Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer

Background and Aims. Biomarkers for systemic inflammation have been introduced into clinical practice for risk-rating in cancer patients’ treatment. This study is aimed at confirming the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) as an effective biomarker for patients with metastati...

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Published in:	Journal of immunology research Vol. 2021; pp. 2549295 - 9
Main Authors:	Gou, Miaomiao, Qu, Tongtong, Wang, Zhikuan, Yan, Huan, Si, Yanhai, Zhang, Yong, Dai, Guanghai
Format:	Journal Article
Language:	English
Published:	Egypt Hindawi 28-12-2021 Hindawi Limited
Subjects:	Adult Aged Angiogenesis Antitumor activity Biomarkers Cancer therapies Chemotherapy Disease control Female Gastric cancer Humans Immune Checkpoint Inhibitors - administration & dosage Immune Checkpoint Inhibitors - adverse effects Immune Checkpoint Inhibitors - therapeutic use Immunology Immunotherapy Leukocyte Count Leukocytes (neutrophilic) Ligands Lymphocyte Count Lymphocytes Male Medical prognosis Metastases Metastasis Middle Aged Molecular Targeted Therapy Monoclonal antibodies Multivariate analysis Neoplasm Staging Neutrophils Oncology Patients PD-1 protein Prognosis Programmed Cell Death 1 Receptor - antagonists & inhibitors ROC Curve Stomach Neoplasms - blood Stomach Neoplasms - diagnosis Stomach Neoplasms - drug therapy Stomach Neoplasms - mortality Treatment Outcome
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Summary:	Background and Aims. Biomarkers for systemic inflammation have been introduced into clinical practice for risk-rating in cancer patients’ treatment. This study is aimed at confirming the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) as an effective biomarker for patients with metastatic gastric cancer (MGC) receiving anti-PD-1 agents. Method. Patients with MGC who received anti-PD-1 treatment at the Chinese PLA General Hospital between January 2016 and November 2020 were reviewed. The study analyzed the association of NLR and overall survival (OS) or progression-free survival (PFS) and antitumor response rate with PD-1 inhibitors. Results. 137 patients were included in the final analysis. The area under the curve value of NLR for 6-month OS was 0.71. The best cut-off value for NLR was 3.23. NLR<3.23 was associated with longer OS (HR=0.38, 95% CI, 0.26-0.57, p<0.001) and PFS (HR=0.42, 95% CI, 0.29-0.62, p<0.001) in patients with MGC. No significant difference was observed in the objective response rate (ORR) (35.8% vs. 28.6%, p=0.377) and disease control rate (DCR) (86.4% vs. 78.6%, p=0.229) in the NLR<3.23 group and in the NLR≥3.23 group, respectively. Univariate analysis and multivariate analysis found that NLR was an independent prognosis biomarker for PFS and OS. Conclusions. Pretreatment elevated NLR was significantly associated with inferior PFS and OS in patients with MGC who received anti-PD-1 inhibitors. Clinicians need to consider patients with elevated NLR for decisions on immunotherapy strategy.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Academic Editor: Qiang Zhang
ISSN:	2314-8861 2314-7156
DOI:	10.1155/2021/2549295