Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular Carcinoma
ABSTRACT Aim This study aims to investigate the clinical utility of the derived neutrophil‐to‐lymphocyte ratio (dNLR) and the Geriatric Nutritional Risk Index (GNRI) in predicting treatment outcomes for patients with unresectable hepatocellular carcinoma (HCC) undergoing combination therapy with ate...
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2025-01-01
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| Online Access: | https://doi.org/10.1002/cam4.70618 |
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| author | Atsushi Naganuma Satoru Kakizaki Atsushi Hiraoka Toshifumi Tada Takeshi Hatanaka Kazuya Kariyama Joji Tani Masanori Atsukawa Koichi Takaguchi Ei Itobayashi Shinya Fukunishi Kunihiko Tsuji Toru Ishikawa Kazuto Tajiri Hidenori Toyoda Chikara Ogawa Hiroki Nishikawa Takashi Nishimura Kazuhito Kawata Hisashi Kosaka Masashi Hirooka Yutaka Yata Hideko Ohama Hidekatsu Kuroda Tomomitsu Matono Tomoko Aoki Yuki Kanayama Kazunari Tanaka Fujimasa Tada Kazuhiro Nouso Asahiro Morishita Akemi Tsutsui Takuya Nagano Norio Itokawa Tomomi Okubo Taeang Arai Michitaka Imai Shinichiro Nakamura Hirayuki Enomoto Masaki Kaibori Yoichi Hiasa Masatoshi Kudo Takashi Kumada |
| author_facet | Atsushi Naganuma Satoru Kakizaki Atsushi Hiraoka Toshifumi Tada Takeshi Hatanaka Kazuya Kariyama Joji Tani Masanori Atsukawa Koichi Takaguchi Ei Itobayashi Shinya Fukunishi Kunihiko Tsuji Toru Ishikawa Kazuto Tajiri Hidenori Toyoda Chikara Ogawa Hiroki Nishikawa Takashi Nishimura Kazuhito Kawata Hisashi Kosaka Masashi Hirooka Yutaka Yata Hideko Ohama Hidekatsu Kuroda Tomomitsu Matono Tomoko Aoki Yuki Kanayama Kazunari Tanaka Fujimasa Tada Kazuhiro Nouso Asahiro Morishita Akemi Tsutsui Takuya Nagano Norio Itokawa Tomomi Okubo Taeang Arai Michitaka Imai Shinichiro Nakamura Hirayuki Enomoto Masaki Kaibori Yoichi Hiasa Masatoshi Kudo Takashi Kumada |
| author_sort | Atsushi Naganuma |
| collection | DOAJ |
| description | ABSTRACT Aim This study aims to investigate the clinical utility of the derived neutrophil‐to‐lymphocyte ratio (dNLR) and the Geriatric Nutritional Risk Index (GNRI) in predicting treatment outcomes for patients with unresectable hepatocellular carcinoma (HCC) undergoing combination therapy with atezolizumab and bevacizumab (Atez/Bev). Methods A retrospective analysis was conducted on 310 patients. The dNLR, NLR, and GNRI were calculated, and their impact on progression‐free survival (PFS) and overall survival (OS) was assessed. The formula for calculating dNLR is: (neutrophil count ÷ [white blood cell count—neutrophil count]), which means it does not require lymphocyte count. Furthermore, GNRI‐dNLR and GNRI‐NLR scores were defined, and their prognostic values were also analyzed. Results The median PFS of this cohort was 7.2 months (95% CI: 5.9–8.5), and the median OS was 24.9 months (95% CI: 19.6–30.2). The dNLR, NLR, and GNRI were significant predictors of both PFS and OS. The dNLR showed a significant correlation with the NLR (Pearson correlation coefficient, p < 0.0001). Patients with high GNRI‐dNLR scores demonstrated significantly worse PFS and OS compared to those with low scores (p = 0.001, p < 0.001, respectively). Compared to stratification by GNRI alone, the GNRI‐dNLR or GNRI‐NLR provided better stratification for both PFS and OS. Conclusion The dNLR could be a valuable substitute for NLR as a prognostic marker in patients with unresectable HCC undergoing Atez/Bev therapy. It offers a feasible alternative for databases lacking lymphocyte count information, ensuring comprehensive patient stratification and outcome prediction. The GNRI‐NLR or GNRI‐dNLR score provided better stratification compared to GNRI alone. |
| format | Article |
