Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet

Inflammation is a new hallmark feature of cancer initiation and progression. We aimed to investigate the association between inflammatory response biomarkers and progression-free survival and overall survival in advanced lung adenocarcinoma patients treated with first-line pemetrexed and platinum do...

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Main Authors: Yanjuan Xiong, Ning Zhao, Yu Zheng, Jian Wang, Feng Wei, Xiubao Ren
Format: Article
Language:English
Published: SAGE Publishing 2017-05-01
Series:Tumor Biology
Online Access:https://doi.org/10.1177/1010428317701639
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author Yanjuan Xiong
Ning Zhao
Yu Zheng
Jian Wang
Feng Wei
Xiubao Ren
author_facet Yanjuan Xiong
Ning Zhao
Yu Zheng
Jian Wang
Feng Wei
Xiubao Ren
author_sort Yanjuan Xiong
collection DOAJ
description Inflammation is a new hallmark feature of cancer initiation and progression. We aimed to investigate the association between inflammatory response biomarkers and progression-free survival and overall survival in advanced lung adenocarcinoma patients treated with first-line pemetrexed and platinum doublet chemotherapy. Patients hospitalized between April 2012 and March 2015 were enrolled and eliminated according to the inclusion and exclusion criteria. The pretreatment neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, derived neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were calculated. Besides the well-established clinical prognostic factors, the prognostic values of the four markers were evaluated by the Kaplan–Meier method and Cox’s proportional hazards regression model. A total of 78 patients were enrolled in this study. Elevated neutrophil-to-lymphocyte ratio and derived neutrophil-to-lymphocyte ratio were correlated with poor treatment response ( p = 0.014, 0.012, respectively). A high pretreatment neutrophil-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio, as well as low lymphocyte-to-monocyte ratio, were associated with worse progression-free survival and overall survival. Multivariate analysis revealed that high neutrophil-to-lymphocyte ratio (hazard ratio = 2.056; 95% confidence interval, 1.281–3.299; p = 0.003) and ≥3 metastasis organs (hazard ratio = 1.989; 95% confidence interval, 1.069–3.702; p  = 0.030) were independent prognostic factors for progression-free survival. Meanwhile, high neutrophil-to-lymphocyte ratio (hazard ratio = 5.540; 95% confidence interval, 2.974–10.321; p < 0.001) and habitual smoking (hazard ratio = 2.806; 95% confidence interval, 1.509–5.221; p = 0.001) were independent prognostic factors for overall survival. In conclusion, Pretreatment neutrophil-to-lymphocyte ratio was an independent prognostic factor for advanced lung adenocarcinoma patients treated with first-line pemetrexed/platinum doublet chemotherapy. Elevated pretreatment derived neutrophil-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio might be potential biomarkers for poorer responses to chemotherapy. To verify these findings, larger well-designed prospective studies are needed.
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spelling doaj-art-b4e50d0931ef4e9b9bf8078443da53ef2025-08-20T02:54:49ZengSAGE PublishingTumor Biology1423-03802017-05-013910.1177/1010428317701639Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doubletYanjuan Xiong0Ning Zhao1Yu Zheng2Jian Wang3Feng Wei4Xiubao Ren5Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. ChinaDepartment of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. ChinaDepartment of Immunology, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Tianjin Key Laboratory of Cancer Immunology and Biotherapy; Tinajin 300060, P.R. ChinaDepartment of Immunology, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Tianjin Key Laboratory of Cancer Immunology and Biotherapy; Tinajin 300060, P.R. ChinaDepartment of Immunology, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Tianjin Key Laboratory of Cancer Immunology and Biotherapy; Tinajin 300060, P.R. ChinaDepartment of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. ChinaInflammation is a new hallmark feature of cancer initiation and progression. We aimed to investigate the association between inflammatory response biomarkers and progression-free survival and overall survival in advanced lung adenocarcinoma patients treated with first-line pemetrexed and platinum doublet chemotherapy. Patients hospitalized between April 2012 and March 2015 were enrolled and eliminated according to the inclusion and exclusion criteria. The pretreatment neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, derived neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were calculated. Besides the well-established clinical prognostic factors, the prognostic values of the four markers were evaluated by the Kaplan–Meier method and Cox’s proportional hazards regression model. A total of 78 patients were enrolled in this study. Elevated neutrophil-to-lymphocyte ratio and derived neutrophil-to-lymphocyte ratio were correlated with poor treatment response ( p = 0.014, 0.012, respectively). A high pretreatment neutrophil-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio, as well as low lymphocyte-to-monocyte ratio, were associated with worse progression-free survival and overall survival. Multivariate analysis revealed that high neutrophil-to-lymphocyte ratio (hazard ratio = 2.056; 95% confidence interval, 1.281–3.299; p = 0.003) and ≥3 metastasis organs (hazard ratio = 1.989; 95% confidence interval, 1.069–3.702; p  = 0.030) were independent prognostic factors for progression-free survival. Meanwhile, high neutrophil-to-lymphocyte ratio (hazard ratio = 5.540; 95% confidence interval, 2.974–10.321; p < 0.001) and habitual smoking (hazard ratio = 2.806; 95% confidence interval, 1.509–5.221; p = 0.001) were independent prognostic factors for overall survival. In conclusion, Pretreatment neutrophil-to-lymphocyte ratio was an independent prognostic factor for advanced lung adenocarcinoma patients treated with first-line pemetrexed/platinum doublet chemotherapy. Elevated pretreatment derived neutrophil-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio might be potential biomarkers for poorer responses to chemotherapy. To verify these findings, larger well-designed prospective studies are needed.https://doi.org/10.1177/1010428317701639
spellingShingle Yanjuan Xiong
Ning Zhao
Yu Zheng
Jian Wang
Feng Wei
Xiubao Ren
Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet
Tumor Biology
title Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet
title_full Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet
title_fullStr Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet
title_full_unstemmed Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet
title_short Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet
title_sort prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first line pemetrexed platinum doublet
url https://doi.org/10.1177/1010428317701639
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