Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, PR China.
Department of Urology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, PR China; Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China.
Lung Cancer. 2019 Apr;130:76-83. doi: 10.1016/j.lungcan.2019.02.009. Epub 2019 Feb 10.
There is unmet need to explore the predictive biomarkers of PD-1/PD-L1 inhibitors in patients with non-small-cell lung cancer (NSCLC). Here, we aimed to investigate the predictive and prognostic value of blood neutrophil-to-lymphocyte ratio (NLR) in NSCLC patients treated with PD-1/PD-L1 inhibitors.
We performed a comprehensive online search to explore the association between blood NLR and overall survival (OS) or progression-free survival (PFS) in NSCLC patients received PD-1/PD-L1 inhibitors. Published data including hazard ratios (HRs) and 95% confidence interval (CI) were eligible. Pooled estimates of treatment outcomes were calculated using Stata/MP 14.1.
1700 patients from sixteen studies were included. The pooled results suggested that high blood NLR was correlated with significantly shorter OS (HR = 2.07, P < 0.001) and PFS (HR = 1.59, P < 0.001). The predictive and prognostic significance of blood NLR were observed consistently across most subgroups including publication year, study design, research region, PD-L1 expression detection, sample size, NLR cutoff, median follow-up time and study quality score. Additionally, there was a significant correlation between elevated NLR cutoff values and OS benefit (r = 0.585, P = 0.036) but not for PFS benefit (r = 0.198, P = 0.496). Notably, HRs of PFS showed significant correlation with HRs of OS (r = 0.686, P = 0.041).
Elevated blood NLR was associated with shorter PFS and OS in NSCLC patients treated with PD-1/PD-L1 inhibitors, suggesting its potential predictive and prognostic value in this clinical scenario.
在非小细胞肺癌（NSCLC）患者中探索 PD-1/PD-L1 抑制剂的预测生物标志物存在未满足的需求。在这里，我们旨在研究 NSCLC 患者接受 PD-1/PD-L1 抑制剂治疗时血液中性粒细胞与淋巴细胞比值（NLR）的预测和预后价值。
我们进行了全面的在线搜索，以探讨 NSCLC 患者接受 PD-1/PD-L1 抑制剂治疗时血液 NLR 与总生存期（OS）或无进展生存期（PFS）之间的关系。合格的发表数据包括风险比（HRs）和 95%置信区间（CI）。使用 Stata/MP 14.1 计算治疗结果的汇总估计值。
来自 16 项研究的 1700 名患者被纳入。汇总结果表明，高血液 NLR 与明显较短的 OS（HR=2.07，P<0.001）和 PFS（HR=1.59，P<0.001）相关。血液 NLR 的预测和预后意义在大多数亚组中均观察到一致，包括发表年份、研究设计、研究区域、PD-L1 表达检测、样本量、NLR 截止值、中位随访时间和研究质量评分。此外，升高的 NLR 截止值与 OS 获益之间存在显著相关性（r=0.585，P=0.036），但与 PFS 获益无关（r=0.198，P=0.496）。值得注意的是，PFS 的 HRs 与 OS 的 HRs 显著相关（r=0.686，P=0.041）。
在接受 PD-1/PD-L1 抑制剂治疗的 NSCLC 患者中，升高的血液 NLR 与较短的 PFS 和 OS 相关，表明其在这种临床情况下具有潜在的预测和预后价值。
