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Lymphocyte-Monocyte Ratio Predicts Survival in Patients With Unresectable Hepatocellular Carcinoma Treated With
Tatsuya Sakane1, Toshifumi Tada1, Hiroshi Tei2
1Division of Gastroenterology, Kobe University Graduate School of Medicine, Hyogo, Japan.
Aim:
To investigate whether lymphocyte-to-monocyte ratio (LMR) can predict outcomes in patients with unresectable hepatocellular carcinoma (HCC) treated with durvalumab plus tremelimumab (Dur/Tre).
Methods:
A total of 70 patients with unresectable HCC treated with Dur/Tre were included. Survival and adverse events were analyzed in this cohort.
Results:
The median progression-free survival (PFS) was 2.8 months (95% confidence interval [CI]: 2.1-8.8) and the median overall survival (OS) was 16.2 months (95% CI: 11.1-not reached [NR]). PFS and OS in the low/high LMR group were 2.3 (95% CI: 1.6-3.8)/3.3 (95% CI: 2.4-6.9) months (p = 0.042) and 11.4 (95% CI: 4.5-NR)/NR (95% CI: 16.2-NR) months (p = 0.001), respectively. The hazard ratio (HR) for PFS in the high LMR group, adjusted for inverse probability weighting (IPW), was 0.556 (95% CI: 0.285-1.084, p = 0.085), and the HR for OS was 0.155 (95% CI: 0.045-0.538, p = 0.003). The distribution of response was 2.9% for complete response, 20.0% for partial response, 28.6% for stable disease, and 37.1% for progressive disease, with no significant difference by LMR. Regarding adverse events, immune-related liver injury of any grade differed significantly among patients with low and high LMR. HR spline curve analysis for OS showed that when LMR ranged from approximately 2.5-4.0, the upper limit of the 95% CI remained at or below 1.
Conclusions:
LMR can predict outcomes in patients with unresectable HCC treated with Dur/Tre. An appropriate LMR cutoff for predicting OS ranges from approximately 2.5-4.0.
