Aging leads to several changes concerning the immune system activity too. This process is known as “immunosenescence” and it can alter the immune response, especially T-cells response. However, there is lack of data about the response to immunotherapy regimen in elderly patients as well as a predictive factor of response. This retrospective study aims to evaluate the association between the lymphocytes/monocytes ratio (LMr) as a factor of better outcomes.
Data were collected in a single center, at University Hospital of Cagliari, from 2016 to 2022. Overall, 65 patients were enrolled. The median age was 77 (±5,6). 51 out of 65 (78%) were males, 14 were females (22%). As for pathology: 31 out 65 (47.7%) had lung cancer, 16/65 (24.6%) had melanoma, 11/65 (16,9%) had kidney cancer, and 7/65 (10,8%) had gastrointestinal carcinoma. All of patients underwent anti PD-1 therapy. ECOG PS were 0 and 1. Statistical analysis were performed through MedCalc package.
ROC curves were performed evaluating LMr in patients alive at 6, 12, and 24 months. All of them were significant for the cut-off of > 2.5 (p < 0.0001). Subsequently, we split patients into two subgroups: one harboring an LMr ≤ 2.5 and the other one an LMr > 2.5 (32 out 65 patients and 33 out of 65 patients had a ratio ≤ and > 2.5, respectively). Patients with ratio > 2.5 showed a statistically significant higher median OS (36 months, 95% CI 31 – 47) than patients with a ratio ≤ 2.5 (16 months, 95% CI 10-44) (p = 0.03).
The results showed a correlation between baseline higher LMr to better outcomes in patients undergoing treatment with Immune Checkpoint Inhibitors. LMr could be a simple efficient tool to predict a higher T-cells activity and a better response to immunotherapy. Further studies are needed to validate it.
The authors.
Has not received any funding.
E. Lai: Financial Interests, Personal, Advisory Board: AstraZeneca, MSD. M. Scartozzi: Financial Interests, Personal, Advisory Board: Amgen, Sanofi, MSD, EISAI, Merck, Bayer; Financial Interests, Personal, Speaker’s Bureau: Amgen, Sanofi, MSD, EISAI, Merck, Bayer. All other authors have declared no conflicts of interest.