Elevated Neutrophil-to-Lymphocyte Ratio Is Associated With Poor Outcomes for Melanoma Patients Treated With PD-1 Inhibitor or Chemotherapy in a Chinese Population

Abstract

Background: Previous studies have suggested that an elevated pre-treatment neutrophil-to-lymphocyte ratio (NLR) is associated with worse outcomes in patients with a variety of cancers. The purpose of this retrospective analysis is to investigate the prognostic value of the NLR in a Chinese melanoma population. Methods: Melanoma patients were divided into two groups based on pre-treatment NLR values (≥3 vs. <3). Cox proportional hazard regression analysis and the Kaplan-Meier method were employed to study the prognostic role of the NLR for overall survival (OS) and progression-free survival (PFS). Results: A total of 159 melanoma patients were included in this study, including 40 patients treated with PD-1 inhibitor and 119 patients treated with chemotherapy. In the PD-1 inhibitor group, the median OS was 18.0 months in the low NLR subgroup and 5.6 months in the high NLR subgroup; the median PFS was 7.0 and 2.2 months, respectively. In chemotherapy group, the median OS was 23.0 months in the low NLR group and 8.0 months in the high NLR group, and the median PFS was 9.0 and 4.0 months, respectively. Multivariate analysis showed that the NLR was significantly associated with OS and PFS in melanoma patients treated with either PD-1 inhibitor immunotherapy or chemotherapy. Conclusion: In the Chinese population, an elevated NLR was closely related to worse survival in patients with melanoma treated with either PD-1 inhibitor monotherapy or chemotherapy.

Multidisciplinary Treatment, Including Locoregional Chemotherapy, for Merkel-Polyomavirus-Positive Merkel Cell Carcinomas: Perspectives for Patients Exhibiting Oncogenic Alternative Δ exon 6–7 TrkAIII Splicing of Neurotrophin Receptor Tropomyosin-Related Kinase A

“…This patient presented with chronic neutropenia and received concomitant sofosbuvir/daclastavir therapy for Hepatitis C infection, suggesting that sofosbuvir/daclastavir therapy may have inadvertently and indirectly inhibited the oncogenic activity MCPyV, rendering disseminated MCC cells that survived locoregional IPLP dormant for the duration of antiviral therapy. This patient presented with relapsed disease approximately 1 year after the suspension of antiviral therapy and was treated with avelumab PD-L1 checkpoint inhibitor but failed to respond (Figure 2B) and subsequently died, suggesting that immune checkpoint inhibitor efficacy should also be re-evaluated in patients presenting with altered immune/inflammatory responses [32] and in patients with stage IIIB, in addition to stage IV, disease.…”

The Prognostic Significance of Baseline Neutrophil-to-Lymphocyte Ratio in Melanoma Patients Receiving Immunotherapy

“…However, these markers and clinical systems had limitations like high costs, complex procedures, and great heterogeneity. 6 Therefore, alternative biomarkers that are economical, simple and reliable still need to be clarified.…”

“…Increasing studies demonstrated that neutrophil-tolymphocyte ratio (NLR), a biomarker of systemic inflammation, was associated with poor clinical prognosis in melanoma, a tumor that is highly associated with inflammation. 6,[22][23][24][25] Considering that tumor inflammation could predict the response of melanoma patients with immunotherapy, 26 we wondered whether baseline NLR could be used as a biomarker for the assessment of clinical response to immunotherapy. Studies reported the associations, but conclusions were inconsistent.…”

Pretreatment neutrophil-to-lymphocyte ratio predicts the benefit of gastric cancer patients with systemic therapy

“…The mechanisms underlying the relationship between pretreatment NLR and the prognosis of inoperable gastric cancer patients with systemic therapy were poorly known, but many studies provided the potential mechanisms [ 13 – 15 , 58 ]. In summary, most neutrophils promote the progression of tumors through inhibiting immune activity, while lymphocytes are regarded as the primary effector cells in the immunotherapy.…”