Abstract
Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) have been identified as predictors of treatment response in a variety of cancers. We conducted a retrospective analysis to investigate the usefulness of NLR, PLR and SII at baseline and at 6 weeks post-treatment as predictors of response to anti-PD-1/PD-L1 antibody treatment in small cell lung cancer (SCLC). Data of 41 SCLC patients receiving immunotherapy as second- or later-line treatment were analyzed. The overall median progression-free survival (PFS) was 5.1 months (95% CI 3.2–6.2). The median PFS was significantly longer in patients with NLR < 5 than in patients with NLR ≥ 5 at 6 weeks post treatment (HR = 0.29, 95%CI 0.09–0.96, P = 0.04). However, median PFS was comparable between patients with NLR < 5 and patients with NLR ≥ 5 at baseline (HR = 0.75, 95% CI 0.24–2.26, P = 0.56). The median PFS was similar between patients with PLR < 169 and those with PLR ≥ 169 at baseline (HR = 0.67, 95% CI 0.25–1.80, P = 0.43) and at 6 weeks post treatment (HR = 0.69, 95% CI 0.25–1.86, P = 0.46). No statistically different PFS was found between patients with SII < 730 and those with SII ≥ 730 at baseline (HR = 0.70, 95% CI 0.26–1.89, P = 0.48) and at 6 weeks post treatment (HR = 0.38, 95% CI 0.013–1.09, P = 0.07). In conclusion, NLR at 6 weeks after start of treatment appears to be a biomarker of response in the early phase in SCLC patients treated with anti-PD-1/PD-L1 antibodies as second- or later-line treatment.
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Acknowledgements
This study is supported by the National Major Research Program during the “13th Five-Year Plan” (2018ZX09201013).
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Study design: YH. Study conduct: QX, ZH, LX, BQ, XZ. Data collecting: QX, ZH, JZ, BY. Data analysis: QX, ZH, LX, GZ. Data interpretation: QX, ZH and WS. Draft manuscript: QX and ZH. YH takes full responsibility for the integrity of the data analysis.
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Xiong, Q., Huang, Z., Xin, L. et al. Post-treatment neutrophil-to-lymphocyte ratio (NLR) predicts response to anti-PD-1/PD-L1 antibody in SCLC patients at early phase. Cancer Immunol Immunother 70, 713–720 (2021). https://doi.org/10.1007/s00262-020-02706-5
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DOI: https://doi.org/10.1007/s00262-020-02706-5