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Neutrophil-to-Lymphocyte Ratio Is a Predictive Biomarker in Patients with Epidermal Growth Factor Receptor (EGFR) Mutated Advanced Non-Small Cell Lung Cancer (NSCLC) Treated with Tyrosine Kinase Inhibitor (TKI) Therapy.
Yun, Nicole K; Rouhani, Sherin J; Bestvina, Christine M; Ritz, Ethan M; Gilmore, Brendan A; Tarhoni, Imad; Borgia, Jeffrey A; Batus, Marta; Bonomi, Philip D; Fidler, Mary Jo.
Afiliação
  • Yun NK; Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
  • Rouhani SJ; Section of Hematology/Oncology, Department of Medicine, The University of Chicago Comprehensive Cancer Center, Chicago, IL 60637, USA.
  • Bestvina CM; Section of Hematology/Oncology, Department of Medicine, The University of Chicago Comprehensive Cancer Center, Chicago, IL 60637, USA.
  • Ritz EM; Bioinformatics and Biostatistics Core, Rush University Medical Center, Chicago, IL 60612, USA.
  • Gilmore BA; Hematology, Oncology and Cell Therapy, Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
  • Tarhoni I; Cell & Molecular Medicine, Pathology, Rush University Medical Center, Chicago, IL 60612, USA.
  • Borgia JA; Cell & Molecular Medicine, Pathology, Rush University Medical Center, Chicago, IL 60612, USA.
  • Batus M; Hematology, Oncology and Cell Therapy, Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
  • Bonomi PD; Hematology, Oncology and Cell Therapy, Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
  • Fidler MJ; Hematology, Oncology and Cell Therapy, Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
Cancers (Basel) ; 13(6)2021 Mar 20.
Article em En | MEDLINE | ID: mdl-33804721
ABSTRACT

BACKGROUND:

First-line treatment for patients with non-small cell lung cancer (NSCLC) with a sensitizing epidermal growth factor receptor (EGFR) mutation is a tyrosine kinase inhibitor (TKI). Despite higher response rates and prolonged progression free survival (PFS) compared with platinum doublet chemotherapy, a subset of these patients do not receive prolonged benefit from these agents. We investigate if the neutrophil-to-lymphocyte ratio (NLR) and other markers of cachexia and chronic inflammation correlate with worse outcomes in these patients.

METHODS:

This study is a retrospective review of 137 patients with advanced EGFR-mutated NSCLC treated with TKIs at Rush University Medical Center and University of Chicago Medicine from August 2011 to July 2019, with outcomes followed through July 2020. The predictive value of NLR and body mass index (BMI) was assessed at the start of therapy, and after 6 and 12 weeks of treatment by univariable and multivariable analyses.

RESULTS:

On univariable analysis, NLR ≥ 5 or higher NLR on a continuous scale were both associated with significantly worse PFS and overall survival (OS) at treatment initiation, and after 6 or 12 weeks of treatment. On multivariable analysis, NLR ≥ 5 was associated with increased risk of death at 12 weeks of therapy (HR 3.002, 95% CI 1.282-7.029, p = 0.011), as was higher NLR on a continuous scale (HR 1.231, 95% CI 1.063-1.425, p = 0.0054). There was no difference in PFS and OS and amongst BMI categories though number of disease sites and Eastern Cooperative Oncology Group (ECOG) performance status was associated with worse PFS and OS.

CONCLUSIONS:

Patients with NLR ≥ 5 have a worse median PFS and median OS than patients with NLR < 5. NLR may have value as a predictive biomarker and may be useful for selecting patients for therapy intensification in the front-line setting either at diagnosis or after 12 weeks on therapy. NLR needs to be validated prospectively.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Cancers (Basel) Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Cancers (Basel) Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos