Inflammation Scores Predict Outcomes in Nasopharyngeal Cancer, Highlight Nutritional Status as Key Factor
HONG KONG - New research indicates that elevated levels of systemic inflammation, as measured by the pan-immune-inflammation value (PIV), are significantly associated with poorer prognoses in patients with locally advanced nasopharyngeal cancer. Simultaneously,the study underscores the critical role of nutritional status,assessed via the nutritional risk index (NRI),in influencing treatment outcomes and overall survival. These findings, published in Cancer Control and Heliyon in early 2024, suggest that incorporating these readily available biomarkers into clinical practise could refine risk stratification and personalize treatment strategies for this challenging cancer.Nasopharyngeal cancer, a malignancy affecting the upper part of the throat, disproportionately impacts populations in Southeast Asia and carries a complex treatment pathway ofen involving chemotherapy, radiation, and immunotherapy. Identifying reliable prognostic indicators is paramount for optimizing patient care.The emerging importance of PIV and NRI stems from their ability to offer a holistic view of a patient’s condition – reflecting both the tumor’s inflammatory habitat and the body’s overall resilience. this dual assessment could move the field beyond conventional staging systems, offering a more nuanced understanding of individual patient risk and potential response to therapy.
Researchers, including teams led by zhang et al. (2024) and others, have demonstrated a consistent correlation between higher PIV scores and reduced overall survival in nasopharyngeal carcinoma patients. PIV, calculated from routine blood tests measuring neutrophil, lymphocyte, and monocyte counts, serves as a proxy for systemic inflammation driven by the tumor and the body’s immune response. This heightened inflammatory state appears to promote cancer progression and hinder treatment efficacy.
Beyond inflammation, nutritional status emerges as a crucial determinant of outcome. A compromised nutritional state, reflected in a lower NRI, is linked to increased risk of treatment-related toxicities and diminished survival rates. This connection highlights the importance of proactive nutritional support throughout the cancer journey, potentially including dietary counseling and supplementation.
the implications extend beyond nasopharyngeal cancer. Similar inflammatory and metabolic vulnerabilities are increasingly recognized in other cancers, including pancreatic and lung cancers. Studies by Liang et al. (2017) and Bartolacci et al. (2022) have revealed that metabolic alterations, such as the Warburg effect and disruptions in lipid metabolism, contribute to tumor growth and resistance to therapy. Moreover, research by Padanad et al. (2016) points to the role of fatty acid oxidation in fueling KRAS-mutant lung tumorigenesis.
The interplay between inflammation, metabolism, and cancer is further underscored by the concept of cancer-associated cachexia – a debilitating syndrome characterized by involuntary weight loss and muscle wasting. As Cortellino et al. (2025) explain, cachexia isn’t merely a symptom of advanced disease, but rather a direct consequence of metabolic reprogramming induced by the tumor.
Recent investigations, such as those by Shen et al. (2024) in colorectal cancer and Qiu et al. (2024) in rectal cancer, emphasize the value of inflammation-based biomarkers in predicting metastasis and recurrence risk. These findings reinforce the potential for integrating PIV and NRI, alongside other clinical and pathological factors, to develop individualized follow-up strategies and optimize long-term patient management.
References
- Li Y, et al. Predictive value of pan-immune-inflammation value (PIV) in locally advanced nasopharyngeal cancers. Cancer control. 2024;31:10732748241290746. doi:10.1177/10732748241290746
- Zhang N, Hou T, Zhang S, et al. prognostic significance of pan-immune-inflammation value (PIV) in nasopharyngeal carcinoma patients. Heliyon. 2024;10(2):e24804. doi:10.1016/j.heliyon.2024.e24804
- liang C, Qin Y, zhang B, et al.ARF6, induced by mutant Kras, promotes proliferation and Warburg effect in pancreatic cancer
