The value of lymphocyte to monocyte ratio in the prognosis of head and neck squamous cell carcinoma: a meta-analysis.

Objectives: Although lymphocyte-monocyte ratio (LMR) is a potential prognostic biomarker in many tumor indications, a doubt occurs around its association with head and neck squamous cell carcinoma (HNSCC). We aimed to evaluate the predictive value of LMR in patients with HNSCC. Methods: We searched PubMed, Web of Science, EMBASE, and the Cochrane database from inception to May 8, 2023 for systematic review and meta-analysis on LMR and outcomes related to HNSCC development. STATA software was used to estimate the correlation between LMR and prognosis. The risk ratio (hazard ratio, HR) and 95% confidence interval l (CI) for overall survival (OS), disease-free survival (DFS), cancer-specific survival (CSS), and progression-free survival (PFS) were calculated, and the association between LMR and OS was further validated by subgroup analysis. The source of heterogeneity with the results of subgroup analysis was analyzed by meta-regression analysis. This meta-analysis was registered at PROSPERO (CRD42023418766). Results: After a comprehensive exploration, the results of 16 selected articles containing 5,234 subjects were evaluated. A raised LMR was connected to improved OS (HR = 1.36% CI [1.14-1.62] P = 0.018), DFS (HR = 0.942, 95% CI [0.631-1.382], P = 0.02), and PFS (HR = 0.932, 95% CI [0.527-1.589], P < 0.022). Subgroup analysis indicated that patients with a low LMR level had a poor prognosis with a critical value of ≥4. The LMR was found to be prognostic for cases with an LMR of <4. The meta-regression analysis showed that the cut-off values and treatment methods were the primary sources of high heterogeneity in patients with HNSCC. Conclusions: Our study suggested that an elevated LMR is a potential prognostic biomarker in patients with HNSCC and could be used to predict patient outcomes.

Efficacy of Cetuximab in Nasopharyngeal Carcinoma Patients Receiving Concurrent Cisplatin-Radiotherapy: A Meta-Analysis.

Background: Nasopharyngeal carcinoma (NPC) is a malignant neoplasm of the nasopharyngeal epithelium. Concurrent chemoradiotherapy has been established as a standard treatment for locoregional NPC, and cisplatin is a common agent in NPC treatment. Cetuximab is a monoclonal antibody against epidermal growth factor receptor. This meta-analysis was performed to evaluate the curative effectiveness and survival outcomes of cetuximab in NPC patients who received concurrent cisplatin-radiotherapy. Methods: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wan Fang, and China Biology Medicine disc (CBM) were used to search publications studying on concurrent chemoradiotherapy and/or cetuximab in NPC. The qualities of included RCTs were assessed by the Newcastle-Ottawa Scale. STATA 14.0 was used to conduct the statistical analysis. Results: In total, 17 trials with 2066 patients were included in this meta-analysis. The results from this study show that cetuximab improved the therapy efficacy in NPC patients who received concurrent cisplatin-radiotherapy. Cetuximab cotreatment improved the complete response (RR = 1.92, 95% CI [1.61, 2.30]), and reduced stable disease (RR = 0.67, 95% CI [0.51, 0.88]) as well as progression disease (RR = 0.24, 95% CI [0.15, 0.40]). Besides, it also improved the overall survival (RR = 1.10, 95% CI [1.02, 1.18]), disease-free survival (RR = 1.09, 95% CI [1.03, 1.15]), metastasis-free survival (RR = 1.06, 95% CI [1.01, 1.11]), and relapse-free survival (RR = 1.04, 95% CI [1.01, 1.07]) in NPC patients. Conclusions: Cetuximab could improve the curative efficacy and survival outcomes of NPC patients who underwent concurrent cisplatin-radiotherapy. However, all the trials included were conducted in China; thus, the quality of the trials in this study remains doubtful. More high-quality RCTs should be included in further relevant studies.