Prognostic Role of Pretreatment Neutrophil-to-lymphocyte Ratio in Non-small Cell Lung Cancer Patients Treated with Systemic Therapy: a Meta-analysis

Overview

Journal Transl Lung Cancer Res

Date 2019 Aug 2

PMID 31367535

Citations 53

Authors

Zimu Wang

Ping Zhan

Yanling Lv

Kaikai Shen

Yuqing Wei

Hongbing Liu

Yong Song

Affiliations

Soon will be listed here.

Abstract

Background: Neutrophil-to-lymphocyte ratio (NLR) is related to prognosis in non-small cell lung cancer (NSCLC). However, no consensus on the relationship of pretreatment NLR and survival outcomes of systemic therapy in NSCLC exists. This meta-analysis investigated the prognostic role of pretreatment NLR during systemic therapy for NSCLC, including chemotherapy, immunotherapy and targeted therapy.

Methods: PubMed, Web of Science and Cochrane Library databases were systematically searched up to April 09, 2019. Hazard ratios (HRs) with their 95% confidence intervals (CIs) were pooled to investigate the association of pretreatment NLR with progression-free survival (PFS) and overall survival (OS).

Results: In total, 27 articles with 4,298 participants were selected. The pooled results showed that elevated pretreatment NLR was associated with inferior PFS (HR, 1.45, 95% CI, 1.28-1.66) and OS (HR, 1.63, 95% CI, 1.43-1.84) during systemic therapy. Subgroup analyses according to the treatment strategy suggested that higher pretreatment NLR was significantly associated with shorter survival in all therapies, including chemotherapy (PFS HR, 1.74, 95% CI, 1.39-2.17; OS HR, 1.73, 95% CI, 1.26-2.36), immunotherapy (PFS HR, 1.53, 95% CI, 1.27-1.84; OS HR, 2.50, 95% CI, 1.60-3.89) and targeted therapy (PFS HR, 1.53, 95% CI, 1.04-2.25; OS HR, 1.92, 95% CI, 1.14-3.24).

Conclusions: Pretreatment NLR is a promising prognostic indicator for NSCLC patients receiving systemic therapy, including chemotherapy, immunotherapy and targeted therapy.

Citing Articles

Assessing the predictive role of platelet-lymphocyte ratio in EGFR-mutated non-small cell lung cancer patients treated with tyrosine kinase inhibitors: an analysis across TKI generations.

Cooper R, Ramaswami D, Thomas J, Nieva J, Hsu R Discov Oncol. 2024; 15(1):689.

PMID: 39570469 PMC: 11582238. DOI: 10.1007/s12672-024-01606-9.

Combining high-resolution CT parameters and inflammatory markers to predict spread through air spaces in lung cancer.

Chen Z, Guo Y, Zhou K Am J Transl Res. 2024; 16(10):5614-5621.

PMID: 39544789 PMC: 11558354. DOI: 10.62347/CEHU4260.

Prognostic Significance of the Advanced Lung Cancer Inflammation Index in Metastatic Small Cell Lung Cancer: A Retrospective Analysis of 96 Patients.

Urun M, Guner G, Sezgin Y, Uysal E, Sakin A, Kilickap S Med Sci Monit. 2024; 30:e945752.

PMID: 39256975 PMC: 11404636. DOI: 10.12659/MSM.945752.

Comparative Analysis of Inflammatory Indexes in Lung Cancer Patients With and Without Brain Metastases.

Tamas F, Tamas C, Suciu B, Manu D, Cehan A, Balasa A Cureus. 2024; 16(5):e60921.

PMID: 38910770 PMC: 11193412. DOI: 10.7759/cureus.60921.

Prognostic Biomarkers of Systemic Inflammation in Non-Small Cell Lung Cancer: A Narrative Review of Challenges and Opportunities.

Stares M, Brown L, Abhi D, Phillips I Cancers (Basel). 2024; 16(8).

PMID: 38672590 PMC: 11048253. DOI: 10.3390/cancers16081508.

References

Teramukai S, Kitano T, Kishida Y, Kawahara M, Kubota K, Komuta K . Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer. 2009; 45(11):1950-8. DOI: 10.1016/j.ejca.2009.01.023. View

Hanahan D, Weinberg R . Hallmarks of cancer: the next generation. Cell. 2011; 144(5):646-74. DOI: 10.1016/j.cell.2011.02.013. View

Chen H, Yan J, Chen W, Kuo M, Lai Y, Lai W . Predictive and prognostic value of human copper transporter 1 (hCtr1) in patients with stage III non-small-cell lung cancer receiving first-line platinum-based doublet chemotherapy. Lung Cancer. 2011; 75(2):228-34. PMC: 3319119. DOI: 10.1016/j.lungcan.2011.06.011. View

Lee Y, Kim S, Han J, Kim H, Yun T, Lee J . Early neutrophil-to-lymphocyte ratio reduction as a surrogate marker of prognosis in never smokers with advanced lung adenocarcinoma receiving gefitinib or standard chemotherapy as first-line therapy. J Cancer Res Clin Oncol. 2012; 138(12):2009-16. DOI: 10.1007/s00432-012-1281-4. View

