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The pretreatment neutrophil-to-lymphocyte ratio is a novel biomarker for predicting clinical responses to pembrolizumab in platinum-resistant metastatic urothelial carcinoma patients.
- Source :
-
Urologic Oncology . Jun2020, Vol. 38 Issue 6, p602.e1-602.e10. 1p. - Publication Year :
- 2020
-
Abstract
- <bold>Purpose: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>Elevated pre-NLR may be a novel biomarker for identifying poor responders to pembrolizumab among platinum-resistant metastatic UC patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TRANSITIONAL cell carcinoma
*PROGRESSION-free survival
*DEATH rate
*DISEASE progression
*CASTRATION-resistant prostate cancer
*TREATMENT effectiveness
*THERAPEUTIC use of monoclonal antibodies
*THERAPEUTIC use of antineoplastic agents
*PREDICTIVE tests
*RETROSPECTIVE studies
*METASTASIS
*KIDNEY pelvis
*LYMPHOCYTES
*NEUTROPHILS
*KIDNEY tumors
*LEUKOCYTE count
*CISPLATIN
*DRUG resistance in cancer cells
BLADDER tumors
URETER tumors
Subjects
Details
- Language :
- English
- ISSN :
- 10781439
- Volume :
- 38
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Urologic Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 143496881
- Full Text :
- https://doi.org/10.1016/j.urolonc.2020.02.005