A Retrospective Cohort Study To Explore The Correlation Between Peripheral Blood Markers And Survival In Solid Tumor Treated With Atezolizumab Monotherapy

Background:Immunotherapy with the programmed cell death ligand 1(PD-L1)antibody Atezolizumab has changed the field of many tumors included non-small cell lung cancer(NSCLC).Atezolizumab has also shown better outcomes compared standard second line chemotherapy in NSCLC and best supportive therapy in some other solid tumors.However,there are lacking reliable prognostic markers with many limitation in clinical.Many studies have found the correlation between neutrophil-lymphocyte ratio(NLR)as well as platelet-lymphocyte ratio(PLR)with high level and worse overall survival(OS)in several tumor types,but have a small amount researches conducted to explore the correlation between these markers and progression free survival(PFS).Objective:To discuss the correlation between peripheral blood markers and survival including OS and PFS in solid tumor treated with Atezolizumab monotherapy.Methods:A retrospective cohort study was conducted to explore the correlation between NLR as well as PLR with high level and OS,PFS of some cancer patients who were treated with Atezolizumab monotherapy from two clinical trials at Sir Run Run Shaw Hospital(SRRSH).Results:A total of 30 patients were identified in this retrospective cohort study.Of them,there were 19 NSCLC patients,6 primary hepatic carcinoma patients,3 esophagus cancer patients and 1 nasopharyngeal carcinoma,1 gastric carcinoma.Average age of all include patients was 58 years(range 23-75).The majority of patients were male(90%).The follow-up period spanned from 1 to 19 cycles(one cycle means 21 days).Median PFS of all patients were 8 cycles(95%CI:5.77-10.23),and mOS were 19 cycles(95%CI:16.55-21.45).High C-reactive protein seemed to have worse PFS with obvious statistical difference(HR = 1.43,95%CI:0.44-2.42,P = 0.005).Elevated NLR were associated with worse OS(HR = 1.55,95%CI:0.02-3.09,P = 0.047).However,there were no obvious significant difference between survival and PLR as well as LDH.Conclusion:Our research showed that NLR and C-reactive protein might be as markers on prognosis of patients with solid tumor treated with immune checkpoint inhibitors Atezolizumab.