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.