Post-treatment changes in hematological parameters predict response to nivolumab monotherapy in non-small cell lung cancer patients

Abstract

BackgroundThe absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute monocyte count (AMC) and neutrophil to lymphocyte ratio (NLR) are known markers of inflammation. We evaluated whether ANC, ALC, AMC and NLR, both before and after treatment with nivolumab, are indicative markers of overall survival (OS) and evaluated change in NLR as a predictive marker of response in non -small cell lung cancer (NSCLC) patients treated with nivolumab.MethodsA total of 109 patients with advanced NSCLC treated with nivolumab were included. ANC, ALC, AMC and NLR were examined at initiation of nivolumab therapy and after two cycles. The prognostic role of ANC, ALC, AMC and NLR with OS and changes in NLR ratio were examined with Kaplan-Meier curves and proportional hazard model.ResultPost-treatment NLR ≥5 after two cycles of nivolumab was associated with poor OS (median OS in NLR = <5 vs NLR = ≥5 was 29.1 (16.2–40.9) vs 24.2(16.1–36.2) months respectively, p<0.001). In addition NLR increased in non-responders after two cycles of nivolumab by 6.6±21.8 as compared to responders (p = 0.027).ConclusionsPost-treatment ANC, ALC and NLR are independent prognostic factors in NSCLC patients treated with nivolumab. Changes in NLR can be an early biomarker for response in NSCLC patients treated with nivolumab.

Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

“…Indeed, all parameters with significant discrimination capacity were collected after the start of RT, rather than at baseline. In line with our results, a number of recently published studies suggest that post-treatment PBC parameters are associated with outcomes of cancer patients after RT or immunotherapy [29][30][31][32][33][34][35]. Barbetta shows that integrating multiple PBC parameters could predict the survival of patients with adult Tlymphoblastic lymphoma [38].…”

Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

“…Indeed, all parameters with significant discrimination capacity were collected after the start of RT, rather than at baseline. In line with our results, a number of recently published studies suggest that post-treatment PBC parameters are associated with outcomes of cancer patients after RT or immunotherapy [3,9,21,25,27,32,40]. Barbetta A et al show that changes of NLR after CRT are associated with risk of recurrence in patients with oesophageal squamous cell carcinoma [3].…”

Current status of prognostic factors in patients with metastatic renal cell carcinoma

“…Although there are few reports of prognostic factors for mRCC treated with ICIs, several studies have shown the association of some inflammatory markers with the prognosis of patients with various malignant diseases treated with ICIs (Table 3). [97][98][99][100][101][102][103][104][105][106] These reports indicate that the parameters related to inflammation might also have some prognostic impact on patients with mRCC treated with ICIs. Further study is expected to clarify the link between the mechanism of inflammation and the effects of ICIs, and to identify the markers related to inflammation to predict or evaluate the effects of ICIs.…”

“…Although there are few reports of prognostic factors for mRCC treated with ICIs, several studies have shown the association of some inflammatory markers with the prognosis of patients with various malignant diseases treated with ICIs (Table ) . These reports indicate that the parameters related to inflammation might also have some prognostic impact on patients with mRCC treated with ICIs.…”