Association Between Baseline and Changes in Early Neutrophil-to-Lymphocyte Ratio on Survival in Patients with Metastatic Bladder Carcinoma Treated with Immunotherapy
<i>Background and Objectives</i>: A high baseline neutrophil-to-lymphocyte ratio (NLR) is a poor prognostic factor in various cancers. However, its predictive role in metastatic bladder cancer (mBC) treated with immunotherapy is unclear. In this study, we aimed to investigate the relatio...
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MDPI AG
2024-12-01
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| author | Ezgi Değerli Çağatay Arslan Fatih Selçukbiricik Ömer Fatih Ölmez Dilek Erdem Jamshid Hamdard Mesut Yılmaz Rumeysa Çolak Caner Kapar Mustafa Erman Fatih Kuş Deniz Tural |
| author_facet | Ezgi Değerli Çağatay Arslan Fatih Selçukbiricik Ömer Fatih Ölmez Dilek Erdem Jamshid Hamdard Mesut Yılmaz Rumeysa Çolak Caner Kapar Mustafa Erman Fatih Kuş Deniz Tural |
| author_sort | Ezgi Değerli |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: A high baseline neutrophil-to-lymphocyte ratio (NLR) is a poor prognostic factor in various cancers. However, its predictive role in metastatic bladder cancer (mBC) treated with immunotherapy is unclear. In this study, we aimed to investigate the relationship between the baseline and change in NLR and overall survival in mBC patients treated with immunotherapy, with the potential to significantly impact patient care. <i>Materials and Methods</i>: A retrospective analysis was conducted on 56 mBC patients who received second-line immunotherapy after progressing on platinum-based chemotherapy. Patients were classified into high and low NLR groups using a cutoff value of 3.3. A further division was made based on NLR changes after two cycles of immunotherapy: whether NLR increased (≥10%) or decreased (≥10%). The endpoint was to estimate the association between clinicopathological features and survival outcomes. <i>Results</i>: The study included 56 patients, with a median age of 66.6 years and a male-to-female ratio of 2.3:1. A low baseline NLR was associated with better OS than a high baseline NLR (<i>p</i> = 0.005). After two immunotherapy cycles, patients with a decreased NLR (≥10%) had significantly longer OS than those with an increased NLR (≥10%), regardless of the baseline NLR (<i>p</i> = 0.003). The overall median survival was 15 months, with 10 months for the NLR-increased group and not reached for the NLR-decreased group. <i>Conclusions</i>: Our study highlights the potential of baseline NLR and early changes in NLR as valuable prognostic markers for mBC patients receiving immunotherapy. Elevated neutrophils and lymphopenia negatively impact prognosis and treatment effectiveness, and NLR shows promise as a prognostic marker, inspiring further research and potential improvements in patient care. |
| format | Article |
| id | doaj-art-ebb07e9f5f384e83b292f42972470c7a |
| institution | OA Journals |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-ebb07e9f5f384e83b292f42972470c7a2025-08-20T02:00:47ZengMDPI AGMedicina1010-660X1648-91442024-12-016012210310.3390/medicina60122103Association Between Baseline and Changes in Early Neutrophil-to-Lymphocyte Ratio on Survival in Patients with Metastatic Bladder Carcinoma Treated with ImmunotherapyEzgi Değerli0Çağatay Arslan1Fatih Selçukbiricik2Ömer Fatih Ölmez3Dilek Erdem4Jamshid Hamdard5Mesut Yılmaz6Rumeysa Çolak7Caner Kapar8Mustafa Erman9Fatih Kuş10Deniz Tural11Department of Medical Oncology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, 34147 Istanbul, TurkeyDepartment of Medical Oncology, Medical Park İzmir Hospital, 35230 Izmir, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Koc University, 34450 Istanbul, TurkeyDepartment of Medical Oncology, Medipol University Hospital, 34810 Istanbul, TurkeyDepartment of Medical Oncology, Medical Park Samsun Hospital, 55200 Samsun, TurkeyDepartment of Medical Oncology, Medipol University Hospital, 34810 Istanbul, TurkeyDepartment of Medical Oncology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, 34147 Istanbul, TurkeyDepartment of Medical