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Clinical value of neutrophil-to-lymphocyte ratio in patients with non-small-cell lung cancer treated with PD-1/PD-L1 inhibitors

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Clinical value of neutrophil-to-lymphocyte ratio in patients with non-small-cell lung cancer treated with PD-1/PD-L1 inhibitors
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介绍
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。

方法
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。

结果
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)。

结论
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。

Abstract

Introduction

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.

Methods

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.

Results

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).

Conclusion

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.

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