Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara-City, Kanagawa, 252-0374, Japan.
Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara-City, Kanagawa, 252-0374, Japan.
Invest New Drugs. 2020 Jun;38(3):885-893. doi: 10.1007/s10637-020-00919-0. Epub 2020 Mar 10.
Background Exon 19 deletion and L858R point mutation in exon 21 of the epidermal growth factor receptor (EGFR) are the most commonly encountered mutations in patients with non-small cell lung cancer (NSCLC) and predict better clinical outcomes following treatment with EGFR-tyrosine kinase inhibitors (TKIs). The inflammatory indicator neutrophil-to-lymphocyte ratio (NLR) in peripheral blood serves as a predictive factor for NSCLC patients treated with chemotherapy. Here, we aimed to evaluate the correlation between NLR and clinical efficacy of EGFR-TKIs in NSCLC patients harboring EGFR mutations. Methods We retrospectively collected information of 205 patients with advanced NSCLC harboring exon 19 deletion or L858R point mutation and receiving gefitinib or erlotinib. The clinical outcomes in the NSCLC patients were evaluated based on NLR level before EGFR-TKI therapy. Results The optimal cut-off value for NLR was 3.55. The response rates in the low-NLR and high-NLR groups were 69.2% and 51.5%, respectively. The median progression-free survival (PFS) in the low-NLR and high-NLR groups were 15.7 months and 6.7 months, respectively. The median overall survival (OS) in the low-NLR and high-NLR groups were 37.6 months and 19.2 months, respectively. The multivariate analysis identified performance status (PS), NLR, stage, and smoking status as independent predictors of PFS. Moreover, the PS and NLR were identified as independent predictors of OS. Conclusions NLR was a significant predictor of clinical efficacy and OS in NSCLC patients harboring EGFR mutations treated with gefitinib or erlotinib.
表皮生长因子受体（EGFR）外显子 19 缺失和外显子 21 的 L858R 点突变是非小细胞肺癌（NSCLC）患者最常见的突变，并且预测 EGFR-酪氨酸激酶抑制剂（TKI）治疗后的临床结局更好。外周血中性粒细胞与淋巴细胞比值（NLR）作为预测接受化疗的 NSCLC 患者的指标。在这里，我们旨在评估 NLR 与携带 EGFR 突变的 NSCLC 患者接受 EGFR-TKI 治疗的临床疗效之间的相关性。
我们回顾性收集了 205 例接受吉非替尼或厄洛替尼治疗的晚期 NSCLC 患者的信息，这些患者携带外显子 19 缺失或 L858R 点突变。根据 EGFR-TKI 治疗前 NLR 水平评估 NSCLC 患者的临床结局。
NLR 的最佳截断值为 3.55。低 NLR 组和高 NLR 组的反应率分别为 69.2%和 51.5%。低 NLR 组和高 NLR 组的中位无进展生存期（PFS）分别为 15.7 个月和 6.7 个月。低 NLR 组和高 NLR 组的中位总生存期（OS）分别为 37.6 个月和 19.2 个月。多变量分析确定表现状态（PS）、NLR、分期和吸烟状况是 PFS 的独立预测因素。此外，PS 和 NLR 是 OS 的独立预测因素。
NLR 是 EGFR 突变型 NSCLC 患者接受吉非替尼或厄洛替尼治疗的临床疗效和 OS 的重要预测指标。
