6533b872fe1ef96bd12d39d5
RESEARCH PRODUCT
Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Outcomes with Nivolumab in Pretreated Non-Small Cell Lung Cancer (NSCLC): A Large Retrospective Multicenter Study
Giuseppina Rosaria Rita RicciardiAntonio GalvanoFrancesco PantanoAlain GelibterMichele AietaDaniele SantiniMarco RussanoGiulia PasquiniAlessandro RussoLorenzo CalvettiGiovanni MansuetoGiuseppe AprileGiuseppe ToniniEnrico VasileSandro BarniMarco ImperatoriFausto PetrelliTindara FranchinaMichele MaioElisa RocaLuana CalabròMaria Rita MigliorinoDaniela IaconoOlga MartelliSilvia QuadriniSalvatore IntagliataVincenzo AdamoMario OcchipintiAlfredo FalconeAntonio RussoAlfredo Berrutisubject
OncologyMale030213 general clinical medicineLung NeoplasmsNeutrophilsLymphocytenon-small cell lung cancer (NSCLC)DiseaseNSCLCchemistry.chemical_compoundLeukocyte Count0302 clinical medicineAntineoplastic Agents ImmunologicalCarcinoma Non-Small-Cell LungPD-180 and overLeukocytesPharmacology (medical)LymphocytesNon-Small-Cell LungAged 80 and overbiologyGeneral MedicineMiddle AgedPrognosisImmunologicalmedicine.anatomical_structureNivolumab030220 oncology & carcinogenesisLDH; Nivolumab; NLR; NSCLC; PD-1; PD-L1; PLR; Prognosis; Adult; Aged; Aged 80 and over; Antineoplastic Agents Immunological; Biomarkers; Carcinoma Non-Small-Cell Lung; Female; Humans; Leukocyte Count; Leukocytes; Lung Neoplasms; Lymphocytes; Male; Middle Aged; Neutrophils; Nivolumab; Prognosis; Retrospective StudiesFemaleNivolumabAdultPD-L1medicine.medical_specialtyLDHAntineoplastic AgentsPLRNONLR03 medical and health sciencesPD-L1Lactate dehydrogenaseInternal medicinemedicineHumansNeutrophil to lymphocyte ratioAgedRetrospective Studiesbusiness.industryCarcinomamedicine.diseaseRheumatologychemistrybiology.proteinLDH; Nivolumab; NLR; NSCLC; PD-1; PD-L1; PLR; PrognosisbusinessBiomarkersdescription
Introduction: Immune checkpoint inhibitors have provided substantial benefit in non-small cell lung cancer (NSCLC) with unprecedented results in terms of survival. However, the identification of reliable predictive biomarkers to these agents is lacking and multiple clinicopathological factors have been evaluated. The aim of this study was to analyze the potential role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) levels in patients with pretreated NSCLC receiving nivolumab. Methods: This was a retrospective multicenter study involving 14 Italian centers, evaluating the role of some laboratory results in patients with NSCLC treated with nivolumab in the second or later lines of therapy for at least four doses and with a disease re-staging. Results: A total of 187 patients with available pretreatment laboratory results were included. NLR levels below 5 were associated with an improvement in terms of both progression-free survival (PFS) (p = 0.028) and overall survival (OS) (p = 0.001), but not in terms of overall response rate (ORR) or disease control rate (DCR). Moreover, PLR levels below 200 were associated with longer PFS (p = 0.0267) and OS (p = 0.05), as well as higher ORR (p = 0.04) and DCR (p = 0.001). In contrast, LDH levels above the upper normal limit (UNL) were not associated with significant impact on patient outcomes. Conclusions: Patients with pretreated NSCLC and high pretreatment levels of NLR and PLR may experience inferior outcomes with nivolumab. Therefore, in this subgroup of patients with poor prognosis the use of alternative therapeutic strategies may be a valuable option, especially in programmed cell death ligand 1 (PD-L1)-negative patients and/or in the presence of other additional poor prognostic factors.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-01-01 |