Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognostic markers in patients with extensive-stage small cell lung cancer treated with atezolizumab in combination with chemotherapy

Kutlu, Yasin; Aydın, Sabin Göktaş; Bılıcı, Ahmet; Öven, Bala Başak; Ölmez, Ömer Fatih; Açıkgöz, Özgür; Hamdard, Jamshid

doi:10.1097/md.0000000000033432

Cited by 9 publications

(3 citation statements)

References 19 publications

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“…Of potential prognostic importance is the patient’s early tumour response, since early tumour shrinkage/response is associated with improved survival in patients with ES-SCLC [ 14 – 16 ], although our patient also had a number of characteristics that could have contributed to his long-term survival, including age < 65 years [ 17 , 18 ] and good performance status [ 16 , 19 – 23 ]. Further, his neutrophil-to-lymphocyte ratio (2.05) was consistent with that considered to be prognostic for better survival (a ratio of ≤ 3.43), as reported in a study that investigated the prognostic role of inflammatory markers in patients with ES-SCLC who were treated with atezolizumab plus chemotherapy [ 24 ]. However, our patient also had risk factors for reduced survival, including male gender [ 16 ] and bone metastasis [ 17 , 18 ].…”

Section: Discussionsupporting

confidence: 78%

Long-Term Survival and Stable Disease in a Patient with Extensive-Stage Small-Cell Lung Cancer after Treatment with Carboplatin, Etoposide and Atezolizumab

Bernabé,

Liu,

Sánchez-Gastaldo

et al. 2024

Oncol Ther

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Survival beyond 2 years is rare in patients with extensive-stage small-cell lung cancer (ES-SCLC) treated with chemotherapy alone. We describe a patient with ES-SCLC who was treated with carboplatin, etoposide and the programmed death-ligand 1 inhibitor atezolizumab in the IMpower133 study (ClinicalTrials.gov registration: NCT02763579) and who achieved exceptionally long-term survival. Treatment-naïve patients with ES-SCLC ( n = 403) were included in the IMpower133 study, and the identified patient had been randomised to the investigational treatment arm, where patients received induction therapy with carboplatin and etoposide plus atezolizumab for four 21–day cycles, followed by ongoing maintenance therapy with atezolizumab. The patient had achieved a partial response after induction therapy, and then received seven cycles of atezolizumab maintenance therapy until immune-related toxicities necessitated discontinuation. The patient was alive with an ongoing response and excellent performance status more than 6 years after starting treatment and 5 years after discontinuing atezolizumab maintenance. In conclusion, this patient with ES-SCLC from the IMpower133 study is a rare example of ongoing survival more than 6 years beyond diagnosis and the start of treatment with first-line atezolizumab. This demonstrates the potential durability of response with immunotherapy.

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Section: Discussionsupporting

confidence: 78%

Long-Term Survival and Stable Disease in a Patient with Extensive-Stage Small-Cell Lung Cancer after Treatment with Carboplatin, Etoposide and Atezolizumab

Bernabé,

Liu,

Sánchez-Gastaldo

et al. 2024

Oncol Ther

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“… 16 However, Yasin et al found that NLR was associated with poor prognosis in 55 extensive-stage SCLC patients who received front-line atezolizumab with etoposide plus platin regimen. 17 The difference of two studies might be due to sample size.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of pretreatment procalcitonin and neutrophil–lymphocyte ratio in extensive-stage small-cell lung cancer

