Department of Medical Oncology, Ataturk Chest Disease and Chest Surgery Research and Training Hospital, Ankara, Turkey.
J Oncol Pharm Pract. 2021 Jan;27(1):71-77. doi: 10.1177/1078155220913106. Epub 2020 Apr 4.
Targeted therapy is the main treatment option for oncogene-addicted non-small cell lung cancer (NSCLC). It is known that inflammation can affect survival. Therefore, we aimed to evaluate the effect of host inflammation on survival and treatment outcome by using the derived neutrophil-lymphocyte ratio (dNLR) and systemic immune-inflammation index (SII).
The advanced epidermal growth factor receptor mutant NSCLC patients diagnosed between 2014 and 2019 were included. SII and dNLR were calculated from pretreatment blood samples. The estimated cutoff for SII and dNLR were 640 and 2, respectively. Progression-free survival and overall survival were calculated by using the Kaplan-Meier test.
One hundred thirty six patients enrolled in the study. Of the total patients, 34.6% and 65.4% were SII-low and high, respectively. In addition, 58.1% and 41.9% of the patients were dNLR-low and high groups, respectively. The progression-free survival was better in low SII (22.4 vs. 13.01 months, HR: 0.50; 95% CI 0.32-0.80; P: 0.003) and low dNLR groups (16.9 vs. 13.01 months, HR, 0.58; 95% CI 0.38-0.88; P: 0.011). The overall survival was also significantly longer in SII-low and dNLR-low groups (32.4 vs. 20.4 months; HR, 0.47; 95% CI 0.27-0.81; P: 0.005 for SII and 32.4 vs. 18.4 months HR: 0.40; 95% CI 0.24-0.66; P < 0.001 for dNLR).
Based on the results of our study, both SII and dNLR can be routinely used as the simple, inexpensive and easily assessable prognostic markers in oncogene-addicted NSCLC.
靶向治疗是治疗致癌基因依赖型非小细胞肺癌(NSCLC)的主要治疗选择。已知炎症会影响生存。因此,我们旨在通过使用衍生中性粒细胞-淋巴细胞比(dNLR)和全身免疫炎症指数(SII)来评估宿主炎症对生存和治疗结果的影响。
纳入 2014 年至 2019 年间诊断的晚期表皮生长因子受体突变型 NSCLC 患者。SII 和 dNLR 从预处理血液样本中计算得出。SII 和 dNLR 的估计截断值分别为 640 和 2。通过 Kaplan-Meier 检验计算无进展生存期和总生存期。
本研究共纳入 136 例患者。总患者中,SII 低值和高值分别占 34.6%和 65.4%。此外,dNLR 低值和高值组分别占 58.1%和 41.9%。SII 低值组(22.4 个月 vs. 13.01 个月,HR:0.50;95%CI 0.32-0.80;P:0.003)和 dNLR 低值组(16.9 个月 vs. 13.01 个月,HR,0.58;95%CI 0.38-0.88;P:0.011)的无进展生存期更好。SII 低值和 dNLR 低值组的总生存期也显著延长(32.4 个月 vs. 20.4 个月;HR,0.47;95%CI 0.27-0.81;P=0.005 对于 SII 和 32.4 个月 vs. 18.4 个月 HR:0.40;95%CI 0.24-0.66;P<0.001 对于 dNLR)。
根据我们的研究结果,SII 和 dNLR 均可作为致癌基因依赖型 NSCLC 的简单、经济且易于评估的预后标志物。