在非小细胞肺癌（NSCLC）患者中探索PD-1 / PD-L1抑制剂的预测生物标志物尚未得到满足。在这里，我们旨在研究用PD-1 / PD-L1抑制剂治疗的NSCLC患者血液中性粒细胞与淋巴细胞比率（NLR）的预测和预后价值。
我们进行了全面的在线搜索，以探索血浆NLR与接受PD-1 / PD-L1抑制剂的NSCLC患者的总生存期（OS）或无进展生存期（PFS）之间的关联。已公布的数据包括风险比（HRs）和95％置信区间（CI）符合条件。使用Stata / MP 14.1计算治疗结果的汇总估计值。
纳入了来自16项研究的1700名患者。汇总结果表明，高血压NLR与显着较短的OS（HR = 2.07，P <0.001）和PFS（HR = 1.59，P <0.001）相关。在大多数亚组中观察到血液NLR的预测和预后意义，包括出版年份，研究设计，研究区域，PD-L1表达检测，样本大小，NLR截止值，中位随访时间和研究质量评分。此外，升高的NLR临界值和OS益处之间存在显着相关性（r = 0.585，P = 0.036），但PFS益处没有（r = 0.198，P = 0.496）。值得注意的是，PFS的HR与OS的HR显着相关（r = 0.686，P = 0.041）。
血液NLR升高与PD-1 / PD-L1抑制剂治疗的NSCLC患者的PFS和OS较短相关，提示其在该临床情况下具有潜在的预测和预后价值。
There is unmet need to explore the predictive biomarkers of PD-1/PD-L1 inhibitors in patients with non-small-cell lung cancer (NSCLC). Here, we aimed to investigate the predictive and prognostic value of blood neutrophil-to-lymphocyte ratio (NLR) in NSCLC patients treated with PD-1/PD-L1 inhibitors.
We performed a comprehensive online search to explore the association between blood NLR and overall survival (OS) or progression-free survival (PFS) in NSCLC patients received PD-1/PD-L1 inhibitors. Published data including hazard ratios (HRs) and 95% confidence interval (CI) were eligible. Pooled estimates of treatment outcomes were calculated using Stata/MP 14.1.
1700 patients from sixteen studies were included. The pooled results suggested that high blood NLR was correlated with significantly shorter OS (HR = 2.07, P < 0.001) and PFS (HR = 1.59, P < 0.001). The predictive and prognostic significance of blood NLR were observed consistently across most subgroups including publication year, study design, research region, PD-L1 expression detection, sample size, NLR cutoff, median follow-up time and study quality score. Additionally, there was a significant correlation between elevated NLR cutoff values and OS benefit (r = 0.585, P = 0.036) but not for PFS benefit (r = 0.198, P = 0.496). Notably, HRs of PFS showed significant correlation with HRs of OS (r = 0.686, P = 0.041).
Elevated blood NLR was associated with shorter PFS and OS in NSCLC patients treated with PD-1/PD-L1 inhibitors, suggesting its potential predictive and prognostic value in this clinical scenario.