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Updated: Jun 18, 2026
Multiplexed Immunofluorescence Analysis and Quantification of Intratumoral PD-1+ Tim-3+ CD8+ T Cells
Published on: February 8, 2018
Pretreatment hyperferritinaemia as an independent prognostic marker in metastatic solid tumors treated with immune
Fatma Pinar Açar1, Caner Acar1, Haydar Çağatay Yüksel1
1Department of Medical Oncology, Ege University Medical Faculty, Izmir, Turkey.
Background:
Hyperferritinaemia is common in cancer and may reflect tumor-associated macrophage activity and ferroptosis resistance, yet its prognostic value during immune checkpoint inhibitor (ICI) therapy is uncertain.
Methods:
We retrospectively analyzed 262 patients with metastatic solid tumors treated with ICIs (January 2015-September 2024). An optimal serum ferritin (SF) cutoff stratified patients into low (<500 ng/mL) vs high (>500 ng/mL) groups. Outcomes were compared between SF groups, and SF was compared with other inflammatory markers - the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and C-reactive protein (CRP).
Results:
Median overall survival (OS) was 6.0 months for high SF vs 23.9 months for low SF; median progression-free survival (PFS) was 2.7 vs 6.4 months (both p < 0.001). High SF independently predicted worse OS (hazard ratio [HR] 2.17) and PFS (HR 1.73). Subgroup interactions were largely non-significant; only age >65 years moderated the OS association (interaction p = 0.035). Across metrics, SF showed the highest C-indices and superior 12-, 24-, and 36-month OS area under the curve (AUC) values compared with NLR, PLR, LMR, and CRP.
Conclusions:
Pretreatment hyperferritinaemia is an inexpensive, readily available biomarker that outperforms conventional inflammatory indices in predicting poor survival and diminished ICI benefit across diverse metastatic solid tumors.
