Platelet-to-lymphocyte ratio as a prognostic marker for advanced hepatocellular carcinoma treated with immune checkpoint inhibitors: Meta-analysis

Abstract Background: The issue of platelet-to-lymphocyte ratio (PLR) may serve as proxy marker for the effectiveness of immune checkpoint inhibitors (ICI) in treating hepatocellular carcinoma (HCC) remains unresolved. This meta-analysis aims to investigate and provide insights into this issue. Methods: We looked up potentially related articles in the Cochrane Library, Web of Science, PubMed and Embase up to December 2022. The correlation of PLR with progression free surviva(PFS) and overall survival（OS）were evaluated by Hazard ratios(HRS) and 95% confidence intervals(CIS). The heterogeneity of the different PLR groups and their potential predictive value in OS and PFS was measured through subgroup analysis. Results: Ten studies were included in our study, which involving 1590 patients with advanced HCC who were received treatment with ICIs. In summary, the meta-analysis demonstrated that a significant correlation between high PLR and adverse OS,as well as PFS. The combination of these findings suggests that high PLR may adversely affect the effectiveness of cancer patients treated with ICIs. Patients who had a high PLR had a significant reduction in OS and PFS compared to a population with a low PLR. Sensitivity analysis showed similar results. Conclusion: Overall, the advanced HCC patients with low PLR who were treated with ICIs, had better OS and PFS. PLR can predict the outcome of treatment with ICIs in patients with advanced HCC.