Change in Neutrophil-to-lymphocyte ratio (NLR) in response to immune checkpoint blockade for metastatic renal cell carcinoma.

TitleChange in Neutrophil-to-lymphocyte ratio (NLR) in response to immune checkpoint blockade for metastatic renal cell carcinoma.
Publication TypeJournal Article
Year of Publication2018
AuthorsLalani, A-KA, Xie, W, Martini, DJ, Steinharter, JA, Norton, CK, Krajewski, KM, Duquette, A, Bossé, D, Bellmunt, J, Van Allen, EM, McGregor, BA, Creighton, CJ, Harshman, LC, Choueiri, TK
JournalJ Immunother Cancer
Volume6
Issue1
Pagination5
Date Published2018 Jan 22
ISSN2051-1426
Abstract

BACKGROUND: An elevated Neutrophil-to-lymphocyte ratio (NLR) is associated with worse outcomes in several malignancies. However, its role with contemporary immune checkpoint blockade (ICB) is unknown. We investigated the utility of NLR in metastatic renal cell carcinoma (mRCC) patients treated with PD-1/PD-L1 ICB.

METHODS: We examined NLR at baseline and 6 (±2) weeks later in 142 patients treated between 2009 and 2017 at Dana-Farber Cancer Institute (Boston, USA). Landmark analysis at 6 weeks was conducted to explore the prognostic value of relative NLR change on overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Cox and logistic regression models allowed for adjustment of line of therapy, number of IMDC risk factors, histology and baseline NLR.

RESULTS: Median follow up was 16.6 months (range: 0.7-67.8). Median duration on therapy was 5.1 months (

CONCLUSIONS: Early decline and NLR at 6 weeks are associated with significantly improved outcomes in mRCC patients treated with ICB. The prognostic value of the readily-available NLR warrants larger, prospective validation.

DOI10.1186/s40425-018-0315-0
Alternate JournalJ Immunother Cancer
PubMed ID29353553
PubMed Central IDPMC5776777
Grant ListKidney Spore / / Foundation for the National Institutes of Health / United States