Oncology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, 34147 Istanbul, TurkeyDepartment of Medical Oncology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, 34147 Istanbul, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Hacettepe University, 06100 Ankara, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Hacettepe University, 06100 Ankara, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Koc University, 34450 Istanbul, Turkey<i>Background and Objectives</i>: A high baseline neutrophil-to-lymphocyte ratio (NLR) is a poor prognostic factor in various cancers. However, its predictive role in metastatic bladder cancer (mBC) treated with immunotherapy is unclear. In this study, we aimed to investigate the relationship between the baseline and change in NLR and overall survival in mBC patients treated with immunotherapy, with the potential to significantly impact patient care. <i>Materials and Methods</i>: A retrospective analysis was conducted on 56 mBC patients who received second-line immunotherapy after progressing on platinum-based chemotherapy. Patients were classified into high and low NLR groups using a cutoff value of 3.3. A further division was made based on NLR changes after two cycles of immunotherapy: whether NLR increased (≥10%) or decreased (≥10%). The endpoint was to estimate the association between clinicopathological features and survival outcomes. <i>Results</i>: The study included 56 patients, with a median age of 66.6 years and a male-to-female ratio of 2.3:1. A low baseline NLR was associated with better OS than a high baseline NLR (<i>p</i> = 0.005). After two immunotherapy cycles, patients with a decreased NLR (≥10%) had significantly longer OS than those with an increased NLR (≥10%), regardless of the baseline NLR (<i>p</i> = 0.003). The overall median survival was 15 months, with 10 months for the NLR-increased group and not reached for the NLR-decreased group. <i>Conclusions</i>: Our study highlights the potential of baseline NLR and early changes in NLR as valuable prognostic markers for mBC patients receiving immunotherapy. Elevated neutrophils and lymphopenia negatively impact prognosis and treatment effectiveness, and NLR shows promise as a prognostic marker, inspiring further research and potential improvements in patient care.https://www.mdpi.com/1648-9144/60/12/2103immunotherapybaseline NLRbladder cancerchange in NLRoverall survival |
| spellingShingle | Ezgi Değerli Çağatay Arslan Fatih Selçukbiricik Ömer Fatih Ölmez Dilek Erdem Jamshid Hamdard Mesut Yılmaz Rumeysa Çolak Caner Kapar Mustafa Erman Fatih Kuş Deniz Tural Association Between Baseline and Changes in Early Neutrophil-to-Lymphocyte Ratio on Survival in Patients with Metastatic Bladder Carcinoma Treated with Immunotherapy Medicina immunotherapy baseline NLR bladder cancer change in NLR overall survival |
| title | Association Between Baseline and Changes in Early Neutrophil-to-Lymphocyte Ratio on Survival in Patients with Metastatic Bladder Carcinoma Treated with Immunotherapy |
| title_full | Association Between Baseline and Changes in Early Neutrophil-to-Lymphocyte Ratio on Survival in Patients with Metastatic Bladder Carcinoma Treated with Immunotherapy |
| title_fullStr | Association Between Baseline and Changes in Early Neutrophil-to-Lymphocyte Ratio on Survival in Patients with Metastatic Bladder Carcinoma Treated with Immunotherapy |
| title_full_unstemmed | Association Between Baseline and Changes in Early Neutrophil-to-Lymphocyte Ratio on Survival in Patients with Metastatic Bladder Carcinoma Treated with Immunotherapy |
| title_short | Association Between Baseline and Changes in Early Neutrophil-to-Lymphocyte Ratio on Survival in Patients with Metastatic Bladder Carcinoma Treated with Immunotherapy |
| title_sort | association between baseline and changes in early neutrophil to lymphocyte ratio on survival in patients with metastatic bladder carcinoma treated with immunotherapy |
| topic | immunotherapy baseline NLR bladder cancer change in NLR overall survival |
| url | https://www.mdpi.com/1648-9144/60/12/2103 |
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