Simple Summary High NLR, PLR, and SII are associated with worse PFS in second-line STS patients. Trabectedin-treated patients have a better PFS when LMR is low, while patients treated with other regimens have a worse PFS when LMR is low. Patients showing a high LMR seem to have high levels of M2 intratumoral macrophages. A second-line standard of treatment has not yet been identified in patients with soft tissue sarcomas (STS), so identifying predictive markers could be a valuable tool. Recent studies have shown that the intratumoral and inflammatory systems significantly influence tumor aggressiveness. We aimed to investigate prognostic values of pre-therapy neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory index (SII), progression-free survival (PFS), and overall survival (OS) of STS patients receiving second-line treatment. In this single-center retrospective analysis, ninety-nine patients with STS were enrolled. All patients received second-line treatment after progressing to anthracycline. PFS and OS curves were calculated using the Kaplan-Meier method of RNA sequencing, and CIBERSORT analysis was performed on six surgical specimens of liposarcoma patients. A high NLR, PLR, and SII were significantly associated with worse PFS (p = 0.019; p = 0.004; p = 0.006). Low LMR was significantly associated with worse OS (p = 0.006). Patients treated with Trabectedin showed a better PFS when the LMR was low, while patients treated with other regimens showed a worse PFS when the LMR was low (p = 0.0154). The intratumoral immune infiltrates analysis seems to show a correlation between intratumoral macrophages and LMR. PS ECOG. The metastatic onset and tumor burden showed prognostic significance for PFS (p = 0.004; p = 0.041; p = 0.0086). According to the histologies, PFS was: 5.7 mo in liposarcoma patients vs. 3.8 mo in leiomyosarcoma patients vs. 3.1 months in patients with other histologies (p = 0.053). Our results confirm the prognostic role of systemic inflammatory markers in patients with STS. Moreover, we demonstrated that LMR is a specific predictor of Trabectedin efficacy and could be useful in daily clinical practice. We also highlighted a possible correlation between LMR levels and the percentage of intratumoral macrophages.

Systemic Inflammatory Indices in Second-Line Soft Tissue Sarcoma Patients: Focus on Lymphocyte/Monocyte Ratio and Trabectedin / Fausti, Valentina; De Vita, Alessandro; Vanni, Silvia; Ghini, Virginia; Gurrieri, Lorena; Riva, Nada; Casadei, Roberto; Maraldi, Marco; Ercolani, Giorgio; Cavaliere, Davide; Pacilio, Carlo Alberto; Pieri, Federica; Foca, Flavia; Bongiovanni, Alberto; Ranallo, Nicoletta; Calpona, Sebastiano; Frassineti, Giovanni Luca; Ibrahim, Toni; Mercatali, Laura. - In: CANCERS. - ISSN 2072-6694. - ELETTRONICO. - 15:4(2023), pp. 1080.1-1080.17. [10.3390/cancers15041080]

Systemic Inflammatory Indices in Second-Line Soft Tissue Sarcoma Patients: Focus on Lymphocyte/Monocyte Ratio and Trabectedin

Fausti, Valentina;De Vita, Alessandro;Gurrieri, Lorena;Ercolani, Giorgio;Pacilio, Carlo Alberto;Ranallo, Nicoletta;Mercatali, Laura
2023

Abstract

Simple Summary High NLR, PLR, and SII are associated with worse PFS in second-line STS patients. Trabectedin-treated patients have a better PFS when LMR is low, while patients treated with other regimens have a worse PFS when LMR is low. Patients showing a high LMR seem to have high levels of M2 intratumoral macrophages. A second-line standard of treatment has not yet been identified in patients with soft tissue sarcomas (STS), so identifying predictive markers could be a valuable tool. Recent studies have shown that the intratumoral and inflammatory systems significantly influence tumor aggressiveness. We aimed to investigate prognostic values of pre-therapy neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory index (SII), progression-free survival (PFS), and overall survival (OS) of STS patients receiving second-line treatment. In this single-center retrospective analysis, ninety-nine patients with STS were enrolled. All patients received second-line treatment after progressing to anthracycline. PFS and OS curves were calculated using the Kaplan-Meier method of RNA sequencing, and CIBERSORT analysis was performed on six surgical specimens of liposarcoma patients. A high NLR, PLR, and SII were significantly associated with worse PFS (p = 0.019; p = 0.004; p = 0.006). Low LMR was significantly associated with worse OS (p = 0.006). Patients treated with Trabectedin showed a better PFS when the LMR was low, while patients treated with other regimens showed a worse PFS when the LMR was low (p = 0.0154). The intratumoral immune infiltrates analysis seems to show a correlation between intratumoral macrophages and LMR. PS ECOG. The metastatic onset and tumor burden showed prognostic significance for PFS (p = 0.004; p = 0.041; p = 0.0086). According to the histologies, PFS was: 5.7 mo in liposarcoma patients vs. 3.8 mo in leiomyosarcoma patients vs. 3.1 months in patients with other histologies (p = 0.053). Our results confirm the prognostic role of systemic inflammatory markers in patients with STS. Moreover, we demonstrated that LMR is a specific predictor of Trabectedin efficacy and could be useful in daily clinical practice. We also highlighted a possible correlation between LMR levels and the percentage of intratumoral macrophages.
2023
Systemic Inflammatory Indices in Second-Line Soft Tissue Sarcoma Patients: Focus on Lymphocyte/Monocyte Ratio and Trabectedin / Fausti, Valentina; De Vita, Alessandro; Vanni, Silvia; Ghini, Virginia; Gurrieri, Lorena; Riva, Nada; Casadei, Roberto; Maraldi, Marco; Ercolani, Giorgio; Cavaliere, Davide; Pacilio, Carlo Alberto; Pieri, Federica; Foca, Flavia; Bongiovanni, Alberto; Ranallo, Nicoletta; Calpona, Sebastiano; Frassineti, Giovanni Luca; Ibrahim, Toni; Mercatali, Laura. - In: CANCERS. - ISSN 2072-6694. - ELETTRONICO. - 15:4(2023), pp. 1080.1-1080.17. [10.3390/cancers15041080]
Fausti, Valentina; De Vita, Alessandro; Vanni, Silvia; Ghini, Virginia; Gurrieri, Lorena; Riva, Nada; Casadei, Roberto; Maraldi, Marco; Ercolani, Giorgio; Cavaliere, Davide; Pacilio, Carlo Alberto; Pieri, Federica; Foca, Flavia; Bongiovanni, Alberto; Ranallo, Nicoletta; Calpona, Sebastiano; Frassineti, Giovanni Luca; Ibrahim, Toni; Mercatali, Laura
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/961494
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