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COMMENTARY
Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 902--903

The Correlation Between Systemic Inflammatory Biomarkers, Tumor-Related Factors, and Survival in Glioblastoma Patients: A prognosticators Perspective

Amir Barzegar Behrooz1, Amir Syahir2,  
1 Nanobiotechnology Research Group, Department of Biochemistry, Faculty of Biotechnology and Biomolecular Science, Universiti Putra, Serdang, Malaysia
2 Nanobiotechnology Research Group, Department of Biochemistry, Faculty of Biotechnology and Biomolecular Science, Universiti Putra; UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, Serdang, Malaysia

Correspondence Address:
Dr. Amir Syahir
Nanobiotechnology Research Group, Department of Biochemistry, Faculty of Biotechnology and Biomolecular Science, Universiti Putra Malaysia, Serdang; UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, Serdang
Malaysia




How to cite this article:
Behrooz AB, Syahir A. The Correlation Between Systemic Inflammatory Biomarkers, Tumor-Related Factors, and Survival in Glioblastoma Patients: A prognosticators Perspective.Neurol India 2021;69:902-903


How to cite this URL:
Behrooz AB, Syahir A. The Correlation Between Systemic Inflammatory Biomarkers, Tumor-Related Factors, and Survival in Glioblastoma Patients: A prognosticators Perspective. Neurol India [serial online] 2021 [cited 2021 Dec 3 ];69:902-903
Available from: https://www.neurologyindia.com/text.asp?2021/69/4/902/325380


Full Text



Tumorigenesis is complicated by inflammation, and little is known about the association between hematological markers and the prognosis of patients with glioblastoma multiforme (GBM). The link between inflammatory biomarkers and GBM survival is a contentious issue that requires more investigation for a decisive prognosis. We thank Madhugiri et al.[1] for sharing their research on this little-discussed topic. In the article, Madhugiri et al.[1] demonstrated that a substantial systemic inflammatory response (SIR) exists in individuals with GBM and is associated with clinical characteristics, the tumor's genetic profile, and poor survival. It is apparent that some molecular alterations, such as the absence of ATRX or the absence of p53 overexpression, are linked with an inflammatory phenotype. In addition, the disparities in biomarkers of systemic inflammation (BMSIs) between patients and controls are maintained despite age and sex matching in the current investigation.

Prognostic factors for GBM include the patient's age, neurologic function status, Karnofsky performance status (KPS), recursive partitioning analysis (RPA) group, extent of curative resection, concurrent plus maintenance temozolomide (TMZ) administration status, and the presence/absence of genetic and molecular markers, such as the O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, isocitrate dehydrogenase 1/2 (IDH1/2) mutation, and 1p/19q codeletion. These critical variables will provide significant insight into the overall prognosis of GBM patients. Despite the differences, the final clinical, pathological, genetic, and molecular results are similar for comparable patients under the standard therapy protocols (Stupp protocol). It shows that there is a critical need for finding prognosticators with increased discriminating strength. A recent study showed that the SIR index can identify those who would survive long-term after being treated for GBM using the Stupp protocol.[2]

Furthermore, other research has shown that many peripheral inflammatory indicators, such as the neutrophil-to-lymphocyte ratio (NLR), have predictive value in GBM patients.[3],[4] NLR could be utilized as a prognostic factor based on peripheral blood cell counts before therapy. Because tumor aggressiveness increases and survival falls as the NLR value grows, GBM patient treatment options can be facilitated.[3]

Additionally, it was found that the NLR, as well as absolute neutrophil and platelet counts, may be helpful to and practical peripheral inflammatory indicators for assessing the prognosis of GBM, for greater levels of NLR were associated with a more prolonged overall survival.[4] However, other research has shown contradictory results that the markers were not linked to survival.[5] Nevertheless, more retrospective and large-scale investigations are required to confirm the prognostic value of SIR in GBMs.

The intricate connection between the microenvironment of GBM and SIR should be further explored to elucidate the mechanisms behind these inflammatory markers. It is likely that in the future, with the help of big data analytics and machine learning, BMSI patterns will be created as a surrogate marker for a more specific tumor molecular profile.

References

1Madhugiri VS, Subeikshanan V, Dutt A. Biomarkers of systemic inflammation in patients with glioblastoma: An analysis of correlation with tumour-Related factors and survival. Neurol India 2021. [In this Issue].
2Topkan E, Kucuk A, Ozdemir Y, Mertsoylu H, Besen AA, Sezen D, et al. Systemic inflammation response index predicts survival outcomes in glioblastoma multiforme patients treated with standard stupp protocol. J Immunol Res 2020;2020: Article ID 8628540, 10 pages. https://doi.org/10.1155/2020/8628540.
3Kaya V, Yildirim M, Yazici G, Yalçin AY, Orhan N, Güzel A. Prognostic significance of indicators of systemic inflammatory responses in glioblastoma patients. Asian Pacific J Cancer Prev 2017;18:3287-91.
4Yang C, Bin Wen H, Zhao YH, Huang WH, Wang ZF, Li ZQ. Systemic inflammatory indicators as prognosticators in glioblastoma patients: A comprehensive meta-analysis. Front Neurol 2020;11:1-11.
5Lopes M, Carvalho B, Vaz R, Linhares P. Influence of neutrophil–lymphocyte ratio in prognosis of glioblastoma multiforme. J Neurooncol 2018;136:173-80.