Trends in Systemic Inflammatory Reaction (SIR) during Paclitaxel and Carboplatin Chemotherapy in Women Suffering from Epithelial Ovarian Cancer

SIMPLE SUMMARY: Epithelial ovarian cancer remains the most fatal gynaecological malignancy, and cytoreductive surgery followed by adjuvant taxane-platinum-based chemotherapy remains the core therapy for women suffering from this cancer. The systemic inflammatory response plays a dual role in the pathophysiology of neoplastic diseases, activating the cytotoxic immune response against cancer cells and contributing to the progression of the disease via inflammatory mediators, including cytokines and growth factors. Increased systemic inflammatory markers at the time of cancer diagnosis are associated with advanced stage and tumour grade and predict poor survival; however, only a few studies have investigated changes in inflammatory markers during anti-cancer treatment in the context of clinical and pathological cancer features as well as applied therapies. In this study, we aimed to investigate the trends in changes in inflammatory markers in women with ovarian cancer receiving standard first-line adjuvant chemotherapy and identify the potential factors influencing these changes. ABSTRACT: Background: Epithelial ovarian cancer (EOC) is the most fatal gynaecological malignancy treated with cytoreductive surgery followed by adjuvant taxane-platinum-based chemotherapy. It has been shown that the pretreatment systemic inflammatory reaction (SIR) in women with OC can be evaluated using the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) and systemic inflammatory index (SII), depending on the stage of disease, and has prognostic value for overall survival. The aim of this study was to evaluate the changes in NLR, LMR, PLR and SII during chemotherapy. Methods: A total of 107 women with EOC (23 with type I and 84 with type II tumours) were included in a retrospective single-centre analysis. The Kologomorov−Smirnoff, Kruskal-Wallis or Friedman analysis of variance tests were used for data analysis, and a p value of 0.05 was considered statistically significant. Results: A significant decrease in NLR, PLR and SII but not LMR was observed during adjuvant treatment. Pretreatment NLR, PLR and SII were dependent on disease stage and tumour grade; however, this association was lost during therapy. Additionally, strong and positive mutual correlations between NLR, LMR, PLR and SII were sustained during the whole course of chemotherapy. Conclusions: During first-line adjuvant chemotherapy in women with EOC, a decrease in SIR is confirmed.