology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima minamimachi Chuo-ku, Kobe-shi, Hyogo-ken, 650-0047, Japan. 2. Cancer Treatment Center, Kansai Medical University Hospital, 2-3-1, Shinmachi, Hirakata-shi, Osaka-fu, 573-1191, Japan. 3. Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi,, Ube-shi, Yamaguchi-ken, 755-8505, Japan. 4. Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, Himeji-shi, Hyogo-ken, 670-8540, Japan. 5. Department of Surgery, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno,, Himeji-shi, Hyogo-ken, 670-8540, Japan. 6. Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku-city, Kochi-ken, 783-8505, Japan. 7. Department of Medical Oncology, Japanese Red Cross Society Osaka Hospital, 5-30 Hudegasaki-cho, Tenouji-ku, Osaka-fu, 543-8555, Japan. 8. Department of Gastroenterology and Hepatology, Japanese Red Cross Society Osaka Hospital, 5-30 Hudegasaki-cho, Tenouji-ku, Osaka-fu, 543-8555, Japan. 9. Department of Surgery, Japanese Red Cross Society Osaka Hospital, 5-30 Hudegasaki-cho,, Tenouji-ku, Osaka-fu, 543-8555, Japan. 10. Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima minamimachi Chuo-ku, Kobe-shi, Hyogo-ken, 650-0047, Japan. 11. Department of Medical Oncology, Kochi Medical School, Kohasu, Oko-cho, Nankoku-city, Kochi-ken, 783-8505, Japan. takeh1977@gmail.com.
Abstract
BACKGROUND: In Japan, nivolumab administration is the standard treatment for patients with unresectable advanced or recurrent esophageal squamous cell carcinoma (ESCC) who are refractory or intolerant to fluoropyrimidines and platinum-based chemotherapy. We determined if inflammatory prognostic factors are useful in patients with ESCC treated with nivolumab monotherapy. METHODS: The clinical data of patients with ESCC treated with nivolumab monotherapy as the second- or later-line treatment were retrospectively analyzed. Neutrophil/lymphocyte, platelet/lymphocyte, and C-reactive protein/albumin ratios (CAR); prognostic index; and prognostic nutritional index were investigated. Cut-off values for each factor were determined according to overall survival using time-dependent receiver operating characteristic curves. RESULTS: During January 2017-June 2021, 93 consecutive patients with ESCC were enrolled from five institutions (median age, 70 years; male, 77%). With a median follow-up period of 9.1 (range, 1.0-34.7) months, the median overall and progression-free survival were 12.8 (95% confidence interval [CI], 9.0-16.6) and 4.0 (95% CI, 2.6-5.4) months, respectively. Of five inflammatory prognostic factors, the cut-off value for CAR was 0.62; prognosis was significantly longer in those with CAR < 0.62 (hazard ratio, 0.39; 95% CI, 0.22-0.67; p = 0.001). CONCLUSIONS: Inflammatory prognostic factors were useful in predicting prognosis for ESCC patients pretreated with nivolumab, especially for those with CAR < 0.62, suggesting that CAR adequately reflects prognosis.
BACKGROUND: In Japan, nivolumab administration is the standard treatment for patients with unresectable advanced or recurrent esophageal squamous cell carcinoma (ESCC) who are refractory or intolerant to fluoropyrimidines and platinum-based chemotherapy. We determined if inflammatory prognostic factors are useful in patients with ESCC treated with nivolumab monotherapy. METHODS: The clinical data of patients with ESCC treated with nivolumab monotherapy as the second- or later-line treatment were retrospectively analyzed. Neutrophil/lymphocyte, platelet/lymphocyte, and C-reactive protein/albumin ratios (CAR); prognostic index; and prognostic nutritional index were investigated. Cut-off values for each factor were determined according to overall survival using time-dependent receiver operating characteristic curves. RESULTS: During January 2017-June 2021, 93 consecutive patients with ESCC were enrolled from five institutions (median age, 70 years; male, 77%). With a median follow-up period of 9.1 (range, 1.0-34.7) months, the median overall and progression-free survival were 12.8 (95% confidence interval [CI], 9.0-16.6) and 4.0 (95% CI, 2.6-5.4) months, respectively. Of five inflammatory prognostic factors, the cut-off value for CAR was 0.62; prognosis was significantly longer in those with CAR < 0.62 (hazard ratio, 0.39; 95% CI, 0.22-0.67; p = 0.001). CONCLUSIONS: Inflammatory prognostic factors were useful in predicting prognosis for ESCC patients pretreated with nivolumab, especially for those with CAR < 0.62, suggesting that CAR adequately reflects prognosis.
Authors: K Hayashi; N Ando; H Watanabe; H Ide; K Nagai; N Aoyama; W Takiyama; K Ishida; K Isono; H Makuuchi; M Imamura; M Shinoda; S Ikeuchi; T Kabuto; H Yamana; H Fukuda Journal: Jpn J Clin Oncol Date: 2001-09 Impact factor: 3.019
Authors: T Iizuka; T Kakegawa; H Ide; N Ando; H Watanabe; O Tanaka; I Takagi; K Isono; K Ishida; M Arimori Journal: Jpn J Clin Oncol Date: 1992-06 Impact factor: 3.019
Authors: Barry J Laird; Stein Kaasa; Donald C McMillan; Marie T Fallon; Marianne J Hjermstad; Peter Fayers; Pal Klepstad Journal: Clin Cancer Res Date: 2013-08-12 Impact factor: 12.531