Neutrophil-To-Lymphocyte Ratio Is Prognostic in Recurrent Glioblastoma Multiforme Treated with Bevacizumab Plus Irinotecan

Abstract

Aim: We intended to survey the prognostic utility of pretreatment neutrophil-to-lymphocyte ratio (NLR) as a novel prognostic index in recurrent glioblastoma multiforme (R-GBMs) treated with bevacizumab plus irinotecan (BEVIRI). Patients & methods: The present retrospective investigation incorporated the R-GBMs patients who underwent BEVIRI. The pre-BEVIRI NLR was calculated for each patient by utilizing the complete blood count tests obtained on the first day of BEVIRI. Results: The data of a total of 103 patients were analyzed. The ideal cut-off was identified at 3.04 (area under the curve: 60%; sensitivity: 60.3%; specificity 60%) for the pre-BEVIRI NLR. Low-NLR group had significantly longer overall survival times than the high-NLR group (15.8 vs 9.3 months; p = 0.015). Conclusion: NLR might be utilized as a novel biomarker in the prognostic stratification of the R-GBMs treated with BEVIRI.

The Role of Preoperative Neutrophil, Platelet, and Monocyte to Lymphocyte Ratios as Independent Prognostic Factors for Patient Survival in WHO 2021 Glioblastoma: A Single-Center Retrospective Study

“…Regarding the state of the systemic immune response in recent years, the scientific literature has accumulated much data on the importance of preoperative NLR for patient survival, with some authors reporting statistical significance not only for survival in GBM but also for tumor grade and as a distinguisher from CNS metastasis (Table 1 ) [ 10 - 12 , 20 - 27 ]. Interesting additional data from these studies are those of Weng and Kemerdere, where a positive correlation was found between the rate of increase in NLR and the histological grade of tumors, as well as data from Haksoyler, who proved that the prognostic value of the index is preserved even in disease recurrence [ 21 , 24 , 26 ]. One contradictory but promising result is the reported elevation of NLR by Figueroa in GBM patients undergoing laser interstitial thermal therapy, where the patients are reported to have a better outcome [ 20 ].…”

Prognostic Value of the Systemic Immune-Inflammation Index and Prognostic Nutritional Index in Patients With Medulloblastoma Undergoing Surgical Resection

“…Index has been extensively studied in other CNS tumors. The recent studies suggest that NLR may be a novel biomarker for the prognostic stratification of R-GBMS treated with BEVIRI (23). Another study conducted by Dr. Erkan Topkan (24) showed that preconditioning pretreatment systemic immune response index (SIRI) is a new, reliable, and independent predictor of prognosis for newly diagnosed patients with GBM intending to undergo postoperative Stupp regiments.…”

Glioblastoma Microenvironment and Cellular Interactions

“…A vicious circle is created. Upon activation, these cells are responsible for the secretion of a substantial number of inflammatory factors: cytokines, matrix metalloproteinases—MMP, growth and oxidative stress factors, that next will suppress or activate the signaling pathways, modifying their beneficial tissular action and promoting tumor development and invasion [ 11 , 12 ].…”