Neutrophil-to-Lymphocyte Ratio Is a Major Prognostic Factor in Non-small Cell Lung Carcinoma Patients Undergoing First Line Immunotherapy With Pembrolizumab

Francesco Jacopo Romano, Riccardo Ronga, Francesca Ambrosio, Dario Arundine, Vito Longo, Domenico Galetta, Cesare Gridelli, Paolo Maione, Valentina Palma, Vincenzo Damiano, Antonio Verde, Ilaria Giacobbe, Maria Rosaria Augurio, Gennaro Iengo, Massimiliano Chetta, Marina Tarsitano, Severo Campione, Giuseppe Failla, Antonio Raucci, Ferdinando Riccardi

Résultats de recherche: Contribution à un journalArticleRevue par des pairs

14 Citations (Scopus)

Résumé

Background/Aim: Lung cancer is one of the most common malignant neoplastic diseases and by far the leading cause of cancer death worldwide. Recently, immune checkpoint inhibitors (ICIs) have received increasing attention for playing a crucial role in non-small cell lung cancer (NSCLC). Biomarkers, such as programmed cell death-ligand 1 (PD-L1) and tumor mutational burden (TMB), seemed to be helpful in selecting patients who are more likely to benefit from ICI treatment: however, their role has not yet been fully clarified. Patients and Methods: In this retrospective study, we evaluated the relationship between pre-treatment peripheral blood neutrophil-to-lymphocyte ratio (NLR) and survival in 252 patients suffering from advanced NSCLC who had received pembrolizumab as their first-line immunotherapy. Results: Compared to their NLR low counterparts who had a median overall survival (OS) of 34.8 months, patients with NLRs above 4.8 had a median OS of 7.6 months (HR=3.26, 95%Cl=2.3-4.6, p-value<0.0000001). In multivariate Cox regression analysis, alongside other variables, such as metastatic sites, age, and sex, NLR and PD-L1 predicted progression-free survival and OS; furthermore, a very high NLR – over 10 – seemed to forecast a very dismal prognosis in patients undergoing immunotherapy, with sudden deaths in the days immediately following therapy (median OS=3.8 months). Conclusion: NLR acts as a valuable and reliable prognostic factor in non-small cell lung carcinoma patients undergoing first line immunotherapy with pembrolizumab. Additional investigation is necessary to fully elucidate the underlying biological rationale, which can be found in myeloid derived suppressor cells, a heterogeneous population of cells with neutrophil-like immunophenotypic features.

langue originaleAnglais
Pages (de - à)44-52
Nombre de pages9
journalCancer Diagnosis and Prognosis
Volume3
Numéro de publication1
Les DOIs
étatPublié - 1 janv. 2023
Modification externeOui

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