Prognostic value of the platelet-to-lymphocyte ratio in lung cancer patients receiving immunotherapy: A systematic review and meta-analysis

PLoS One. 2022 May 6;17(5):e0268288. doi: 10.1371/journal.pone.0268288. eCollection 2022.

Abstract

Background: Current studies have revealed that the platelet to lymphocyte ratio (PLR) may lead to a poor prognosis in lung cancer patients receiving immunotherapy. We conducted a meta-analysis to explore the prognostic value of PLR in lung cancer patients receiving immunotherapy.

Methods: We retrieved potential studies from the PubMed, Web of Science, Embase, and Scopus databases up to June 2021 and merged the hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) to evaluate the association between PLR and overall survival (OS) or progression-free survival.

Results: Fourteen studies involving 1761 patients were included in our meta-analysis. The results indicated that an elevated level of pretreatment PLR was associated with poorer OS and PFS in lung cancer patients receiving immunotherapy (OS: HR = 1.88, 95% CI: 1.37-2.58; PFS: HR = HR = 1.40, 95% CI: 1.11-1.76). The association remained consistent after subgroup analysis and was robust even after sensitivity analysis.

Conclusions: PLR may be a prognostic factor of lung cancer patients receiving immunotherapy, which can lead to worse survival outcomes. However, further studies are necessary for evidence in clinical application.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Platelets
  • Humans
  • Immunologic Factors
  • Immunotherapy
  • Lung Neoplasms* / therapy
  • Lymphocytes*
  • Prognosis

Substances

  • Immunologic Factors

Grants and funding

This work was supported by National Natural Science Foundation of China [grant numbers 91859203 and 81871890] and Major Science and Technology Innovation Project of Chengdu City [grant number 2020-YF08-00080-GX] and the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.