Peripheral blood markers predictive of outcome in Upper gastrointestinal cancers treated with immune checkpoint inhibitors

Purpose: In view of the fact that peripheral blood parameters have been reported as predictors of immunotherapy to various cancers, this study aimed to determine the predictors of response to immune checkpoint inhibitors (ICIs) therapy in patients with upper gastrointestinal cancers from peripheral blood parameters.MethodsThe respective data of 93 patients with upper gastrointestinal tumor who received ICIs combination therapy were included in this study. The peripheral blood indexes of interest were neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lactate dehydrogenase (LDH), and fibrinogen/albumin ratio (FAR). Survival probabilities of progression-free survival (PFS) was estimated using Kaplan–Meier curves and log-rank tests and the multivariate Cox proportional hazards model. Receiver-operating characteristic curve was used to determine a cutoff value for parameters and area under the curve.ResultsThe median PFS of all upper gastrointestinal cancers patients was 7.33 months. Baseline LDH0<194.5,NLR0<4.39,PLR0<218.7 and FAR0<0.13 were associated with longer PFS(13.4 VS 4.9 months; p < 0.001,10.8 VS 4.2 months; p<0.001,10.8 VS 6.7 months; p<0.05,8.4 VS 5.0 months; p<0.05,respectively).The 6 weeks after treatment value, LDH1<264.5,PLR1<117.2 were associated with longer PFS(7.5 VS 2.7 months; p < 0.05, 12.0 VS 6.2 months; p<0.05, respectively). The first disease progression value,LDH2<216.5 was associated with longer PFS(9.5 VS 4.2 months; p < 0.05). The NLR1 / NLR0 < 1.75 was associated with significant prolongation of PFS (7.5 VS 4.9 months, P <0.05).ConclusionsOur research illustrated that baseline LDH0,NLR0,PLR0,FAR0 and LDH1,LDH2,PLR1 at post-treatment are independent predictors for PFS in upper gastrointestinal tumor patients treated with ICIs.