Increased Posttreatment Neutrophil-to-Lymphocyte Ratio Is an Independent Prognostic Marker for Worse Overall Survival in Patients Receiving Concurrent Chemoradiation for Lung Cancer

2016 ◽  
Vol 96 (2) ◽  
pp. E479 ◽  
Author(s):  
J.G. Bazan ◽  
C. Barney ◽  
N. Scoville ◽  
K.E. Haglund ◽  
J.C. Grecula ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Prognostic Marker ◽  
Neutrophil To Lymphocyte Ratio ◽  
Concurrent Chemoradiation ◽  
Lymphocyte Ratio ◽  
Independent Prognostic Marker

scholarly journals Astragalus Polysaccharide Injection (PG2) Normalizes the Neutrophil-to-Lymphocyte Ratio in Patients with Advanced Lung Cancer Receiving Immunotherapy

2021 ◽  
Vol 20 ◽  
pp. 153473542199525
Author(s):  
Shih Ming Tsao ◽  
Tz Chin Wu ◽  
JiZhen Chen ◽  
Feichi Chang ◽  
Thomos Tsao
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Survival Data ◽  
Treatment Initiation ◽  
Checkpoint Inhibitors ◽  
Neutrophil To Lymphocyte Ratio ◽  
Advanced Lung Cancer ◽  
Control Group ◽  
Lymphocyte Ratio ◽  
Astragalus Polysaccharide

Objectives: The neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker in patients with cancer receiving immunotherapy. Recent studies have shown that a high NLR was associated with a poor response and decreased survival. However, there is no intervention to reverse abnormally high NLR and improve clinical outcomes. Astragalus polysaccharide injection (PG2) is an immunomodulatory therapy for cancer-related fatigue. This study aimed to examine whether PG2 might normalize the NLR and affect the overall survival of patients with lung cancer treated with immunotherapy. Materials and Methods: We retrospectively examined the medical records of patients with lung cancer treated with immune checkpoint inhibitors (ICIs) between October 1, 2015 and November 30, 2019. All patients received ICI combination chemotherapies, and some similarly received PG2 (Control vs PG2). The NLR was assessed before treatment and 6 weeks after ICI initiation, and the survival data was collected at least 4 years after treatment initiation for the first enrolled patient. Results: Fifty-three patients were included. Six weeks after ICI initiation, 91.3% of the patients in the PG2 group exhibited a predefined “Decrease or no change” in the NLR, which was 28% higher than that in the Control group (63.3%) ( P = .028). The NLR significantly decreased by 31.60% from baseline in the PG2 group ( P = .012), whereas it increased by 5.80% in the Control group ( P = .572). Six weeks after ICI treatment initiation, both groups had a median NLR of 3.73, and the overall survival was also similar (PG2 vs Control, 26.1 months vs 25.4 months, respectively); however, the PG2 group had a higher median baseline NLR than the Control group (PG2 vs Control, 4.51 vs 2.81, respectively). Conclusion: This study demonstrated that PG2 could normalize the NLR in patients with lung cancer receiving ICI combination treatments.

scholarly journals P17 Neutrophil to Lymphocyte Ratio as an Inexpensive Prognostic Marker in Metastatic Non–Small Cell Lung Cancer

2018 ◽  
Vol 13 (9) ◽  
pp. S167-S168
Author(s):  
E. Alanya Rodriguez ◽  
A. Figueroa Torrejon ◽  
W. Li Torres ◽  
D. Castro ◽  
N. Cuevas ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Prognostic Marker ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Neutrophil To Lymphocyte Ratio ◽  
Small Cell Lung ◽  
Lymphocyte Ratio

scholarly journals Neutrophil to lymphocyte ratio influences impact of steroids on efficacy of immune checkpoint inhibitors in lung cancer brain metastases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adam Lauko ◽  
Bicky Thapa ◽  
Mayur Sharma ◽  
Baha’eddin Muhsen ◽  
Addison Barnett ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Brain Metastases ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
The Impact

