Research on ovarian cancer (OC) is considerably neglected in Morocco. OVANORDEST (“OVAire dans le NORD-EST” (ovarian cancer in North-East of Morocco)) is a three-steps research project that aims to develop clinical research on this aggressive women's cancer for the first time in Morocco. This abstract is a biomarker analysis of affordable predictive and prognostic biomarkers based on systemic inflammatory response previously described in the hallmarks of cancer. This includes lymphocyte to monocyte (LMR), neutrophil to lymphocyte (NLR), and platelet to lymphocyte ratios (PLR) as available biomarkers for under-resourced settings to predict outcomes in OC.
We have first appraised all available meta-analyses that investigated the predictive value of these three biomarkers for overall survival using an umbrella systematic review (El Bairi et al. Front Oncol, 2021; PROSPERO: CRD42020201493). We further developed a real-world cohort of OC patients at the Mohammed VI University Hospital during the period 2005-2020. ROC (receiver operating characteristic) and Cox regression models were used to study the predictive impact of selected biomarkers.
This retrospective study enrolled 250 cases of histologically confirmed epithelial OC with available data on the three biomarkers used. On univariable analysis, LMR, NLR, and PLR were all associated with overall survival (p <0.001). which was confirmed on multivariable analysis. In fact, patients with an LMR>3 had higher median overall survival (mOS) (31 vs. 23 months) (HR= 1.62; 95% CI: 1.00-2.6; p = 0.04) and those with an NLR<1.6 had also superior mOS (50 vs. 20 months) (HR= 2.04; 95% CI: 1.25-3.35; p = 0.0043). Similarly, OC patients with a PLR <134.2 had favourable mOS (49 vs.21 months; HR= 1.66; 95% CI: 1.07-2.58; p = 0.02).
These encouraging results on the prognostic value of peripheral immune response on OS were supportive of OVANORDEST-2 that will validate these findings using a prospective study to develop a prognostic nomogram.
The authors.
Has not received any funding.
All authors have declared no conflicts of interest.