Serum neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in prognosticating immunotherapy efficacy

Immunotherapy. 2020 Aug;12(11):785-798. doi: 10.2217/imt-2020-0105. Epub 2020 Jul 13.

Abstract

Aim: To examine neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in prognosticating immunotherapy efficacy. Methods: A retrospective study of 156 patients with metastatic melanoma and non-small-cell lung cancer on PD-1 inhibitors. Results: Baseline NLR ≥5 was associated with worse progression-free survival (hazard ratio [HR]: 1.53; 95% CI: 1.01-2.31; p = 0.043) but nonsignificant worse overall survival trend (HR: 1.51; 95% CI: 0.98-2.34; p = 0.064). PLR ≥200 was associated with worse overall survival (HR: 1.94; 95% CI: 1.29-2.94; p = 0.002) and worse progression-free survival (HR: 1.894; 95% CI: 1.27-2.82; p = 0.002). NLR or PLR are prognosticating factors regardless of cancer types, with PLR having a stronger association with outcomes than NLR. Conclusion: High baseline NLR or PLR (alone and combined) were associated with worse immunotherapy efficacy regardless of cancer type, indicating their potential role as an agnostic marker for immunotherapy efficacy.

Keywords: immunotherapy; NLR; PLR; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; treatment outcomes.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers, Pharmacological
  • Blood Platelets / pathology*
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / therapy
  • Cell Count
  • Female
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Immunotherapy / methods*
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / therapy
  • Lymphocytes / pathology*
  • Male
  • Melanoma / diagnosis*
  • Melanoma / mortality
  • Melanoma / therapy
  • Neoplasm Metastasis
  • Neutrophils / pathology*
  • Prognosis
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Retrospective Studies
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / mortality
  • Skin Neoplasms / therapy
  • Survival Analysis

Substances

  • Biomarkers, Pharmacological
  • Immune Checkpoint Inhibitors
  • Programmed Cell Death 1 Receptor