| id | doaj-art-168c385cdbb24857b569f84158efedd6 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-168c385cdbb24857b569f84158efedd62025-01-24T08:46:07ZengWileyCancer Medicine2045-76342025-01-01142n/an/a10.1002/cam4.70618Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular CarcinomaAtsushi Naganuma0Satoru Kakizaki1Atsushi Hiraoka2Toshifumi Tada3Takeshi Hatanaka4Kazuya Kariyama5Joji Tani6Masanori Atsukawa7Koichi Takaguchi8Ei Itobayashi9Shinya Fukunishi10Kunihiko Tsuji11Toru Ishikawa12Kazuto Tajiri13Hidenori Toyoda14Chikara Ogawa15Hiroki Nishikawa16Takashi Nishimura17Kazuhito Kawata18Hisashi Kosaka19Masashi Hirooka20Yutaka Yata21Hideko Ohama22Hidekatsu Kuroda23Tomomitsu Matono24Tomoko Aoki25Yuki Kanayama26Kazunari Tanaka27Fujimasa Tada28Kazuhiro Nouso29Asahiro Morishita30Akemi Tsutsui31Takuya Nagano32Norio Itokawa33Tomomi Okubo34Taeang Arai35Michitaka Imai36Shinichiro Nakamura37Hirayuki Enomoto38Masaki Kaibori39Yoichi Hiasa40Masatoshi Kudo41Takashi Kumada42Department of Gastroenterology NHO Takasaki General Medical Center Takasaki JapanDepartment of Clinical Research NHO Takasaki General Medical Center Takasaki JapanGastroenterology Center Ehime Prefectural Central Hospital Matsuyama JapanDepartment of Internal Medicine Japanese Red Cross Himeji Hospital Himeji JapanDepartment of Gastroenterology Gunma Saiseikai Maebashi Hospital Maebashi JapanDepartment of Gastroenterology Okayama City Hospital Okayama JapanDepartment of Gastroenterology and Neurology Kagawa University Kita‐gun JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo JapanDepartment of Hepatology Kagawa Prefectural Central Hospital Takamatsu JapanDepartment of Gastroenterology Asahi General Hospital Asahi JapanDivision of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology Hyogo Medical University Nishinomiya JapanCenter of Gastroenterology Teine Keijinkai Hospital Sapporo JapanDepartment of Gastroenterology Saiseikai Niigata Hospital Niigata JapanDepartment of Gastroenterology Toyama University Hospital Toyama JapanDepartment of Gastroenterology and Hepatology Ogaki Municipal Hospital Ogaki JapanDepartment of Gastroenterology and Hepatology Takamatsu Red Cross Hospital Takamatsu JapanDepartment of Gastroenterology Osaka Medical and Pharmaceutical University Osaka JapanDivision of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology Hyogo Medical University Nishinomiya JapanHepatology Division, Department of Internal Medicine II Hamamatsu University School of Medicine Hamamatsu JapanDepartment of Hepatobiliary Surgery Kansai Medical University Hirakata JapanDepartment of Gastroenterology and Metabology Ehime University Graduate School of Medicine Matsuyama JapanDepartment of Gastroenterology Hanwa Memorial Hospital Osaka JapanDepartment of Gastroenterology Takarazuka City Hospital Takarazuka JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine Iwate Medical University Iwate JapanDepartment of Gastroenterology Hyogo Prefectural Harima‐Himeji General Medical Center Himeji JapanDepartment of Gastroenterology and Hepatology Kindai University Faculty of Medicine Osaka JapanDepartment of Gastroenterology Gunma Saiseikai Maebashi Hospital Maebashi JapanCenter of Gastroenterology Teine Keijinkai Hospital Sapporo JapanGastroenterology Center Ehime Prefectural Central Hospital Matsuyama JapanDepartment of Gastroenterology Okayama City Hospital Okayama JapanDepartment of Gastroenterology and Neurology Kagawa University Kita‐gun JapanDepartment of Hepatology Kagawa Prefectural Central Hospital Takamatsu JapanDepartment of Hepatology Kagawa Prefectural Central Hospital Takamatsu JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo JapanDepartment of Gastroenterology Saiseikai Niigata Hospital Niigata JapanDepartment of Internal Medicine Japanese Red Cross Himeji Hospital Himeji JapanDivision of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology