Background:
The relationship between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) and the dire prognosis of non-small cell lung carcinoma patients who received immune checkpoint inhibitors (ICIs) are not known yet.
Methods:
We screened the articles that meet the criteria from the database. The relationship between NLR/PLR/LMR levels and the survival and prognosis of non-small cell lung cancer patients treated with ICIs was analyzed. Summarize hazard ratio (HR) with 95% confidence interval (CI) to study progression-free survival (PFS) and overall survival (OS).
Results:
Thirty-four studies involving 3124 patients were enrolled in the final analysis. In short, high pre-treatment NLR was related to poor OS (HR = 2.13, 95% CI:1.74–2.61,
P
< .001, I
2
= 83.3%,
P
< .001) and PFS (HR = 1.77, 95% CI:1.44–2.17,
P
< .001, I
2
= 79.5%,
P
< .001). Simultaneously, high pre-treatment PLR was related to poor OS (HR = 1.49, 95% CI:1.17–1.91,
P
< .001, I
2
= 57.6%,
P
= .003) and PFS (HR = 1.62, 95% CI:1.38–1.89,
P
< .001, I
2
= 47.1%,
P
= .036). In all subgroup analysis, most subgroups showed that low LMR was related to poor OS (HR = 0.45, 95% CI: 0.34–0.59,
P
< .001) and PFS (HR = 0.60, 95% CI: 0.47–0.77, P < 0.001, I
2
= 0.0%,
P
< .001).
Conclusion:
High pre-treatment NLR and pre-treatment PLR in non-small cell lung carcinoma patients treated with ICIs are associated with low survival rates. Low pre-treatment and post-treatment LMR are also related to unsatisfactory survival outcomes. However, the significance of post-treatment NLR and post-treatment PLR deserve further prospective research to prove.