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. 2024 Jan 23:14:1293680.
doi: 10.3389/fonc.2024.1293680. eCollection 2024.

Prognostic value of platelet-to-lymphocyte ratio in patients with unresectable hepatocellular carcinoma undergoing transarterial chemoembolization and tyrosine kinase inhibitors plus immune checkpoints inhibitors

Yiwan Guo #  1 , Wenlong Wu #  2 , Bo Sun #  2 , Tingting Guo  1 , Keke Si  1 , Chuansheng Zheng  1 , Xin Li  1
Affiliations

Prognostic value of platelet-to-lymphocyte ratio in patients with unresectable hepatocellular carcinoma undergoing transarterial chemoembolization and tyrosine kinase inhibitors plus immune checkpoints inhibitors

Yiwan Guo et al. Front Oncol. .

Abstract

Purpose: To investigate the prognostic value of platelet-to-lymphocyte ratio (PLR) in patients with unresectable hepatocellular carcinoma (uHCC) treated with transarterial chemoembolization (TACE) and tailored tyrosine kinase inhibitors (TKIs) plus immune checkpoints inhibitors (ICIs).

Materials and methods: Ninety-eight patients from May 2018 to January 2022 in our hospital were enrolled in this study. The receiver operating characteristic (ROC) curve analysis was performed and the corresponding Youden index was used to determine the optimal PLR cut-off. Overall survival (OS), progression-free survival (PFS), and adverse events (AEs) of patients were evaluated based on the PLR cut-off. The factors affecting survival were assessed using univariate and multivariate Cox proportional hazards regression analyses.

Results: The PLR cut-off was 98.89. There were 49 patients in the low pretreatment PLR group (PLR ≤ 98.89) and 49 patients in the high PLR group (PLR > 98.89). Patients with low pretreatment PLR had significantly longer median OS (25.7 months vs 16.1 months; P < 0.001) and PFS (14.9 months vs 10.2 months; P < 0.001) than those with high pretreatment PLR. The multivariate analysis revealed that ALT, tumor size, and PLR are risk factors affecting OS. The three independent factors affecting PFS are tumor size, AFP, and PLR. The AEs were tolerable and manageable.

Conclusion: The low pretreatment PLR (PLR ≤ 98.89) was an independent protective factor for the survival outcomes of patients in this study. PLR was helpful for clinicians to predict the prognosis and identify the patients with uHCC who were most likely to benefit from TACE + TKIs + ICIs.

Keywords: hepatocellular carcinoma; immune checkpoint inhibitors; platelet-to-lymphocyte ratio; tailored tyrosine kinase inhibitors; transarterial chemoembolization.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Receiver operating characteristic curve analysis was performed to determine the optimal cut-off for PLR. The cut-off was 98.89. PLR, platelet-to-lymphocyte ratio.
Figure 3
Figure 3
Kaplan-Meire (K-M) curves of two groups. (A) K-M curve for overall survival (OS); (B) K-M curve for progression-free survival (PFS).
See this image and copyright information in PMC

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