Therapeutic efficacy and prognostic factors in advanced esophageal squamous cell carcinoma patients on a therapy of immune checkpoint inhibitors
OBJECTIVE To identify the potential pre-treatment predictors of immune checkpoint inhibitors(ICIs)and examine the effects of clinical characteristics and peripheral blood biomarkers on therapeutic efficacy and prognostic outcomes of patients with advanced esophageal squamous cell carcinoma on a therapy of ICIs.METHODS Clinical characteristics and periph-eral blood biomarkers were recorded for 157 advanced esophageal squamous cell carcinoma patients on a therapy of ICIs at Jieyang People's Hospital from January 2020 to June 2022.According to the inclusion and exclusion criteria,individuals with ＜2 treat-ment cycles,combined radiotherapy,non-standardized treatment,incomplete data and PD-1 inhibitor dosing for less than 6 months without progression or death were excluded and 65 eligible patients elected.Their correlations with durable clinical benefit(DCB)and progression-free survival(PFS)were evaluated.RESULTS Univariate analysis showed that individuals with base-line lymphocyte-to-monocyte ratio(LMR)≥3.64,albumin(ALB)≥38.75 g·L-1 and prognostic nutritional index(PNI)≥44.40 had better DCB with statistical significance(P＜0.05).Multivariate analysis revealed that baseline LMR≥3.64 and ALB≥38.75 g·L-1 were independent influencing factors of DCB(P＜0.05).Median PFS was 6.7 months(95％CI:4.48-8.86).Univariate analysis hinted at a significant association between baseline performance status(PS)score of 0-1,LMR≥3.64,ALB≥38.75 g·L-1 and improved PFS(P＜0.05).Multivariate Cox regression analysis indicated that individuals with baseline LMR≥3.64 and ALB≥38.75 g·L-1 had longer PFS(P＜0.05).CONCLUSION Baseline LMR≥3.64 and ALB≥38.75 g·L-1 are correlated positively with the prognosis of advanced esophageal squamous cell carcinoma patients on a therapy of ICIs.
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