Evidence map›Paper›PMID 34103355›Full record

ArticleJournal for immunotherapy of cancer2021

On-treatment immune prognostic score for patients with relapsed and/or metastatic head and neck squamous cell carcinoma treated with immunotherapy.

Pablo Nenclares, Lucinda Gunn, Heba Soliman, Mateo Bover, Amy Trinh, Isla Leslie, Kee Howe Wong, Alan Melcher, Kate Newbold, Chris M Nutting and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal for immunotherapy of cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 4 pooled it
3.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 42 citations in OpenAlex.

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  16. Fibrinogen and tumors.Frontiers in oncology · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 2 countries.

Pablo NenclaresHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK pablo.nenclares@icr.ac.uk.ORCID 0000-0002-1750-3179
Lucinda GunnHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Heba SolimanHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Mateo BoverHead and Neck Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
Amy TrinhHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Isla LeslieHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Kee Howe WongHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Alan MelcherHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Kate NewboldHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Chris M NuttingHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Derfel Ap DafyddHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Shreerang A BhideHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.
Kevin HarringtonHead and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK.ORCID 0000-0002-6014-348X
Royal Marsden Hospital · GBInstitute of Cancer Research · GBHospital Universitario 12 De Octubre · ES

Funding

Cancer Research UK 28724
6 · The paper itself

Abstract

backgroundPrevious studies have suggested that inflammatory markers (neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH) and fibrinogen) are prognostic biomarkers in patients with a variety of solid cancers, including those treated with immune checkpoint inhibitors (ICIs). We aimed to develop a model that predicts response and survival in patients with relapsed and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with immunotherapy.

methodsAnalysis of 100 consecutive patients with unresectable R/M HNSCC who were treated with ICI. Baseline and on-treatment (day 28) NLR, fibrinogen and LDH were calculated and correlated with response, progression-free survival (PFS) and overall survival (OS) using univariate and multivariate analyses. The optimal cut-off values were derived using maximally selected log-rank statistics.

resultsLow baseline NLR and fibrinogen levels were associated with response. There was a statistically significant correlation between on-treatment NLR and fibrinogen and best overall response. On-treatment high NLR and raised fibrinogen were significantly associated with poorer outcome. In multivariate analysis, on-treatment NLR (≥4) and on-treatment fibrinogen (≥4 ng/mL) showed a significant negative correlation with OS and PFS. Using these cut-off points, we generated an on-treatment score for OS and PFS (0-2 points). The derived scoring system shows appropriate discrimination and suitability for OS (HR 2.4, 95% CI 1.7 to 3.4, p<0.0001, Harrell's C 0.67) and PFS (HR 1.8, 95% CI 1.4 to 2.3, p<0.0001, Harrell's C 0.68). In the absence of an external validation cohort, results of fivefold cross-validation of the score and evaluation of median OS and PFS on the Kaplan-Meier survival distribution between trained and test data exhibited appropriate accuracy and concordance of the model.

conclusionsNLR and fibrinogen levels are simple, inexpensive and readily available biomarkers that could be incorporated into an on-treatment scoring system and used to help predict survival and response to ICI in patients with R/M HNSCC.

Indexed as

AdultAgedAged, 80 and overFemaleHumansImmunotherapyMaleMiddle AgedNeoplasm MetastasisPrognosisRecurrenceSquamous Cell Carcinoma of Head and Neckbiomarkershead and neck neoplasmsimmunotherapytumor

Identifiers

PMID34103355
PMCPMC8190047
OpenAlexW3171893145

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.