Pre-treatment pan-immune-inflammation value as a prognostic marker of pazopanib in soft tissue sarcoma

Cheng-Han Wu; Cheng-Lun Lai; Yong-Chen Hsu; Chiann-Yi Hsu; Yu-Chao Wang; Hsin-Chen Lin

doi:10.1177/17588359241292255

Pre-treatment pan-immune-inflammation value as a prognostic marker of pazopanib in soft tissue sarcoma

Ther Adv Med Oncol. 2024 Oct 28:16:17588359241292255. doi: 10.1177/17588359241292255. eCollection 2024.

Authors

Cheng-Han Wu^{1

2}, Cheng-Lun Lai¹, Yong-Chen Hsu³, Chiann-Yi Hsu⁴, Yu-Chao Wang², Hsin-Chen Lin^{5

6}

Affiliations

¹ Division of Medical Oncology, Department of Oncology, Taichung Veterans General Hospital, Taichung, Taiwan.
² Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan.
³ Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan.
⁴ Biostatistics Task Force, Taichung Veterans General Hospital, Taichung, Taiwan.
⁵ Division of Medical Oncology, Department of Oncology, Taichung Veterans General Hospital, Taichung 407219, Taiwan.
⁶ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan.

Abstract

Background: Increasingly, more evidence has shown that inflammation stress and the tumor microenvironment pose a negative effect on targeted therapy. The neutrophil-to-lymphocyte ratio is considered to be a surrogate biomarker of inflammation and can predict pazopanib treatment effect in non-adipocytic soft-tissue sarcoma (STS). The role of the pan-immune-inflammation value (PIV) in STS is still yet to be determined.

Objectives: We sought whether the pre-treatment PIV could be applied to predict the response of pazopanib in STS.

Design: We conducted a retrospective analysis of 75 patients who had been treated with pazopanib for recurrent or metastatic non-adipocytic STS.

Methods: Our cohort was stratified into either a pre-treatment high PIV group with PIV ⩾310 (n = 45) or a low PIV group with PIV <310 (n = 30). We compared their clinical features and outcomes. Cox regression analysis was employed to determine the risk factors of disease progression and mortality. Kaplan-Meier survival curves were utilized to assess both the progression-free survival (PFS) and overall survival (OS).

Results: The results revealed that a pre-treatment high PIV (⩾310) is a risk factor for progression under pazopanib (hazard ratio: 1.91; 95% confidence interval: 1.08-3.36; p = 0.025). The median PFS and OS of the pre-treatment high PIV group were found to be significantly lower than the low PIV group (0.33 vs 0.75 years; p = 0.023, 0.46 vs 1.63 years; p = 0.025).

Conclusion: High pre-treatment PIV in STS patients may indicate an elevated risk of disease progression and mortality. Pre-treatment PIV reflects inflammation stress and acts as a practical biomarker for STS patients treated with pazopanib.

Keywords: pan-immune-inflammation value; pazopanib; sarcoma.