Abstract
Purpose
Lymphocyte-monocyte ratio (LMR) has previously been used as a prognostic predictor in various solid tumors. This research aims in comparing the prognostic predictive Please check and conability of several inflammatory parameters and clinical parameters to validate further the excellent prognostic value of LMR in patients with gastric cancer treated with apatinib.
Methods
Monitor inflammatory, nutritional parameters and tumor markers. Cutoff values of the parameters concerned were identified with the X-tile program. Subgroup analysis was made via Kaplan–Meier curves, and univariate and multivariate Cox regression analyses were used to find independent prognostic factors. The nomogram of logistic regression models was constructed according to the results.
Results
A total of 192 patients (115 divided into training group and 77 into validation group) who received the second- or later-line regimen of apatinib were retrospectively analyzed. The optimal cutoff value for LMR was 1.33. Patients with high LMR (LMR-H) were significantly longer than those with low LMR (LMR-L) in progression-free survival (median 121.0 days vs. median 44.5 days, P < 0.001). The predictive value of LMR was generally uniform across subgroups. Meanwhile, LMR and CA19-9 were the only hematological parameters with significant prognostic value in multivariate analysis. The area under the LMR curve (0.60) was greatest for all inflammatory indices. Adding LMR to the base model significantly enhanced the predictive power of the 6-month probability of disease progression (PD). The LMR-based nomogram showed good predictive power and discrimination in external validation.
Conclusion
LMR is a simple but effective predictor of prognosis for patients treated with apatinib.
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Data availability
Raw data supporting the conclusions of this article will be provided unreservedly by the authors. Supporting Information 1 contains the training dataset we used and Supporting Information 2 contains the validation dataset we used.
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The authors thank all patients who participated in the present study.
Funding
This study was supported by Hefei Key Common Technology Research and Major Scientific and Technological Achievement Project (2021YL005), Anhui Province Key Research and Development Program Project (202104j07020044), and Health Commission of Anhui Province Scientific Research Project (AHWJ2021b105). The funding source had no role in the design, practice or analysis of this study.
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HS was involved in (1) conception and design, analysis, and interpretation of data and (2) drafting the article. WXD was involved in the analysis and interpretation of data. RXS, SSW and MGL were involved in the interpretation of data. ZHZ and XDL were involved in the acquisition of data. YFH was involved in (1) conception and design and analysis and interpretation of data and (2) revising it critically for important intellectual content. All authors read and approved the final manuscript.
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This study was reviewed and approved by the Ethics Committee of Anhui Provincial Hospital (Batch No:2023-RE-010), which waived the requirement for informed consent due to the retrospective nature of this study.
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Shen, H., Dang, W., Su, R. et al. Pretreatment lymphocyte-monocyte ratio (LMR) as a superior predictor of short-term progression outcomes in patients with gastric cancer receiving second- and later-line apatinib regimens. J Cancer Res Clin Oncol 149, 10715–10726 (2023). https://doi.org/10.1007/s00432-023-04976-9
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DOI: https://doi.org/10.1007/s00432-023-04976-9