Proctor M, McMillan D, Morrison D, Fletcher C, Horgan P, Clarke S . A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer. Br J Cancer. 2012; 107(4):695-9. PMC: 3419948. DOI: 10.1038/bjc.2012.292. View

Yao Y, Yuan D, Liu H, Gu X, Song Y . Pretreatment neutrophil to lymphocyte ratio is associated with response to therapy and prognosis of advanced non-small cell lung cancer patients treated with first-line platinum-based chemotherapy. Cancer Immunol Immunother. 2012; 62(3):471-9. PMC: 11028855. DOI: 10.1007/s00262-012-1347-9. View

Paramanathan A, Saxena A, Morris D . A systematic review and meta-analysis on the impact of pre-operative neutrophil lymphocyte ratio on long term outcomes after curative intent resection of solid tumours. Surg Oncol. 2014; 23(1):31-9. DOI: 10.1016/j.suronc.2013.12.001. View

Jiang A, Lu H . The Glasgow prognostic score as a prognostic factor in patients with advanced non-small cell lung cancer treated with cisplatin-based first-line chemotherapy. J Chemother. 2014; 27(1):35-9. DOI: 10.1179/1973947814Y.0000000188. View

Templeton A, McNamara M, Seruga B, Vera-Badillo F, Aneja P, Ocana A . Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014; 106(6):dju124. DOI: 10.1093/jnci/dju124. View

10.

van Soest R, Templeton A, Vera-Badillo F, Mercier F, Sonpavde G, Amir E . Neutrophil-to-lymphocyte ratio as a prognostic biomarker for men with metastatic castration-resistant prostate cancer receiving first-line chemotherapy: data from two randomized phase III trials. Ann Oncol. 2014; 26(4):743-749. DOI: 10.1093/annonc/mdu569. View

11.

Mitchell P, Thatcher N, Socinski M, Wasilewska-Tesluk E, Horwood K, Szczesna A . Tecemotide in unresectable stage III non-small-cell lung cancer in the phase III START study: updated overall survival and biomarker analyses. Ann Oncol. 2015; 26(6):1134-1142. DOI: 10.1093/annonc/mdv104. View

12.

Rizvi N, Hellmann M, Snyder A, Kvistborg P, Makarov V, Havel J . Cancer immunology. Mutational landscape determines sensitivity to PD-1 blockade in non-small cell lung cancer. Science. 2015; 348(6230):124-8. PMC: 4993154. DOI: 10.1126/science.aaa1348. View

13.

Garon E, Rizvi N, Hui R, Leighl N, Balmanoukian A, Eder J . Pembrolizumab for the treatment of non-small-cell lung cancer. N Engl J Med. 2015; 372(21):2018-28. DOI: 10.1056/NEJMoa1501824. View

14.

Grenader T, Nash S, Plotkin Y, Furuse J, Mizuno N, Okusaka T . Derived neutrophil lymphocyte ratio may predict benefit from cisplatin in the advanced biliary cancer: the ABC-02 and BT-22 studies. Ann Oncol. 2015; 26(9):1910-1916. DOI: 10.1093/annonc/mdv253. View

15.

Peng B, Wang Y, Liu Y, Ma L . Prognostic significance of the neutrophil to lymphocyte ratio in patients with non-small cell lung cancer: a systemic review and meta-analysis. Int J Clin Exp Med. 2015; 8(3):3098-106. PMC: 4443032. View

16.

Gu X, Tian T, Tian X, Zhang X . Prognostic significance of neutrophil-to-lymphocyte ratio in non-small cell lung cancer: a meta-analysis. Sci Rep. 2015; 5:12493. PMC: 4513342. DOI: 10.1038/srep12493. View

17.

Yin Y, Wang J, Wang X, Gu L, Pei H, Kuai S . Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: A meta-analysis. Clinics (Sao Paulo). 2015; 70(7):524-30. PMC: 4498150. DOI: 10.6061/clinics/2015(07)10. View

18.

Zhao Q, Yang Y, Xu S, Zhang X, Wang H, Zhang H . Prognostic role of neutrophil to lymphocyte ratio in lung cancers: a meta-analysis including 7,054 patients. Onco Targets Ther. 2015; 8:2731-8. PMC: 4599071. DOI: 10.2147/OTT.S90875. View

19.

Ferrucci P, Ascierto P, Pigozzo J, Del Vecchio M, Maio M, Antonini Cappellini G . Baseline neutrophils and derived neutrophil-to-lymphocyte ratio: prognostic relevance in metastatic melanoma patients receiving ipilimumab. Ann Oncol. 2016; 27(4):732-8. DOI: 10.1093/annonc/mdw016. View

20.

Berardi R, Rinaldi S, Santoni M, Newsom-Davis T, Tiberi M, Morgese F . Prognostic models to predict survival in patients with advanced non-small cell lung cancer treated with first-line chemo- or targeted therapy. Oncotarget. 2016; 7(18):26916-24. PMC: 5042025. DOI: 10.18632/oncotarget.8309. View