Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer

Background and Aims. Biomarkers for systemic inflammation have been introduced into clinical practice for risk-rating in cancer patients’ treatment. This study is aimed at confirming the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) as an effective biomarker for patients with metastati...

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Main Authors: Miaomiao Gou, Tongtong Qu, Zhikuan Wang, Huan Yan, Yanhai Si, Yong Zhang, Guanghai Dai
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Immunology Research
Online Access:http://dx.doi.org/10.1155/2021/2549295
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author Miaomiao Gou
Tongtong Qu
Zhikuan Wang
Huan Yan
Yanhai Si
Yong Zhang
Guanghai Dai
author_facet Miaomiao Gou
Tongtong Qu
Zhikuan Wang
Huan Yan
Yanhai Si
Yong Zhang
Guanghai Dai
author_sort Miaomiao Gou
collection DOAJ
description Background and Aims. Biomarkers for systemic inflammation have been introduced into clinical practice for risk-rating in cancer patients’ treatment. This study is aimed at confirming the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) as an effective biomarker for patients with metastatic gastric cancer (MGC) receiving anti-PD-1 agents. Method. Patients with MGC who received anti-PD-1 treatment at the Chinese PLA General Hospital between January 2016 and November 2020 were reviewed. The study analyzed the association of NLR and overall survival (OS) or progression-free survival (PFS) and antitumor response rate with PD-1 inhibitors. Results. 137 patients were included in the final analysis. The area under the curve value of NLR for 6-month OS was 0.71. The best cut-off value for NLR was 3.23. NLR<3.23 was associated with longer OS (HR=0.38, 95% CI, 0.26-0.57, p<0.001) and PFS (HR=0.42, 95% CI, 0.29-0.62, p<0.001) in patients with MGC. No significant difference was observed in the objective response rate (ORR) (35.8% vs. 28.6%, p=0.377) and disease control rate (DCR) (86.4% vs. 78.6%, p=0.229) in the NLR<3.23 group and in the NLR≥3.23 group, respectively. Univariate analysis and multivariate analysis found that NLR was an independent prognosis biomarker for PFS and OS. Conclusions. Pretreatment elevated NLR was significantly associated with inferior PFS and OS in patients with MGC who received anti-PD-1 inhibitors. Clinicians need to consider patients with elevated NLR for decisions on immunotherapy strategy.
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spelling doaj-art-74ad2af764af49bea3cf993a1aa1ce3a2025-08-20T02:06:50ZengWileyJournal of Immunology Research2314-71562021-01-01202110.1155/2021/2549295Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric CancerMiaomiao Gou0Tongtong Qu1Zhikuan Wang2Huan Yan3Yanhai Si4Yong Zhang5Guanghai Dai6Medical Oncology DepartmentMedical Oncology DepartmentMedical Oncology DepartmentMedical Oncology DepartmentMedical Oncology DepartmentMedical Oncology DepartmentMedical Oncology DepartmentBackground and Aims. Biomarkers for systemic inflammation have been introduced into clinical practice for risk-rating in cancer patients’ treatment. This study is aimed at confirming the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) as an effective biomarker for patients with metastatic gastric cancer (MGC) receiving anti-PD-1 agents. Method. Patients with MGC who received anti-PD-1 treatment at the Chinese PLA General Hospital between January 2016 and November 2020 were reviewed. The study analyzed the association of NLR and overall survival (OS) or progression-free survival (PFS) and antitumor response rate with PD-1 inhibitors. Results. 137 patients were included in the final analysis. The area under the curve value of NLR for 6-month OS was 0.71. The best cut-off value for NLR was 3.23. NLR<3.23 was associated with longer OS (HR=0.38, 95% CI, 0.26-0.57, p<0.001) and PFS (HR=0.42, 95% CI, 0.29-0.62, p<0.001) in patients with MGC. No significant difference was observed in the objective response rate (ORR) (35.8% vs. 28.6%, p=0.377) and disease control rate (DCR) (86.4% vs. 78.6%, p=0.229) in the NLR<3.23 group and in the NLR≥3.23 group, respectively. Univariate analysis and multivariate analysis found that NLR was an independent prognosis biomarker for PFS and OS. Conclusions. Pretreatment elevated NLR was significantly associated with inferior PFS and OS in patients with MGC who received anti-PD-1 inhibitors. Clinicians need to consider patients with elevated NLR for decisions on immunotherapy strategy.http://dx.doi.org/10.1155/2021/2549295
spellingShingle Miaomiao Gou
Tongtong Qu
Zhikuan Wang
Huan Yan
Yanhai Si
Yong Zhang
Guanghai Dai
Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer
Journal of Immunology Research
title Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer
title_full Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer
title_fullStr Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer
title_full_unstemmed Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer
title_short Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer
title_sort neutrophil to lymphocyte ratio nlr predicts pd 1 inhibitor survival in patients with metastatic gastric cancer
url http://dx.doi.org/10.1155/2021/2549295
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