1. The pretreatment neutrophil-to-lymphocyte ratio is a novel biomarker for predicting clinical responses to pembrolizumab in platinum-resistant metastatic urothelial carcinoma patients.
- Author
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Ogihara K, Kikuchi E, Shigeta K, Okabe T, Hattori S, Yamashita R, Yoshimine S, Shirotake S, Nakazawa R, Matsumoto K, Mizuno R, Hara S, Oyama M, Masuda T, Niwakawa M, and Oya M
- Subjects
- Aged, Aged, 80 and over, Carcinoma, Transitional Cell secondary, Cisplatin therapeutic use, Drug Resistance, Neoplasm, Female, Humans, Kidney Neoplasms pathology, Leukocyte Count, Male, Middle Aged, Neoplasm Metastasis, Predictive Value of Tests, Retrospective Studies, Treatment Outcome, Ureteral Neoplasms pathology, Urinary Bladder Neoplasms pathology, Antibodies, Monoclonal, Humanized therapeutic use, Antineoplastic Agents therapeutic use, Carcinoma, Transitional Cell blood, Carcinoma, Transitional Cell drug therapy, Kidney Neoplasms blood, Kidney Neoplasms drug therapy, Kidney Pelvis, Lymphocytes, Neutrophils, Ureteral Neoplasms blood, Ureteral Neoplasms drug therapy, Urinary Bladder Neoplasms blood, Urinary Bladder Neoplasms drug therapy
- Abstract
Purpose: We investigated the relationship between pretreatment neutrophil-to-lymphocyte ratio (pre-NLR) levels just before the initiation of treatment with pembrolizumab and clinical outcomes in platinum-resistant metastatic urothelial carcinoma (UC) patients treated with pembrolizumab., Methods: Our study population comprised 78 patients diagnosed with metastatic UC and treated with pembrolizumab after platinum-based chemotherapy at our institutions between December 2017 and April 2019. We examined the relationships between pre-NLR levels just before pembrolizumab treatment and clinical outcomes. A pre-NLR level of ≥3.35 was defined as elevated according to a calculation by a receiver-operating curve analysis., Results: The high pre-NLR group consisted of 33 patients (42.3%). Overall, 29.5% of patients had a clinical response and the sum of the target lesion longest diameter was decreased in 18.8% of the high pre-NLR group, which was significantly lower than that in the low pre-NLR group (58.1%, P = 0.005). Six-month progression-free survival and cancer-specific survival rates for the high pre-NLR group were 9.1 and 58.0%, which were significantly lower than those for their counterpart (45.9 and 89.1%, P < 0.001 and P = 0.002, respectively). The pre-NLR level was an independent indicator of disease progression and cancer-specific death (P < 0.001 and P = 0.003). Furthermore, patients with a postpembrolizumab NLR level that had decreased ≥25% from the pre-NLR level had significantly lower disease progression and cancer-specific death rates than their counterparts (P = 0.01 and P = 0.022, respectively)., Conclusions: Elevated pre-NLR may be a novel biomarker for identifying poor responders to pembrolizumab among platinum-resistant metastatic UC patients., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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