scholarly journals Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic advanced gastric cancer

2014 ◽  
Vol 17 (4) ◽  
pp. 703-710 ◽  
Author(s):  
In Rae Cho ◽  
Jun Chul Park ◽  
Chan Hyuk Park ◽  
Jung Hyun Jo ◽  
Hyun Jik Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Prognostic Marker ◽  
Neutrophil To Lymphocyte Ratio ◽  
Survival Outcomes ◽  
Lymphocyte Ratio ◽  
Chemotherapeutic Response ◽  
Pre Treatment

scholarly journals Decrease in Blood Neutrophil-to-Lymphocyte Ratio Indicates Better Survival After Neoadjuvant Chemotherapy in Patients With Advanced Gastric Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Ziyi Liu ◽  
Yahang Liang ◽  
Xiaolong Tang ◽  
Hui Qu
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Proportional Hazards ◽  
Disease Free Survival ◽  
Distant Recurrence ◽  
Cox Proportional Hazards ◽  
Neutrophil To Lymphocyte Ratio ◽  
Curative Surgery ◽  
Lymphocyte Ratio

Introduction: Gastric cancer is the fifth most commonly diagnosed tumor and is the fourth leading cause of cancer-related mortality, worldwide. Due to the low rate of early diagnosis, approximately two-thirds of patients are first diagnosed at an advanced stage. Neoadjuvant chemotherapy (NAC) is recommended for patients with advanced gastric cancer (AGC). The neutrophil-to-lymphocyte ratio (NLR), a combined inflammatory and immunogenic factor, has been universally used for predicting outcomes in AGC patients. Given that NLR is a dynamic process, in this study, we investigated the value of NLR change for the prediction of chemotherapeutic responses and prognosis in patients with AGC.Methods: We retrospectively enrolled 111 patients with AGC who underwent NAC following curative surgery. Patients were divided into two groups according to the NLR change after chemotherapy into the increased and decreased groups. Outcome measures were overall survival (OS) and disease-free survival (DFS). Univariate was calculated by Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards regression model.Results: Post-chemotherapy, NLR increased in 36 patients and decreased in 75 patients. After a median follow-up time of 19 months, six patients developed local recurrence, 23 developed distant recurrence, and 34 died. Patients with reduced post-chemotherapy NLR showed significantly longer OS (p < 0.001) and DFS (p < 0.001). A decrease in the NLR after NAC was an independent indicator associated with better OS (p < 0.001) and DFS (p < 0.001).Conclusions: In patients with AGC, a decrease in NLR after NAC indicated better survival. NLR change could serve as a robust indicator for the efficiency of NAC and prognostic prediction in patients with AGC.

The combination of the changes and the value of neutrophil-to-lymphocyte ratio is useful for prediction of response for advanced gastric cancer treated with nivolumab: A multicenter retrospective study.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 150-150
Author(s):  
Takatsugu Ogata ◽  
Hironaga Satake ◽  
Misato Ogata ◽  
Kentaro Inoue ◽  
Madoka Hamada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Progression Free Survival ◽  
Complete Response ◽  
Class Ii ◽  
Neutrophil To Lymphocyte Ratio ◽  
Class I ◽  
Class Iii ◽  
Lymphocyte Ratio ◽  
Ecog Ps

