Neutrophil‐to‐lymphocyte ratio as a prognostic marker for head and neck squamous cell carcinoma treated with immune checkpoint inhibitors: Meta‐analysis

Abstract

We investigated the prognostic impact of the neutrophil‐to‐lymphocyte ratio (NLR) in patients with head and neck squamous cell carcinoma (HNSCC) treated with immune checkpoint inhibitors (ICIs). We systematically searched electronic databases and identified articles reporting an association between NLR and treatment results in patients with HNSCC treated with ICIs. Hazard ratios (HRs) for overall survival (OS) and progression‐free survival (PFS) and odds ratios (ORs) for response and disease control were extracted. Pooled HRs and ORs were estimated using random‐effects models. Fourteen studies involving 929 patients were included. A higher NLR was associated with poor OS (HR 2.03, 95% confidence interval [CI] 1.50–2.74), PFS (HR 2.15, 95% CI 1.44–3.21), response (OR 0.49, 95% CI 0.26–0.93), and disease control (OR 0.30, 95% CI 0.12–0.74). The NLR predicts treatment results with ICIs in patients with HNSCC.

Focus on the Dynamics of Neutrophil-to-Lymphocyte Ratio in Cancer Patients Treated with Immune Checkpoint Inhibitors: A Meta-Analysis and Systematic Review

“…[ 56 ]. More importantly, the prognostic role of NLR seems to be applicable to most patients with various tumors receiving ICI treatment [ 57 , 58 , 59 ]; therefore, it is necessary to conduct a further meta-analysis on NLR.…”

Ability of Blood Cell Parameters to Predict Clinical Outcomes of Nivolumab Monotherapy in Advanced Esophageal Squamous Cell Carcinoma

“…26 Therefore, the NLR and LMR are systemic inflammation indicators of the balance between an antitumor immune response and protumor inflammation, and are indicators of a tumor response and the prognosis of various types of cancers treated by ICIs. [11][12][13][14][15]18 We also found that the NLR and LMR before and during the early days of nivolumab monotherapy were significantly associated with the clinical therapeutic effect and survival for unresectable advanced or recurrent ESCC.…”

“…Pretreatment NLR is a prognostic indicator for various types of cancer treated by ICIs. The reported cutoffs of pretreatment NLRs required to significantly stratify survival range from 3 to 7 in these studies, [11][12][13]18 and 3.84, 5.0 and 6.0 for unresectable advanced and recurrent esophageal cancer, although the reports [11][12][13] included patients with esophageal adenocarcinoma treated by some types of ICI or by combination chemotherapies. [27][28][29] The optimal cutoff for pretreatment NLRs required to significantly stratify the survival of patients with ESCC who underwent nivolumab monotherapy in the present study was 4.9.…”

“…Blood cell parameters such as neutrophil-to-lymphocyte, platelet-to-lymphocyte and lymphocyte-to-monocyte ratios (NLRs, PLRs and LMRs, respectively) are predictive markers of therapeutic effects and survival rates among patients with various types of cancer treated with ICIs. [11][12][13][14][15][16][17][18] However, to the best of our knowledge, correlations among blood parameters, therapeutic effects and survival have not been fully evaluated in patients with ESCC under nivolumab monotherapy. Here, we evaluated the ability of various clinical factors, including NLR, PLR and LMR, to predict therapeutic effects and survival in patients with unresectable advanced or recurrent ESCC treated with second-or laterline nivolumab monotherapy.…”

Neutrophil‐to‐lymphocyte and hypopharyngeal cancer prognosis: System review and meta‐analysis

“…In a previous study 23 that included 5716 patients from 20 studies, high NLR was shown to be associated with poor OS, PFS, and DFS in laryngeal cancer. Takenaka et al, 24 Tham et al, 25 and Takenaka et al's 26 high‐quality studies also demonstrated the relationship between NLR and head and neck cancer, confirming that high pretreatment NLR is associated with poor prognosis. The outcomes in above studies covered all the outcomes we selected, further supporting the accuracy and authenticity of our analysis.…”