Neutrophil-to-lymphocyte ratio predicts platinum sensitivity in epithelial ovarian cancer patients: A MITO24 retrospective study

Background The prognostic value of the inflammatory indexes (eg. neutrophil-to-lymphocyte ratio, NLR; and systemic immune-inflammation index, SII) was demonstrated among patients with epithelial ovarian cancer (EOC). This study aimed to evaluate their predictive value in terms of platinum-free interval (PFI) as regard to bevacizumab treatment received. Methods A total of 375 EOC patients were retrospectively analyzed, 301 treated with chemotherapy alone and 74 with bevacizumab, with the decision to include this drug in the chemotherapy regimen left to the discretion of the treating physician. The correlation between NLR (defined as the ratio of neutrophil to lymphocyte count) and SII, calculated as (platelet count × neutrophil count)/lymphocyte count, and PFI were analyzed using logistic regression analyses adjusted for baseline patient characteristics. Cutoff values were determined using Receiver Operating Characteristic (ROC) analysis. Results In univariate analysis, patients with high NLR (≥3) and SII (≥730) had a significantly shorter PFI at 6 and 12 months in overall cohort. In multivariate analysis, only NLR was an independent predictive factor for PFI at 6 months (OR = 2.52, 95% CI 1.30–4.87, p = 0.006) and at 12 months (OR = 2.05, 95% CI 1.05–4.01, p = 0.036) in the overall population and in the chemotherapy group (OR = 2.77, 95% CI 1.38–5.56, p = 0.004; HR = 2.27, 95% CI 1.10–4.70, p = 0.027, respectively). Inflammatory indexes were not predictive for PFI in the bevacizumab group (Table). Table: 1020P . PFI at 6 months PFI at 12 months N. pts N. pts OR (95% CI) p N. pts N. pts OR (95% CI) p NLR 74 139 1.00 113 98 1.00 ≥3 80 68 2.52 (1.30-4.87) 0.006 106 37 2.05 (1.05-4.01) 0.036 SII 52 99 1.00 76 73 1.00 ≥730 102 108 0.74 (0.36-1.53) 0.413 143 62 0.91 (0.45-1.84) 0.786 CT NLR 62 115 1.00 98 78 1.00 ≥3 69 48 2.77 (1.38-5.56) 0.004 89 24 2.27 (1.10-4.70) 0.027 SII 41 80 1.00 63 56 1.00 ≥730 90 83 0.76 (0.35-1.67) 0.498 124 46 0.84 (0.39-1.82) 0.663 CT+B NLR 12 24 1.00 15 20 1.00 ≥3 11 20 0.47 (0.04-5.15) 0.538 17 13 0.75 (0.11-5.25) 0.774 SII 11 19 1.00 13 17 1.00 ≥730 12 25 1.65 (0.13-20.56) 0.696 19 16 1.78 (0.21-15.14) 0.599 Conclusions The NLR was an independent predictive factor for platinum-sensitivity in patients with EOC treated with chemotherapy. Its predictive role seems to be lost in patients treated with bevacizumab. Legal entity responsible for the study MITO group. Funding MITO group. Disclosure All authors have declared no conflicts of interest.