Clinical value of neutrophil-to-lymphocyte ratio in patients with non-small-cell lung cancer treated with PD-1/PD-L1 inhibitors
Clinical value of neutrophil-to-lymphocyte ratio in patients with non-small-cell lung cancer treated with PD-1/PD-L1 inhibitors
复制标题
PD-1/PD-L1抑制剂治疗非小细胞肺癌患者中性粒细胞与淋巴细胞比值的临床价值
DOI：
10.1016/j.lungcan.2019.02.009
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发表时间：
2019-04-01
期刊：
影响因子：
5.3
通讯作者：
Zhou, Caicun
中科院分区：
文献类型：
--
作者：
Jiang, Tao;Bai, Yuchen;Zhou, Caicun
引言：探索PD-1/PD-L1抑制剂在非小细胞肺癌（NSCLC）患者中的预测性生物标志物的需求尚未得到满足。本研究旨在探讨PD-1/PD-L1抑制剂治疗的NSCLC患者中血液嗜中性粒细胞/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检索，以探讨接受PD-1/PD-L1抑制剂治疗的NSCLC患者中血液NLR与总生存期（OS）或无进展生存期（PFS）之间的关系。包括风险比（HR）和95%置信区间（CI）在内的已发表数据符合要求。采用Stata/MP 14.1计算治疗结果的汇总估计值。结果：纳入16项研究的1700例患者。合并结果显示，高血NLR与OS（HR = 2.07，P < 0.001）和PFS（HR = 1.59，P < 0.001）显著缩短相关。在包括发表年份、研究设计、研究地区、PD-L1表达检测、样本量、NLR截止值、中位随访时间和研究质量评分在内的大多数亚组中，均观察到血液NLR的预测和预后意义。此外，NLR临界值升高与OS获益显著相关（r = 0.585，P = 0.036），但与PFS获益无关（r = 0.198，P = 0.496）。结论：在PD-1/PD-L1抑制剂治疗的NSCLC患者中，血NLR升高与PFS和OS缩短相关，提示其在临床上具有潜在的预测和预后价值。
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.