Neutrophil-to-Lymphocyte Ratio(NLR)as a Predictive Indicator of the Response to Nivolumab in Patients with Oral Squamous Cell Carcinoma

• Published in: Gan to kagaku ryoho Vol. 48; no. 12; p. 1485
• Main Authors: Tachinami, Hidetake, Tomihara, Kei, Ikeda, Atsushi, Sekido, Katsuhisa, Sakurai, Kotaro, Imaue, Shuichi, Fujiwara, Kumiko, Hayashi, Ryuji, Noguchi, Makoto
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.12.2021
• Subjects: Carcinoma, Squamous Cell - drug therapy; Head and Neck Neoplasms; Humans; Lymphocytes; Mouth Neoplasms - drug therapy; Neoplasm Recurrence, Local; Neutrophils; Nivolumab - therapeutic use; Prognosis; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck
• ISSN: 0385-0684

The immune checkpoint inhibitor (ICI) nivolumab has revolutionized the treatment for recurrent or metastatic advanced oral cancer. Because the response rate remains low, the identification of predictive indicators of the response to nivolumab is among the most critical issues. The neutrophil-to-lymphocyte ratio(NLR)is a potential predictive marker of the response to nivolumab in patients with various cancer types. However, the utility of the NLR as a biomarker for predicting the response of oral cancer patients to ICIs is poorly understood. In this retrospective cohort study, we evaluated the association between NLR and nivolumab treatment outcome in 13 patients diagnosed with recurrent or metastatic oral squamous cell carcinoma(OSCC)treated with nivolumab at the Toyama University Hospital between December 2017 and December 2019. Complete response(CR)and partial response(PR)rates of 38.5%(5/13)and 0% (0/13), respectively, were observed in responders; stable disease(SD)and progressive disease(PD)rates of 7.7%(1/13) and 53.8%(7/13), respectively, were observed in non-responders. After nivolumab treatment, the median NLR among responders decreased to 3.3(3.0-3.9)from 4.1(3.7-4.3)during pre-treatment assessment and increased from 5.6(3.2- 9.2)at pre-treatment to 9.4(5.3-17.9)among non-responders. Moreover, patients with higher NLRs(≥5)in the post- treatment group had a significantly worse overall survival than those with lower NLRs(<5). Specifically, patients with a higher post-treatment NLR(≥10)had significantly worse outcomes for post-nivolumab salvage chemotherapy. The NLR could be a useful marker for predicting the treatment response to nivolumab or post-nivolumab salvage chemotherapy in OSCC patients.