Prognostic nutritional index of early post‑pembrolizumab therapy predicts long‑term survival in patients with advanced urothelial carcinoma

Prognostic nutritional index of early post‑pembrolizumab therapy predicts long‑term survival in patients with advanced urothelial carcinoma

Pembrolizumab has been widely used to treat advanced urothelial carcinoma that has progressed after first-line platinum-based chemotherapy. Because its clinical benefits are limited, biomarkers that can predict a good response to pembrolizumab are required. The prognostic nutritional index (PNI), ca...

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Bibliographic Details
Published in:Oncology letters Vol. 25; no. 2; p. 1
Main Authors: Kageyama, Susumu, Yoshida, Tetsuya, Kobayashi, Kenichi, Wada, Akinori, Nagasawa, Masayuki, Kubota, Shigehisa, Kusaba, Takuto, J, Fumiyasu, Nakagawa, Shota, Johnin, Kazuyoshi, Narita, Mitsuhiro, Kawauchi, Akihiro
Format: Journal Article
Language:English
Published: Athens Spandidos Publications 01-02-2023
Spandidos Publications UK Ltd
D.A. Spandidos
Subjects:
Albumin
Biomarkers
Bladder cancer
Cancer
Cancer patients
Cancer therapies
Carcinoma
Chemotherapy
Development and progression
Disease control
Hematology
Immunotherapy
Medical prognosis
Medical research
Medicine, Experimental
Metastasis
Monoclonal antibodies
Observational studies
Oncology
Patient outcomes
Prognosis
Response rates
Targeted cancer therapy
Tomography
Japan
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Summary:Pembrolizumab has been widely used to treat advanced urothelial carcinoma that has progressed after first-line platinum-based chemotherapy. Because its clinical benefits are limited, biomarkers that can predict a good response to pembrolizumab are required. The prognostic nutritional index (PNI), calculated using the serum albumin level and peripheral lymphocyte count, has been evaluated as a predictive biomarker in cancer immunotherapy. The present study investigated the application of PNI as a predictive biomarker for pembrolizumab response in patients with advanced urothelial cancer. A retrospective study was conducted on 34 patients treated with pembrolizumab at Shiga University of Medical Science Hospital between January 2018 and July 2022. The posttreatment PNI (post-PNI) was calculated within 2 months of starting pembrolizumab. The present study investigated the association between post-PNI and objective response, overall survival (OS) and progression-free survival (PFS). The patient cohort was stratified into two categories, high and low post-PNI groups, with a cutoff value of post-PNI at 40. The higher post-PNI group demonstrated a better disease control rate than the lower post-PNI group (complete response + partial response + stable disease, 75 vs. 21%, P=0.004). Regarding median OS, the higher post-PNI group exhibited a significantly longer survival time than the lower post-PNI group (23.1 vs. 2.9 months, P<0.001). Similarly, the higher post-PNI group exhibited a significantly longer PFS than the lower post-PNI group (10.2 vs.1.9 months, P<0.001). Multivariate analysis showed that a higher post-PNI value was an independent predictor for OS (hazard ratio, 0.04; 95% confidence interval, 0.01-0.14; P<0.001) and PFS (hazard ratio, 0.12; 95% confidence interval, 0.04-0.35; P<0.001). The present study indicated that the post-PNI was a predictor of favorable clinical outcomes in patients treated with pembrolizumab for advanced urothelial carcinoma. Key words: immunotherapy, oncological outcome, pembrolizumab, prognostic nutritional index, urothelial carcinoma
ISSN:1792-1074
1792-1082
DOI:10.3892/ol.2022.13635