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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 [Urol Oncol] 2020 Jun; Vol. 38 (6), pp. 602.e1-602.e10. Date of Electronic Publication: 2020 Mar 02. - Publication Year :
- 2020
-
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.<br />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.<br />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).<br />Conclusions: Elevated pre-NLR may be a novel biomarker for identifying poor responders to pembrolizumab among platinum-resistant metastatic UC patients.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2496
- Volume :
- 38
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Urologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 32139290
- Full Text :
- https://doi.org/10.1016/j.urolonc.2020.02.005