Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Outcomes with Nivolumab in Pretreated Non-Small Cell Lung Cancer (NSCLC): A Large Retrospective Multicenter Study

Antonio Galvano, Antonio Russo, Francesco Pantano, Tindara Franchina, Fausto Petrelli, Enrico Vasile, Antonio Russo, Silvia Quadrini, Salvatore Intagliata, Daniela Iacono, Marco Imperatori, Giuseppina R. R. Ricciardi, Lorenzo Calvetti, Antonio Russo, Elisa Roca, Marco Russano, Antonio Galvano, Alessandro Russo, Giulia Pasquini, Michele AietaMario Occhipinti, Luana Calabrò, Alfredo Berruti, Olga Martelli, Giuseppe Aprile, Maria R. Migliorino, Vincenzo Adamo, Giovanni Mansueto, Alfredo Falcone, Alfredo Berruti, Michele Maio, Giuseppe Tonini, Sandro Barni, Daniele Santini, Alain Gelibter, Elena Procaccianti

Risultato della ricerca: Articlepeer review

23 Citazioni (Scopus)


Introduction: Immune checkpoint inhibitors have provided substantial benefit in non-small cell lung cancer (NSCLC) with unprecedented results in terms of survival. However, the identification of reliable predictive biomarkers to these agents is lacking and multiple clinicopathological factors have been evaluated. The aim of this study was to analyze the potential role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) levels in patients with pretreated NSCLC receiving nivolumab. Methods: This was a retrospective multicenter study involving 14 Italian centers, evaluating the role of some laboratory results in patients with NSCLC treated with nivolumab in the second or later lines of therapy for at least four doses and with a disease re-staging. Results: A total of 187 patients with available pretreatment laboratory results were included. NLR levels below 5 were associated with an improvement in terms of both progression-free survival (PFS) (p = 0.028) and overall survival (OS) (p = 0.001), but not in terms of overall response rate (ORR) or disease control rate (DCR). Moreover, PLR levels below 200 were associated with longer PFS (p = 0.0267) and OS (p = 0.05), as well as higher ORR (p = 0.04) and DCR (p = 0.001). In contrast, LDH levels above the upper normal limit (UNL) were not associated with significant impact on patient outcomes. Conclusions: Patients with pretreated NSCLC and high pretreatment levels of NLR and PLR may experience inferior outcomes with nivolumab. Therefore, in this subgroup of patients with poor prognosis the use of alternative therapeutic strategies may be a valuable option, especially in programmed cell death ligand 1 (PD-L1)-negative patients and/or in the presence of other additional poor prognostic factors.
Lingua originaleEnglish
pagine (da-a)1145-1155
Numero di pagine11
RivistaAdvances in Therapy
Stato di pubblicazionePublished - 2020

All Science Journal Classification (ASJC) codes

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