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

Autor:	Romano FJ; Oncology Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Ronga R; Oncology Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Ambrosio F; Oncology Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Arundine D; Oncology Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Longo V; Thoracic Oncology Unit, National Cancer Institute 'Giovanni Paolo II', Bari, Italy., Galetta D; Thoracic Oncology Unit, National Cancer Institute 'Giovanni Paolo II', Bari, Italy., Gridelli C; Oncology Unit, 'San Giuseppe Moscati' Hospital, Avellino, Italy., Maione P; Oncology Unit, 'San Giuseppe Moscati' Hospital, Avellino, Italy., Palma V; Oncology Unit, 'San Giuseppe Moscati' Hospital, Avellino, Italy., Damiano V; Oncology Unit, Department of Clinical Medicine - 'Federico II' University, Naples, Italy., Verde A; Oncology Unit, Department of Clinical Medicine - 'Federico II' University, Naples, Italy., Giacobbe I; Experimental Medicine Department, University of Campania 'Luigi Vanvitelli', Naples, Italy., Augurio MR; Oncology Unit, Department of Clinical Medicine - 'Federico II' University, Naples, Italy., Iengo G; Oncology Unit, Department of Clinical Medicine - 'Federico II' University, Naples, Italy., Chetta M; Medical Genetics Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Tarsitano M; Medical Genetics Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Campione S; Pathology Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Failla G; Interventional Pulmonology Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Raucci A; Radiology Unit, 'Antonio Cardarelli' Hospital, Naples, Italy., Riccardi F; Oncology Unit, 'Antonio Cardarelli' Hospital, Naples, Italy.
Jazyk:	angličtina
Zdroj:	Cancer diagnosis & prognosis [Cancer Diagn Progn] 2023 Jan 03; Vol. 3 (1), pp. 44-52. Date of Electronic Publication: 2023 Jan 03 (Print Publication: 2023).
DOI:	10.21873/cdp.10178
Abstrakt:	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. Competing Interests: The Authors have no conflicts of interest to declare in relation to this study. (Copyright 2023, International Institute of Anticancer Research.)
Databáze:	MEDLINE
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