Hyogo Medical University Nishinomiya JapanDepartment of Hepatobiliary Surgery Kansai Medical University Hirakata JapanDepartment of Gastroenterology and Metabology Ehime University Graduate School of Medicine Matsuyama JapanDepartment of Gastroenterology and Hepatology Kindai University Faculty of Medicine Osaka JapanGifu Kyoritsu University Ogaki JapanABSTRACT Aim This study aims to investigate the clinical utility of the derived neutrophil‐to‐lymphocyte ratio (dNLR) and the Geriatric Nutritional Risk Index (GNRI) in predicting treatment outcomes for patients with unresectable hepatocellular carcinoma (HCC) undergoing combination therapy with atezolizumab and bevacizumab (Atez/Bev). Methods A retrospective analysis was conducted on 310 patients. The dNLR, NLR, and GNRI were calculated, and their impact on progression‐free survival (PFS) and overall survival (OS) was assessed. The formula for calculating dNLR is: (neutrophil count ÷ [white blood cell count—neutrophil count]), which means it does not require lymphocyte count. Furthermore, GNRI‐dNLR and GNRI‐NLR scores were defined, and their prognostic values were also analyzed. Results The median PFS of this cohort was 7.2 months (95% CI: 5.9–8.5), and the median OS was 24.9 months (95% CI: 19.6–30.2). The dNLR, NLR, and GNRI were significant predictors of both PFS and OS. The dNLR showed a significant correlation with the NLR (Pearson correlation coefficient, p < 0.0001). Patients with high GNRI‐dNLR scores demonstrated significantly worse PFS and OS compared to those with low scores (p = 0.001, p < 0.001, respectively). Compared to stratification by GNRI alone, the GNRI‐dNLR or GNRI‐NLR provided better stratification for both PFS and OS. Conclusion The dNLR could be a valuable substitute for NLR as a prognostic marker in patients with unresectable HCC undergoing Atez/Bev therapy. It offers a feasible alternative for databases lacking lymphocyte count information, ensuring comprehensive patient stratification and outcome prediction. The GNRI‐NLR or GNRI‐dNLR score provided better stratification compared to GNRI alone.https://doi.org/10.1002/cam4.70618dNLRGNRIhepatocellular carcinomaimmune checkpoint inhibitorprognosis |
| spellingShingle | Atsushi Naganuma Satoru Kakizaki Atsushi Hiraoka Toshifumi Tada Takeshi Hatanaka Kazuya Kariyama Joji Tani Masanori Atsukawa Koichi Takaguchi Ei Itobayashi Shinya Fukunishi Kunihiko Tsuji Toru Ishikawa Kazuto Tajiri Hidenori Toyoda Chikara Ogawa Hiroki Nishikawa Takashi Nishimura Kazuhito Kawata Hisashi Kosaka Masashi Hirooka Yutaka Yata Hideko Ohama Hidekatsu Kuroda Tomomitsu Matono Tomoko Aoki Yuki Kanayama Kazunari Tanaka Fujimasa Tada Kazuhiro Nouso Asahiro Morishita Akemi Tsutsui Takuya Nagano Norio Itokawa Tomomi Okubo Taeang Arai Michitaka Imai Shinichiro Nakamura Hirayuki Enomoto Masaki Kaibori Yoichi Hiasa Masatoshi Kudo Takashi Kumada Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular Carcinoma Cancer Medicine dNLR GNRI hepatocellular carcinoma immune checkpoint inhibitor prognosis |
| title | Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular Carcinoma |
| title_full | Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular Carcinoma |
| title_fullStr | Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular Carcinoma |
| title_full_unstemmed | Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular Carcinoma |
| title_short | Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular Carcinoma |
| title_sort | evaluation of treatment outcomes using dnlr and gnri in combination therapy with atezolizumab and bevacizumab for hepatocellular carcinoma |
| topic | dNLR GNRI hepatocellular carcinoma immune checkpoint inhibitor prognosis |
| url | https://doi.org/10.1002/cam4.70618 |
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