Pretreatment Neutrophil-to-Lymphocyte Ratio and Smoking History as Prognostic Factors in Advanced Non–Small Cell Lung Cancer Patients Treated with Osimertinib

Park, Ji Young; Jang, Seung Hun; Lee, Chang Youl; Kim, Tae-Hee; Chung, Soo Jie; Lee, Ye-Jin; Kim, Hwan Il; Kim, Joohee; Park, Sunghoon; Hwang, Yong Il; Jung, Ki‐Suck

doi:10.4046/trd.2021.0139

Cited by 5 publications

(3 citation statements)

References 42 publications

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“…Sixty-one eligible patients were included retrospectively. 17 Thirty-one of the patients received second-line treatment with osimertinib, while the remaining 30 patients received third line or later treatment with osimertinib. The T790M mutation status of these patients came from either tissue rebiopsy or liquid biopsy.…”

Section: Discussionmentioning

confidence: 99%

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The Role of Neutrophil-to-Lymphocyte Ratio in Advanced EGFR-Mutant NSCLC Patients Treated with First-Line Osimertinib

Chen¹,

Huang²,

Hsu³

et al. 2023

OTT

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Purpose Although serum neutrophil-to-lymphocyte ratio (NLR) is correlated with the outcome of various cancer types, its role in treatment-naïve, advanced, epidermal growth factor receptor ( EGFR )-mutant non-small cell lung cancer (NSCLC) patients treated with osimertinib remains uncertain. We have the intention to use this biomarker to evaluate the outcomes in NSCLC. Patients and Methods Advanced EGFR -mutant NSCLC patients receiving osimertinib as the first-line treatment were included. We evaluated the prognostic role of baseline NLR and explored its association with patients’ characteristics. A high NLR was defined as pretreatment serum NLR ≥ 5. Results A total of 112 eligible patients were included. The objective response rate was 83.7%. The median progression-free survival (PFS) and overall survival (OS) were 20.5 months (95% CI 14.5–26.5) and 47.3 months (95% CI 36.7–58.2), respectively. A high NLR predicted an inferior PFS (HR 1.90 [95% CI 1.02–3.51], P = 0.042) and OS (HR 3.85 [95% CI 1.39–10.66], P = 0.009). Patients with stage IVB disease were more likely to have a high baseline NLR than those with stage IIIB-IVA (33.9% vs 15.1%, P = 0.029). Other patients’ characteristics did not correlate with the baseline NLR significantly. Patients with a high NLR had significantly more metastatic organs than those with a low NLR (2.5 ± 1.3 vs 1.8 ± 0.9, P = 0.012), particularly brain, liver, and bone metastasis. There was no significant association between NLR and intrathoracic metastasis. Conclusion Baseline serum NLR could act as an important prognostic marker for EGFR -mutant NSCLC patients receiving first-line osimertinib. A high NLR was associated with higher metastatic burden, more extrathoracic metastases, and therefore, a worse outcome.

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Section: Discussionmentioning

confidence: 99%

“…Studies focusing on osimertinib remain limited. 17 Herein, we evaluated the prognostic role of baseline serum NLR in treatment-naïve EGFR -mutant NSCLC patients treated with osimertinib and explored the association between NLR and patients’ characteristics.…”

Section: Introductionmentioning

confidence: 99%

The Role of Neutrophil-to-Lymphocyte Ratio in Advanced EGFR-Mutant NSCLC Patients Treated with First-Line Osimertinib

Chen¹,

Huang²,

Hsu³

et al. 2023

OTT

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“…18 Specifically, elevated D-dimer levels in lung adenocarcinoma patients were associated with reduced response rates, shorter PFS, and OS to EGFR TKI. 19 Therefore, this multicenter retrospective study aims to examine the prognostic significance of pretreatment plasma D-dimer levels in EGFR-positive advanced NSCLC patients receiving osimertinib.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Pretreatment Plasma D-dimer Levels in EGFR-Positive Advanced Non-Small Cell Lung Cancer Patients Receiving Osimertinib: A Multicentre Retrospective Study

Liu,

Tan,

et al. 2023

IJGM

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This study examined the association between plasma D-dimer levels and overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients treated with osimertinib. Methods: In this multicenter study, 88 patients with advanced non-small cell lung cancer (NSCLC) carrying epidermal growth factor receptor (EGFR) mutations and receiving osimertinib were enrolled. The target independent and dependent variables were the D-dimer levels before osimertinib treatment and OS time, respectively. The t-test or chi-square test was utilized to analyze the variances among various groups. The predictive significance of D-dimer for overall survival (OS) was assessed using Kaplan-Meier survival analysis and the Cox proportional hazard regression model. Results: The selected patients had an average age of 58.01±10.72 years, with females comprising 54.55%. Based on their D-dimer levels, the patients were categorized into three groups: low-level (< 0.6 mg/L), middle-level (0.6 ~ 2 mg/L), and high-level (≥ 2 mg/L). After accounting for possible confounding variables, the Cox proportional hazard model showed that increased D-dimer levels were linked to a greater likelihood of death (HR 2.28, 95% CI = 1.09 ~ 4.76, p = 0.029). Importantly, there was a significant trend indicating that as D-dimer levels rose, the risk of mortality also increased (p for trend, HR 1.15, 95% CI = 1.03 ~ 1.28, p = 0.012). Consistently comparable outcomes were noted in the majority of subcategories. Patients with low-middle and high D dimer levels had a median OS of 28.6 and 17 months, respectively (p =0.014). Conclusion:In conclusion, elevated levels of D-dimer in the bloodstream were found to have a significant negative correlation with the overall survival (OS) of patients with EGFR-positive non-small cell lung cancer (NSCLC) who underwent treatment with osimertinib.

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The study of primary and acquired resistance to first-line osimertinib to improve the outcome of EGFR-mutated advanced Non-small cell lung cancer patients: the challenge is open for new therapeutic strategies

Ferro,

Marinato,

Mulargiu

et al. 2024

Critical Reviews in Oncology/Hematology

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Pretreatment Neutrophil-to-Lymphocyte Ratio and Smoking History as Prognostic Factors in Advanced Non–Small Cell Lung Cancer Patients Treated with Osimertinib

Cited by 5 publications

References 42 publications

The Role of Neutrophil-to-Lymphocyte Ratio in Advanced EGFR-Mutant NSCLC Patients Treated with First-Line Osimertinib

The Role of Neutrophil-to-Lymphocyte Ratio in Advanced EGFR-Mutant NSCLC Patients Treated with First-Line Osimertinib

Prognostic Significance of Pretreatment Plasma D-dimer Levels in EGFR-Positive Advanced Non-Small Cell Lung Cancer Patients Receiving Osimertinib: A Multicentre Retrospective Study

The study of primary and acquired resistance to first-line osimertinib to improve the outcome of EGFR-mutated advanced Non-small cell lung cancer patients: the challenge is open for new therapeutic strategies

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