Chen,

Xu,

Zhao

et al. 2024

Cancer Biology & Therapy

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Background To investigate the influence of pretreatment neutrophil-to-lymphocyte ratio (NLR) and procalcitonin (PCT) on progression-free survival (PFS) in extensive-stage small-cell lung cancer (SCLC) patients. Method A total of 100 extensive-stage SCLC patients were enrolled in our study. Patients were stratified according to the median values of pretreatment NLR and PCT levels: low NLR group (NLR ≤3.17), high NLR group (NLR＞3.17), low PCT group (PCT ≤0.06; ng/ml), high PCT group (PCT＞0.06; ng/ml). The Kaplan-Meier method and multivariable Cox regression model were used to reveal the prognostic effects of pretreatment NLR and PCT on PFS. Results The median PFS of the total extensive-stage SCLC patients was 6.0 months. The median PFS of low pretreatment NLR group (NLR ≤3.17) was not significantly different from that of high pretreatment NLR group (6.2 months vs 5.8 months; p = .675). Patients with low pretreatment PCT (PCT ≤0.06; ng/ml) had significantly better PFS than patients with high pretreatment PCT (PCT＞0.06; ng/ml) (6.9 months vs 5.7 months; p = .043). With the multivariable Cox regression analysis, the response to first-line chemotherapy ( p ≤ .001) and pretreatment PCT (HR = 0.516; 95%CI 0.326–0.817; p = .005) were identified as independent factors associated with PFS. Conclusion Pretreatment PCT is an independent factor associated with PFS in extensive-stage SCLC patients treated with first-line chemotherapy, but pretreatment NLR reflects no significant prognostic value in our study.

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“…This approach is also supported by previous studies that have demonstrated the value of combining multiple inflammatory markers to improve prognostic stratification in patients with SCLC. 6 , 47 , 48 , 49 …”

Section: Discussionmentioning

confidence: 99%

Lipocalin‐2 as a prognostic biomarker and its association with systemic inflammation in small cell lung cancer

Go,

Yang,

Lee

et al. 2024

Thoracic Cancer

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BackgroundSystemic inflammation is believed to contribute to small cell lung cancer (SCLC) progression, but the underlying relationship remains unclear. Lipocalin‐2, a potential biomarker of inflammation, has been implicated in various cancers but its prognostic value in SCLC is underexplored.MethodsWe retrospectively analyzed 191 patients with SCLC (72 with limited‐stage [LD] and 119 with extensive‐stage) treated using platinum‐based chemotherapy. Lipocalin‐2 expression was evaluated using immunohistochemistry. Optimal cutoff values for lipocalin‐2 and neutrophil‐to‐lymphocyte ratio (NLR) were determined using time‐dependent receiver operating characteristic curve analysis. The pectoralis muscle index was used to assess sarcopenia.ResultsIn LD‐SCLC, high lipocalin‐2 expression was associated with worse progression‐free survival (PFS; median: 7.0 vs. 15.9 months, p = 0.015) and overall survival (OS; median: 12.9 vs. 30.3 months, p = 0.035) compared with low lipocalin‐2 expression. Patients were stratified into three prognostic groups by combining lipocalin‐2 with NLR: low lipocalin‐2/low NLR, high lipocalin‐2/low NLR or low lipocalin‐2/high NLR, and high lipocalin‐2/high NLR (median PFS: 17.3 vs. 11.0 vs. 6.3 months, p = 0.004; median OS: 30.5 vs. 17.3 vs. 8.6 months, p = 0.002). Similar trends were observed when combining lipocalin‐2 with the pectoralis muscle index. High lipocalin‐2 expression was also associated with lower complete response rates (18.9% vs. 34.3%, p = 0.035). No significant prognostic implications were found for lipocalin‐2 in extensive‐stage SCLC.ConclusionsHigh lipocalin‐2 expression is potentially associated with poorer survival in LD‐SCLC. Combining lipocalin‐2 with other inflammation‐related markers could improve prognostic stratification.

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Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognostic markers in patients with extensive-stage small cell lung cancer treated with atezolizumab in combination with chemotherapy

Cited by 9 publications

References 19 publications

Long-Term Survival and Stable Disease in a Patient with Extensive-Stage Small-Cell Lung Cancer after Treatment with Carboplatin, Etoposide and Atezolizumab

Long-Term Survival and Stable Disease in a Patient with Extensive-Stage Small-Cell Lung Cancer after Treatment with Carboplatin, Etoposide and Atezolizumab

Prognostic value of pretreatment procalcitonin and neutrophil–lymphocyte ratio in extensive-stage small-cell lung cancer

Lipocalin‐2 as a prognostic biomarker and its association with systemic inflammation in small cell lung cancer

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