The Influence of Circulating Immune Cell and CA125 Dynamics on Neoadjuvant Therapy Selection for Advanced Ovarian Cancer

• Published in: Medicina (Kaunas, Lithuania) Vol. 60; no. 8; p. 1290
• Main Authors: Lazar, Alexandra, Popa, Ana Maria, Orlov-Slavu, Cristina, Cotan, Horia-Teodor, Iaciu, Cristian Ion, Olaru, Cristina Mihaela, Schreiner, Oliver Daniel, Ciobanu, Romeo Cristian, Nitipir, Cornelia
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 09.08.2024; MDPI
• Subjects: Adjuvant treatment; Adult; Aged; baseline NLR; Biomarkers; CA-125 Antigen - blood; Cancer; Cancer therapies; circulating immune cell; Cytoreduction Surgical Procedures - methods; Development and progression; Endometrial cancer; Female; Humans; Lymphocytes; Middle Aged; neoadjuvant therapy; Neoadjuvant Therapy - methods; Neutrophils; Ovarian cancer; Ovarian Neoplasms - blood; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - therapy; post-therapeutic NLR; Prognosis; Retrospective Studies; Romania; circulating immune cell; ovarian cancer; neoadjuvant therapy; baseline NLR; post-therapeutic NLR
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60081290

Ovarian cancer, including tubal and peritoneal cancer, is the third most common gynecological cancer and the leading cause of death from gynecological malignancies in developed countries. This study explores the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in determining the optimal duration of neoadjuvant chemotherapy (NACT) for advanced ovarian cancer. It also investigates the correlation between NLR dynamics and the KELIM score, a chemosensitivity marker, to enhance individualized therapeutic strategies. A total of 79 patients underwent NACT followed by interval debulking surgery (IDS) or palliative care. The data collected included demographic information, tumor characteristics, treatment modalities, and laboratory parameters. The baseline NLR (NLR-T0) and post-therapeutic NLR (NLR-T1) were calculated, and their variation (NLR∆) was analyzed. The KELIM score was determined using CA-125 values. Patients with a high baseline NLR (≥2.5) had significantly worse progression-free survival (PFS) and overall survival (OS) compared to those with a low NLR (<2.5). A negative NLR∆ was associated with poorer PFS and OS. The KELIM score indicated a more effective treatment response, with higher scores correlating with better outcomes. The majority of patients achieved R0 resection, and those with favorable KELIM scores showed improved survival rates. The NLR is a valuable prognostic marker for assessing treatment response and guiding NACT duration in advanced ovarian cancer.