Neutrophil-to-Lymphocyte Ratio Is a Predictive Biomarker in Patients with Epidermal Growth Factor Receptor (EGFR) Mutated Advanced Non-Small Cell Lung Cancer (NSCLC) Treated with Tyrosine Kinase Inhibitor (TKI) Therapy
| Autor: | Jeffrey A. Borgia, Imad Tarhoni, Mary J. Fidler, Sherin J. Rouhani, Brendan A. Gilmore, Philip Bonomi, Ethan M. Ritz, Marta Batus, Nicole K. Yun, Christine M. Bestvina |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty medicine.drug_class tyrosine kinase inhibitor (TKI) medicine.medical_treatment non-small cell lung cancer (NSCLC) lcsh:RC254-282 Article Tyrosine-kinase inhibitor Cachexia 03 medical and health sciences 0302 clinical medicine Internal medicine body mass index (BMI) Medicine Progression-free survival Epidermal growth factor receptor Neutrophil to lymphocyte ratio predictive biomarker neutrophil-to-lymphocyte ratio (NLR) Chemotherapy biology Performance status business.industry fungi lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease epidermal growth factor receptor (EGFR) 030104 developmental biology advanced non-small cell lung cancer (NSCLC) 030220 oncology & carcinogenesis biology.protein business |
| Zdroj: | Cancers Volume 13 Issue 6 Cancers, Vol 13, Iss 1426, p 1426 (2021) |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers13061426 |
| Popis: | Background: First-line treatment for patients with non-small cell lung cancer (NSCLC) with a sensitizing epidermal growth factor receptor (EGFR) mutation is a tyrosine kinase inhibitor (TKI). Despite higher response rates and prolonged progression free survival (PFS) compared with platinum doublet chemotherapy, a subset of these patients do not receive prolonged benefit from these agents. We investigate if the neutrophil-to-lymphocyte ratio (NLR) and other markers of cachexia and chronic inflammation correlate with worse outcomes in these patients. Methods: This study is a retrospective review of 137 patients with advanced EGFR-mutated NSCLC treated with TKIs at Rush University Medical Center and University of Chicago Medicine from August 2011 to July 2019, with outcomes followed through July 2020. The predictive value of NLR and body mass index (BMI) was assessed at the start of therapy, and after 6 and 12 weeks of treatment by univariable and multivariable analyses. Results: On univariable analysis, NLR ≥ 5 or higher NLR on a continuous scale were both associated with significantly worse PFS and overall survival (OS) at treatment initiation, and after 6 or 12 weeks of treatment. On multivariable analysis, NLR ≥ 5 was associated with increased risk of death at 12 weeks of therapy (HR 3.002, 95% CI 1.282–7.029, p = 0.011), as was higher NLR on a continuous scale (HR 1.231, 95% CI 1.063–1.425, p = 0.0054). There was no difference in PFS and OS and amongst BMI categories though number of disease sites and Eastern Cooperative Oncology Group (ECOG) performance status was associated with worse PFS and OS. Conclusions: Patients with NLR ≥ 5 have a worse median PFS and median OS than patients with NLR < 5. NLR may have value as a predictive biomarker and may be useful for selecting patients for therapy intensification in the front-line setting either at diagnosis or after 12 weeks on therapy. NLR needs to be validated prospectively. |
| Databáze: | OpenAIRE |
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