AbstractSteroids are often utilized to manage patients with non-small cell lung cancer brain metastases (NSCLCBM). Steroids and elevated neutrophil-to-lymphocyte ratio (NLR) have been associated with decreased overall survival (OS) in patients treated with immune checkpoint inhibitors (ICI). We retrospectively investigated patients treated with ICI after the diagnosis of NSCLCBM at a single tertiary care institution examing the impact of steroids and NLR. Overall survival (OS) and intracranial progression-free survival (PFS) were analyzed. 171 patients treated with ICI for NSCLCBM were included. Thirty-six received steroids within 30 days of the start of ICI, and 53 patients had an NLR ≥ 5 before the start of ICI. Upfront steroids was associated with decreased OS on multivariable analysis (median OS 10.5 vs. 17.9 months, p = .03) and intracranial PFS (5.0 vs. 8.7 months, p = .045). NLR ≥ 5 was indicative of worse OS (10.5 vs. 18.4 months, p = .04) but not intracranial PFS (7.2 vs. 7.7 months, p = .61). When NLR and upfront steroids are modeled together, there is a strong interaction (p = .0008) indicating that the impact of steroids depended on the patient’s NLR. In a subgroup analysis, only in patients with NLR < 4 was there a significant difference in OS with upfront steroids (26.1 vs. 15.6 months, p = .032). The impact of steroids on the efficacy of ICI in patients with NSCLCBM is dependent on the patient's NLR underscoring its importance in these patients. Patients with a low NLR, steroid use decreases the efficacy of ICI. These results can inform clinicians about the impact of steroids in patients treated with ICI.

Neutrophil-to-lymphocyte ratio as a prognostic marker for metastatic pancreatic cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 251-251
Author(s):  
Jasmin Radhika Desai ◽  
Bradley Scott Colton ◽  
Hongkun Wang ◽  
John Marshall ◽  
Sunnie S. Kim ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Prognostic Marker ◽  
Prognostic Value ◽  
Retrospective Chart Review ◽  
Progression Free Survival ◽  
Neutrophil To Lymphocyte Ratio ◽  
Metastatic Pancreatic Cancer ◽  
Lymphocyte Ratio ◽  
Institutional Experience

251 Background: Metastatic pancreatic cancer is a deadly disease, with a median survival that remains less than 12 months. However, more patients than ever before are surviving for more than 1 year, though it has been difficult to determine which patients have a better or worse prognosis. In the MPACT trial of gemcitabine + nab-paclitaxel vs gemcitabine alone, the neutrophil-to-lymphocyte ratio (NLR) prior to treatment was found to be a promising prognostic marker. However, the significance of NLR has not been confirmed. We examined our institutional experience with assessing the prognostic value of the NLR for patients with metastatic pancreatic cancer treated with standard chemotherapies. Methods: We performed an IRB approved retrospective chart review of patients with metastatic pancreatic adenocarcinoma. Patients were eligible if a routine blood count from which an NLR would be calculated was available prior to initiating any chemotherapy. 41 patients were identified who were treated with either FOLFOX (n = 9), FOLFIRINOX (n = 8) or gemcitabine + nab-paclitaxel (n = 24). Patients were stratified into two groups: NLR < 5 and NLR > 5. The median progression free survival and overall survival were determined, and statistical analyses performed to observe any correlation to NLR. Results: In this review, patients with an elevated NLR (NLR > 5) had an improved PFS and OS when compared with patients with a decreased NLR (NLR < 5). OS was 12.2 months in NLR > 5 and 11.0 months in NLR < 5. PFS was 4.7 months and 3.6 months, respectively. When comparing patients that were treated with 5-FU based regimens, the overall survival was similar with the NLR > 5 of 11.5 months and the NLR < 5 group of 11.0 months. However, those patients treated with gemcitabine and abraxane had more of a difference; patients with an NLR > 5 had an OS of 16.0 months and NLR < 5, the OS was 11.5 months. Conclusions: Our single institution experience suggests that NLR could be a marker for prognosis for metastatic pancreatic cancer. However, our data contradicts the results of the MPACT trial where an increased NLR was associated with a worsened overall survival. Therefore, additional confirmatory studies will need to be performed to find the true prognostic value of the NLR.

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