Prognostic value of inflammation‑ and nutrition‑based biomarkers in patients with recurrent or metastatic oral squamous cell carcinoma treated with immune checkpoint inhibitors: A retrospective study

The prognostic value of inflammation‑ and nutrition-based biomarkers in oral squamous cell carcinoma (OSCC) remains unclear. The present study evaluated the prognostic significance of these biomarkers in patients with recurrent or metastatic OSCC (R/M‑OSCC) undergoing immune checkpoint inhibitor (ICI) therapy. The retrospective study analyzed 45 patients with R/M‑OSCC who were treated with ICIs at Hiroshima University Hospital (Hiroshima, Japan) between October 2017 and December 2024. Clinical and treatment data were collected alongside inflammation‑based prognostic scores (IBPSs). These biomarkers were calculated prior to and 4‑6 weeks after ICI initiation. The 1‑ and 2‑year overall survival (OS) rates for patients were 40 and 22%, respectively, with a median OS of 8.1 months [95% confidence interval (CI): 5.2‑14.2). The 1‑ and 2‑year progression‑free survival (PFS) rates for patients were 34 and 6.7%, respectively (median PFS, 5.3 months; 95% CI: 2.7‑7.9). Post‑treatment biomarkers demonstrated superior prognostic value compared with pre‑treatment values. Male sex [hazard ratio (HR)=4.11, P=0.0059] and lower body mass index (HR=3.33, P=0.0188) were significantly associated with poorer OS. Post‑treatment neutrophil‑to‑lymphocyte ratio (NLR) (HR=4.17, P=0.0337) and prognostic nutritional index (PNI) (HR=3.92, P=0.0073) were significantly associated with OS. Post‑treatment NLR (HR=3.80, P=0.0339), lymphocyte-to‑monocyte ratio (LMR) (HR=4.02, P=0.0304) and PNI (HR=2.96, P=0.0342) were significantly associated with PFS. Furthermore, post‑treatment IBPS markers, including NLR (P=0.0006), LMR (P=0.0065), platelet‑to‑lymphocyte ratio (P=0.0396), C‑reactive protein‑to‑albumin ratio (P=0.0062), PNI (P=0.0358) and lymphocyte counts (P=0.0321), were significantly associated with the disease control rate. In conclusion, post‑treatment inflammation‑ and nutrition‑based biomarkers could help clinicians identify early those patients most likely to benefit from ICIs and support the development of individualized treatment strategies.