Naples prognostic score may predict overall survival in metastatic pancreatic cancer.

INTRODUCTION: Naples prognostic score (NPS) based on nutritional and inflammatory parameters can predict response to chemotherapy and overall survival (OS) in many cancer types. However, its significance in metastatic pancreatic cancer (PC) remains unclear. We evaluated the prognostic significance of the NPS in patients with metastatic PC receiving first line chemotherapy. METHODS: We retrospectively analyzed 215 patients with metastatic PC receiving first line FOLFIRINOX chemotherapy. NPS's were calculated using pre-chemotherapy laboratory data. Patients were divided into three groups according to their scores (NPS: 0; 1 & 2; 3 & 4 were grouped as 1, 2 and 3, respectively). The association of NPS with clinicopathological features and OS were evaluated. RESULTS: Median age was 64 years, and median OS was 10.5 months. Hemoglobin levels were lower and Ca-19-9 values were higher with increasing NPS. Frequency of patients with bone and/or liver metastases, and with greater than 5 metastatic focus were higher in group 3. A lower NPS was associated with longer OS. The median OS in groups 1, 2, and 3 were 19.5, 12, and 8 months, respectively, and differed significantly. Univariate analysis revealed effect of NPS (3-4) on OS (HR: 2.38, 1.77-3.19). Other prognostic factors affecting OS were age, ECOG, liver, bone or lymph node metastases, number of metastatic foci (<5 vs >5), de-novo metastatic disease, and serum Ca-19-9 levels. NPS (3-4) was identified as an independent prognostic factor negatively affecting OS (HR: 1.89, 1.34-2.65) in multivariate analysis. CONCLUSION: NPS may be a useful prognostic marker for the prediction of OS in metastatic PC patients receiving systemic chemotherapy.

Prognostic importance of SUVmax values evaluated by 18F-FDG-PET/CT before nivolumab treatment in patients with metastatic renal cell carcinoma.

BACKGROUND: Nivolumab is a monoclonal antibody that binds to the programmed death-1 (PD-1) receptor and blocks its interaction with PD-L1 and PD-L2. High response rates have been achieved with its use in the treatment of metastatic renal cell carcinoma (mRCC). We aimed to determine a relationship between 18-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography/Computed Tomography (18F-FDG-PET/CT) performed before nivolumab treatment and treatment-related survival. METHODS: Between 2014 and 2021, 32 patients who received nivolumab and had pre-treatment 18F-FDG-PET/CT evaluation were included in this retrospective study. The total SUVmax (sum of SUVmax) of all tumoral foci and the lesion with the highest SUVmax value were recorded. The relationship of these values with progression-free survival (PFS) and overall survival (OS) was evaluated. RESULTS: The median highest SUVmax and sum of SUVmax values were found as 14.4 and 41.4, respectively. PFS and OS were longer in the group with a sum of SUVmax value below 41.4 compared to the group with a higher group (OS, median 9.52 vs. 4.2 months [P=0.018]; PFS, median 9.6 vs. 3 months [P=0.003], respectively). In the group with the highest SUVmax value below 14.4, PFS was evaluated as statistically significant compared to the higher group (PFS, median 16.74 vs. 3.3 months [P=0.004]), while OS was not found to be statistically significant (OS, median 25.45 vs. 16.74 months (P=0.110)). CONCLUSIONS: Our study showed that there might be a relationship between SUVmax values and PFS and OS. The SUVmax values before nivolumab treatment can be used to predict prognosis and survival in mRCC patients.

Evaluation of predictive factors in patients with bladder cancer undergoing atezolizumab treatment: Case reports.

This series consists of three cases. Clinical features and pathological characteristics, expression of tumor-infiltrating lymphocytes (TIL), TIL-PD-L1 expression, microsatellite instability (MSI), and programmed death-ligand (PD-L1) were evaluated for predicting response to immunotherapy in patients receiving atezolizumab for advanced bladder cancer. Tumor PDL-1 level was 80% in case 1; however, PDL-1 level was detected as 0% in other cases. TIL PDL-1 level was 5% in the first case, and 1% and 0% in the second and third cases, respectively. TIL density was higher in the first case than in the other two cases. MSI was not detected in any of the cases. With atezolizumab treatment, the radiologic response was obtained only in the first case and progression free survival (PFS) lasting 8 months was detected. In the other two cases, there was no response with atezolizumab and the disease progressed. When the clinical factors (performance status, hemoglobin level, presence of liver metastases, and response time to platinum regimen) predicting the response to the second series of treatments were evaluated, patients had a risk factor of 0, 2, and 3, respectively. The overall survival of the cases was determined as 28, 11, and 11 months, respectively. In our study, when compared with the other cases, the first case reported a higher PD-L1, higher TIL PD-L1 level, higher TIL density, and low clinical risk factors and had longer survival with atezolizumab.