Cargando…

The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer

Malnutrition is a frequent comorbidity in head and neck cancer patients and has been shown to impair immunotherapy response in other cancer types. The geriatric nutritional risk index (GNRI) assesses malnutrition using the patient’s ideal weight, actual weight, and serum albumin. The aim of this stu...

Descripción completa

Detalles Bibliográficos
Autores principales: Haas, Markus, Lein, Alexander, Fuereder, Thorsten, Brkic, Faris F., Schnoell, Julia, Liu, David T., Kadletz-Wanke, Lorenz, Heiduschka, Gregor, Jank, Bernhard J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961934/
https://www.ncbi.nlm.nih.gov/pubmed/36839241
http://dx.doi.org/10.3390/nu15040880
_version_ 1784895878317735936
author Haas, Markus
Lein, Alexander
Fuereder, Thorsten
Brkic, Faris F.
Schnoell, Julia
Liu, David T.
Kadletz-Wanke, Lorenz
Heiduschka, Gregor
Jank, Bernhard J.
author_facet Haas, Markus
Lein, Alexander
Fuereder, Thorsten
Brkic, Faris F.
Schnoell, Julia
Liu, David T.
Kadletz-Wanke, Lorenz
Heiduschka, Gregor
Jank, Bernhard J.
author_sort Haas, Markus
collection PubMed
description Malnutrition is a frequent comorbidity in head and neck cancer patients and has been shown to impair immunotherapy response in other cancer types. The geriatric nutritional risk index (GNRI) assesses malnutrition using the patient’s ideal weight, actual weight, and serum albumin. The aim of this study was to evaluate the prognostic relevance of malnutrition as determined by the GNRI for the response to immunotherapy in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). A total of 162 patients with R/M HNSCC who received immune checkpoint inhibitors were included. The associations between the GNRI and progression-free survival (PFS), overall survival (OS), and the disease control rate (DCR) were computed. Univariable analysis showed worse PFS for GNRI ≤ 98 (p < 0.001), ECOG performance status (PS) ≥ 2 (p = 0.012), and enteral (p = 0.009) and parenteral (p = 0.015) nutritional supplementation, and worse OS for GNRI < 92 (p < 0.001), ECOG PS ≥ 2 (p < 0.001), and enteral (p = 0.008) and parenteral (p = 0.023) nutritional supplementation. In our multivariable model, GNRI ≤ 98 (p = 0.012) and ECOG PS ≥ 2 (p = 0.025) were independent prognostic factors for PFS. For OS, GNRI < 92 (p < 0.001) and ECOG PS ≥ 2 (p < 0.001) were independent prognostic factors. A GNRI ≤ 98 was significantly associated with a lower DCR compared to a GNRI > 98 (p = 0.001). In conclusion, our findings suggest that the GNRI may be an effective predictor for response to immunotherapy in R/M HNSCC.
format Online
Article
Text
id pubmed-9961934
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99619342023-02-26 The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer Haas, Markus Lein, Alexander Fuereder, Thorsten Brkic, Faris F. Schnoell, Julia Liu, David T. Kadletz-Wanke, Lorenz Heiduschka, Gregor Jank, Bernhard J. Nutrients Article Malnutrition is a frequent comorbidity in head and neck cancer patients and has been shown to impair immunotherapy response in other cancer types. The geriatric nutritional risk index (GNRI) assesses malnutrition using the patient’s ideal weight, actual weight, and serum albumin. The aim of this study was to evaluate the prognostic relevance of malnutrition as determined by the GNRI for the response to immunotherapy in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). A total of 162 patients with R/M HNSCC who received immune checkpoint inhibitors were included. The associations between the GNRI and progression-free survival (PFS), overall survival (OS), and the disease control rate (DCR) were computed. Univariable analysis showed worse PFS for GNRI ≤ 98 (p < 0.001), ECOG performance status (PS) ≥ 2 (p = 0.012), and enteral (p = 0.009) and parenteral (p = 0.015) nutritional supplementation, and worse OS for GNRI < 92 (p < 0.001), ECOG PS ≥ 2 (p < 0.001), and enteral (p = 0.008) and parenteral (p = 0.023) nutritional supplementation. In our multivariable model, GNRI ≤ 98 (p = 0.012) and ECOG PS ≥ 2 (p = 0.025) were independent prognostic factors for PFS. For OS, GNRI < 92 (p < 0.001) and ECOG PS ≥ 2 (p < 0.001) were independent prognostic factors. A GNRI ≤ 98 was significantly associated with a lower DCR compared to a GNRI > 98 (p = 0.001). In conclusion, our findings suggest that the GNRI may be an effective predictor for response to immunotherapy in R/M HNSCC. MDPI 2023-02-09 /pmc/articles/PMC9961934/ /pubmed/36839241 http://dx.doi.org/10.3390/nu15040880 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Haas, Markus
Lein, Alexander
Fuereder, Thorsten
Brkic, Faris F.
Schnoell, Julia
Liu, David T.
Kadletz-Wanke, Lorenz
Heiduschka, Gregor
Jank, Bernhard J.
The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer
title The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer
title_full The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer
title_fullStr The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer
title_full_unstemmed The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer
title_short The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer
title_sort geriatric nutritional risk index (gnri) as a prognostic biomarker for immune checkpoint inhibitor response in recurrent and/or metastatic head and neck cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961934/
https://www.ncbi.nlm.nih.gov/pubmed/36839241
http://dx.doi.org/10.3390/nu15040880
work_keys_str_mv AT haasmarkus thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT leinalexander thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT fuerederthorsten thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT brkicfarisf thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT schnoelljulia thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT liudavidt thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT kadletzwankelorenz thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT heiduschkagregor thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT jankbernhardj thegeriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT haasmarkus geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT leinalexander geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT fuerederthorsten geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT brkicfarisf geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT schnoelljulia geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT liudavidt geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT kadletzwankelorenz geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT heiduschkagregor geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer
AT jankbernhardj geriatricnutritionalriskindexgnriasaprognosticbiomarkerforimmunecheckpointinhibitorresponseinrecurrentandormetastaticheadandneckcancer