Prognostic Value of Lymphocyte-to-Monocyte Ratio (LMR) in Cancer Patients Undergoing Immune Checkpoint Inhibitors

Abstract

Background. There is accumulating evidence that the lymphocyte-to-monocyte ratio (LMR) is related to the outcomes of cancer patients treated with immune checkpoint inhibitors (ICIs). However, the results remain controversial. Method. Electronic databases were searched to retrieve the studies that explore the relationship between LMR and the efficacy of ICIs. The primary endpoints were overall survival (OS) and progression-free survival (PFS), evaluated by the hazard ratios (HRs) with 95% confidence intervals (CI), and the secondary endpoints included disease control rate (DCR) and immune-related adverse events (irAEs), assessed by the odd ratios (ORs) with 95% CI. Results. A total of 27 studies involving 4,322 patients were eligible for analysis. The results indicated that increased LMR at baseline was associated with a superior OS (HR: 0.46, 95% CI: 0.39-0.56, p < 0.001 ), PFS (HR: 0.60, 95% CI: 0.49-0.74, p < 0.001 ), and DCR (OR: 3.16, 95% CI: 1.70-5.87, p < 0.001 ). Posttreatment LMR was linked to a better PFS (HR: 0.46, 95% CI: 0.29-0.71, p = 0.001 ), but failed to show this correlation in the analysis of OS and DCR. No correlation existed between LMR and irAEs regardless of the testing time (baseline or posttreatment). Subgroup analyses focusing on baseline LMR revealed that higher baseline LMR possessed a better OS in renal cell cancer (RCC) arm, nonsmall cell lung cancer (NSCLC) arm, multiple cancer arm, monotherapy arm, LMR <2 arm, LMR ≥2 arm, western countries arm, eastern countries arm, and anti-PD-1 arm. Higher baseline LMR correlated with better PFS in RCC arm, NSCLC arm, gastric cancer (GC) arm, multiple cancer arm, LMR <2 arm, LMR ≥2 arm, western countries arm, and eastern countries arm. Conclusions. Higher LMR at baseline was positively correlated with a superior OS, PFS, and DCR for ICIs, but not with irAEs.

Peripheral monocyte transcriptomics associated with immune checkpoint blockade outcomes in metastatic melanoma

“…Conversely, consistent with the hospital blood monocyte count, increasing monocyte proportion as a total of peripheral blood mononuclear cells (PBMCs) pre-treatment was associated with reduced OS (pre-treatment, P= 0.014, log-rank test), and post-ICB reduced PFS and OS (post-treatment PFS P = 0.028; OS, P= 0.031, log rank test) (Figure 4C). In keeping with previous studies 25 , a higher lymphocyte to monocyte ratio (LMR) at baseline was associated with extended OS (p = 0.035, log-rank) (Supplementary Figure 3).…”

The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world setting

“…A survival receiver operating characteristic (ROC) analysis was adopted to identify potential cut-offs that optimally stratify patients into risk groups. Optimal thresholds for blood cell count-derived ratios were determined based on literature reviews [7][8][9][10][11][12][13] and our previous work, where we used those cut-offs and verified their applicability. 14 The cut-off values were set as follows: NLR 3, PLR 160, LMR 2, SII 800 and dNLR 1,9, respectively.…”

A Nomogram Model Based on the Inflammation-Immunity-Nutrition Score (IINS) and Classic Clinical Indicators for Predicting Prognosis in Extranodal Natural Killer/T-Cell Lymphoma

“…9,10 A growing number of studies have illustrated the diagnostic and prognostic values of inflammatory markers, such as LMR, NLR, systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI), in various cancers. [26][27][28][29] Recently, a study found that the Glasgow Prognostic Score (GPS), an inflammation-based prognostic evaluation system comprising measures of C-reactive protein and albumin, showed significant prognostic value in ENKTL. 30 However, the prognostic system is The results showed that the CONUT score was more efficient in predicting ENKTL prognosis than the IPI, KPI and PINK models.…”