150 Background: The ATTRACTION-2 study showed that nivolumab is effective in treating advanced gastric cancer (AGC). Many studies have examined the effectiveness of predictive factors. We previously suggested that neutrophil-to-lymphocyte ratio (NLR) was associated with progression-free survival (PFS) and overall survival. The objective of this study was to determine the effectiveness of the changes of NLR for AGC treated with nivolumab. Methods: Data on patients with AGC treated with nivolumab from November 2014 to December 2017 were collected at two centers. NLRs were calculated before the first cycle (NLRpre) and 2 weeks after the first cycle (NLRpost) of nivolumab, and the changes in NLR (cNLR) was calculated by NLRpost/NLRpre. The association of NLRpre and cNLR with the disease control rate (DCR) and PFS were assessed. Results: Forty-one patients (pts), with the median age of 64 years, were enrolled. Twenty-seven pts were men and 14 were women. Regarding ECOG PS, 34 pts had scores of 0-1 and 7 had a score of 2. The median NLRpre, NLRpost, and cNLR were 2.01 (range, 0.79–18.4), 2.76 (1.27–12.3), and 1.22 (0.16–5.20), respectively. With a median follow-up period of 6.1 months, DCR was 34.1% (complete response [CR], 1 pt; partial response [PR] 3 pts, stable disease [SD], 10 pts). Patients were divided into 3 classes: 8 in Class I (NLRpre≤5 and cNLR≤ 1); 17 in Class II (NLRpre ≤ 5 and 1 < cNLR≤ 2); and 16 in Class III (NLRpre> 5 or cNLR > 2). There were 8 pts, 17 pts, and 16 pts in Class I, II, and III, respectively. DCRs of Class I, II, and III was 87.5% (CR, 1 pt; PR, 2 pts; SD 4 pts), 29.4% (PR, 1 pts; SD 4 pts), and 12.5% (SD 2 pts), respectively. The median PFS was 2.0 months (mo), and it was longer in Class I than in Classes II+III (5.6 vs. 1.4 mo; p = 0.017) and shorter in Class III than in Classes I+II (3.1 vs. 1.3 mo; p = 0.008). The median PFS was 2.0 months (mo). The median PFS was longer in Class I compared with in Class II+III (5.6 vs 1.4 mo; p = 0.017). The median PFS was shorter in Class III compared with in Class I+II (3.1 vs 1.3 mo; p = 0.008). Conclusions: The combined use of NLRpre and cNLR seemed to be effective in predicting the response of AGC to nivolumab.

Pre-treatment status of inflammation-based biomarkers in the patients with advanced gastric cancer who will be treated with nivolumab.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16107-e16107
Author(s):  
Tetsuya Kusumoto ◽  
Kensuke Kudou ◽  
Sho Nanbara ◽  
Yasuo Tsuda ◽  
Eiji Kusumoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Survival Data ◽  
Prognostic Index ◽  
Prognostic Scores ◽  
Lymphocyte Ratio ◽  
Treatment Status ◽  
Pre Treatment ◽  
Grade 3 ◽  
Line Chemotherapy

e16107 Background: Nivolumab is currently proved to be one of the most recommended regimens as the third-line chemotherapy for patients with advanced gastric cancer (AGC) in Japan. A variety of scores based on the systemic inflammation-based biomarkers have been reported to reflect survival in cancer patients. Kudou et al. recently reported that newly designed combined score of 5 inflammation-based prognostic scores (IBPSs), composed of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, Glasgow prognostic scale, prognostic index and prognostic nutritional index, might be predictive for the prognosis of resected gastric cancer (Ann Surg Oncol, 2020). The aim of the study is to investigate the clinical significance of nivolumab monotherapy in patients with AGC, associated with pre-treatment status of IBPSs including Kudou’s combined score (min 0 to max 10). Methods: Thirty-six patients received nivolumab monotherapy in our institute and enrolled to this retrospective study. We conducted a retrospective review of the data of 24 patients with AGC who received ≧ 2 cycles of nivolumab as the 3rd-line chemotherapy. Adverse events, tumor responses, the IBPSs and survival data were analyzed. Results: Three patients quitted the continuation of nivolumab except for the progressive disease, due to non-hematological toxicities higher than grade 3 including myositis, hypothyroidism, dermatitis and liver dysfunction. The rate of hematological toxicities, which showed severe anemia of higher than grade 3 was 20.8%. The ORR and the DCR were 4.2% and 41.7%, respectively. The median PFS and the OS after nivolumab administration were 69 and 274 days, respectively. Pre-chemotherapeutic combined score of IBPSs below 7 was significantly associated with the longer OS (P=0.014) in exposure of nivolumab, compared with the patients group presenting more than 7. Conclusions: Nivolumab monotherapy as the 3rd-line is one of the best regimens for patients with AGC showing better PS or lower combined score of IBPSs.

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