Prognostic value of platelet-to-lymphocyte ratio in neoadjuvant chemotherapy for solid tumors

Abstract

Introduction: Previous research indicates that the platelet-to-lymphocyte ratio (PLR) may be an indicator of poor prognosis in many tumor types. However, the PLR is rarely described in patients undergoing neoadjuvant chemotherapy (NAC) for solid tumors. Thus, we performed a meta-analysis to investigate the prognostic value of this ratio for patients with solid tumors treated by NAC.Methods: A comprehensive search of the literature was conducted using the PubMed, EMBASE, Cochrane Library, and Web of Science databases, followed by a manual search of references from the retrieved articles. Pooled hazard ratios (HRs) with 95% confidence interval (CIs) were used to evaluate the association between PLR and 3 outcomes, namely, overall survival, disease-free survival, and pathological complete response rate after NAC.Results: Eighteen studies published no earlier than 2014 were included in our study. A lower PLR was associated with better overall survival (HR = 1.46, 95% CI, 1.11-1.92) and favorable disease-free survival (HR = 1.81, 95% CI, 1.27-2.59). A PLR that was higher than a certain cutoff was associated with a lower pathological complete response rate in patients with cancer who received NAC (Odds ratio = 1.93, 95% CI, 1.40-2.87).Conclusion: Elevated PLR is associated with poor prognosis in various solid tumors. PLR may be a useful biomarker in delineating those patients with poorer prognoses who may benefit from neoadjuvant therapies.Abbreviations: CI = confidence interval, DFS = disease-free survival, HR = hazard ratio, NOS = Newcastle-Ottawa Scale, OR = odds ratio, OS = overall survival, PFS = progression-free survival, PLR = platelet-to-lymphocyte ratio, NAC = neoadjuvant chemotherapy, nCRT = neoadjuvant chemoradiotherapy, pCR = pathological complete response, ROC = receiver operating characteristic curve.

Predictive value of pretreatment circulating inflammatory response markers in the neoadjuvant treatment of breast cancer: meta-analysis

“…A meta-analysis by Long et al . 63 suggested that a lower PLR was associated with an increased likelihood of a pCR, in combined analysis of breast and rectal tumours. This is the first systematic review to investigate the role of the PLR in predicting a pCR, specifically in breast cancer.…”