Dynamics of Neutrophils-to-Lymphocyte Ratio Predict Outcomes of PD-1PD-L1 Blockade

Abstract EN

Introduction.

Baseline neutrophil-to-lymphocyte ratio (NLR) has been repeatedly reported as a significant prognostic factor in advanced cancer patients.

We explored whether changes in NLR may predict outcome of advanced cancer patients enrolled into phase 1 trials and treated with PD-1/PD-L1 inhibitors.

Patients and Methods.

Advanced cancer patients enrolled into phase 1 trials between September 2013 and May 2016 and treated with anti-PD-1/PD-L1 agents were included in this retrospective study.

NLR was calculated at baseline and after 2 cycles of treatment.

Royal Marsden Hospital (RMH) prognostic score and Eastern Cooperative Group (ECOG) performance status (PS) were determined at baseline.

Kaplan-Meier estimation and Cox regression analyses were used to assess the impact of NLR dynamics on PFS.

Results.

Among the 55 patients eligible, 26 (47%) were treated with anti-PD-L1 monotherapy, 22 (40%) received single agent anti-PD-1, and 7 (13%) were given a tyrosine kinase inhibitor (TKI) plus a PD-1 inhibitor.

Neither ECOG PS nor RMH prognostic score was significantly associated with PFS in our cohort, whereas changes in NLR significantly impacted on PFS.

Conclusion.

Changes in the NLR may be a useful predicting factor in advanced cancer patients treated with anti-PD-1/PD-L1 agents.

Further prospective trials are needed to verify these findings.