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The following is a summary of “Prognostic value of platelet-to-lymphocyte ratio in hepatocellular carcinoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis,” published in the June 2025 issue of BMC Gastroenterology by Zhou et al. 

Researchers conducted a retrospective analysis to evaluate whether pretreatment platelet-to-lymphocyte ratio (PLR) could serve as a predictive biomarker for survival outcomes in adults with hepatocellular carcinoma (HCC), the most common type of primary liver cancer, undergoing immune checkpoint inhibitor (ICI) therapy. 

They retrieved eligible studies on pretreatment PLR in patients with HCC/liver cancer receiving ICIs from PubMed, Embase, and the Cochrane Library databases up to March 31, 2024. Study quality was evaluated using the Newcastle–Ottawa Scale (NOS). Pooled hazard ratios (HRs) and 95% CIs were calculated to analyze associations between PLR and overall survival (OS) and progression-free survival (PFS). Subgroup analyses, publication bias assessments, and sensitivity analyses were conducted to explore heterogeneity and verify the robustness of the results. 

The results showed that analysis of 15 studies found elevated PLR levels were linked to worse OS (HR: 1.79, 95% CI: 1.44–2.22, P < 0.001) and PFS (HR: 1.80, 95% CI: 1.40–2.30, P < 0.001) in patients with HCC/liver cancer treated with ICIs. Subgroup analyses maintained consistent outcomes for both survival measures. Publication bias and sensitivity estimations revealed no significant bias, confirming the robustness of the pooled findings. 

Investigators concluded that elevated PLR was associated with poorer survival and may serve as a prognostic indicator in patients with HCC/liver cancer receiving ICI therapy. 

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-04028-1