Post-treatment neutrophil-to-lymphocyte ratio (NLR) predicts response to anti-PD-1/PD-L1 antibody in SCLC patients at early phase

• Published in: Cancer Immunology, Immunotherapy Vol. 70; no. 3; pp. 713 - 720
• Main Authors: Xiong, Qi, Huang, Ziwei, Xin, Lingli, Qin, Boyu, Zhao, Xiao, Zhang, Jing, Shi, Weiwei, Yang, Bo, Zhang, Guoqing, Hu, Yi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2021; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; B7-H1 Antigen - antagonists & inhibitors; Cancer Research; Female; Humans; Immune Checkpoint Inhibitors - pharmacology; Immune Checkpoint Inhibitors - therapeutic use; Immunology; Immunotherapy; Kaplan-Meier Estimate; Leukocyte Count; Leukocytes (neutrophilic); Lung Neoplasms - blood; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lymphocyte Count; Lymphocytes; Male; Medicine; Medicine & Public Health; Middle Aged; Neutrophils; Oncology; Original; Original Article; PD-1 protein; PD-L1 protein; Prognosis; Programmed Cell Death 1 Receptor - antagonists & inhibitors; Small cell lung carcinoma; Small Cell Lung Carcinoma - blood; Small Cell Lung Carcinoma - drug therapy; Small Cell Lung Carcinoma - mortality; Small Cell Lung Carcinoma - pathology; Treatment Outcome; SCLC; Anti-PD-1/PD-L1 antibody; SII; NLR; PLR
• ISSN: 0340-7004; 1432-0851
• DOI: 10.1007/s00262-020-02706-5

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.