Drug Development Unit, Sarah Cannon Research Institute, London, UK.
University Hospital of Basel, Basel, Switzerland.
Biomed Res Int. 2017;2017:1506824. doi: 10.1155/2017/1506824. Epub 2017 Nov 28.
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.
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.
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.
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.
基线中性粒细胞与淋巴细胞比值（NLR）已被反复报道为晚期癌症患者的重要预后因素。我们探讨了 NLR 的变化是否可以预测接受 PD-1/PD-L1 抑制剂治疗的 1 期试验入组的晚期癌症患者的结局。
本回顾性研究纳入了 2013 年 9 月至 2016 年 5 月期间入组 1 期试验并接受抗 PD-1/PD-L1 药物治疗的晚期癌症患者。在基线和治疗 2 个周期后计算 NLR。在基线时确定皇家马斯登医院（RMH）预后评分和东部合作肿瘤组（ECOG）表现状态（PS）。使用 Kaplan-Meier 估计和 Cox 回归分析评估 NLR 动态对 PFS 的影响。
在 55 名符合条件的患者中，26 名（47%）接受了抗 PD-L1 单药治疗，22 名（40%）接受了单药抗 PD-1 治疗，7 名（13%）接受了酪氨酸激酶抑制剂（TKI）联合 PD-1 抑制剂治疗。在我们的队列中，ECOG PS 或 RMH 预后评分均与 PFS 无显著相关性，而 NLR 的变化显著影响 PFS。
接受抗 PD-1/PD-L1 药物治疗的晚期癌症患者的 NLR 变化可能是一个有用的预测因素。需要进一步的前瞻性试验来验证这些发现。
