(ChemotherapyAdvisor) – Neutrophil to lymphocyte ratio (NLR) is associated with response to combination platinum-based chemotherapy and survival rates among patients with non-small cell lung cancer (NSCLC), according to a study published in the Cancer Immunology and Immunotherapy.

The study found NLR to be “associated with treatment response, PFS (progression-free survival) and OS (overall survival) for first-line platinum-based chemotherapy-treated advanced NSCLC patients,” reported Yanwen Yao, MD, Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China, and coauthors.

“Patients with low pretreatment NLR ≤2.63 had a better platinum-based chemotherapy response and longer PFS and OS,” they wrote. “In multivariate survival analysis, after adjusting (for) gender, smoking status, pathologic stage, CRP and monocyte count, NLR remained (an) independent factor associated with treatment response, PFS and OS.”

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The study enrolled 182 patients during 2007 to 2010. NLR was calculated as the absolute neutrophil count divided by absolute lymphocyte count. Median PFS was 164.5 days and median OS was 439.5 days, the authors wrote.

In univariate analyses, pretreatment NLR >2.63 was associated with worse PFS (HR 2.004, P=0.002) and worse OS (2.036; P=0.001). In multivariate analyses, PFS and OS remained significantly associated with high pretreatment NLR, as well as distant metastasis. Low pretreatment NLR (≤2.63) was associated with tumor response to first-line platinum-based chemotherapy (OR 2.043; P=0.043), as was decreased posttreatment NLR (OR 2.368; P=0.013).

“Recent clinical studies reveal that NLR was associated with prognosis in many cancers, such as breast cancer, metastasis renal carcinoma and colorectal cancer,” the authors noted. “Research on the inflammatory tumor microenvironment supported that chronic inflammation contributed to cancer initiation, promotion, progression and invasion. Preclinical studies also indicated that neutrophils may act as tumor promoting leukocytes through TGF-β induced signal pathway.”