Decrease in Neutrophil-to-Lymphocyte Ratio during Neoadjuvant Chemotherapy as a Predictive and Prognostic Marker in...

Area of Science:

• Oncology
• Inflammation research
• Chemotherapy response monitoring

Background:

• Chronic inflammation is linked to ovarian cancer progression.
• Pre-treatment neutrophil-to-lymphocyte ratio (NLR) has been studied for ovarian cancer prognosis.
• The dynamic changes of NLR during neoadjuvant chemotherapy (NACT) require further investigation.

Purpose of the Study:

• To evaluate the dynamic behavior of NLR during NACT in high-grade serous (HGS) advanced epithelial ovarian cancer.
• To assess the correlation of NLR changes with clinical response, progression-free survival (PFS), and other inflammatory markers.
• To determine if NLR can serve as an early predictive marker for NACT response.

Main Methods:

• Prospective observational study of 161 patients undergoing NACT for advanced HGS ovarian cancer.
• NLR was measured before NACT and after three cycles.
• Patients were categorized into responsive and non-responsive groups based on response after three cycles.

Main Results:

• Baseline NLR did not predict NACT response, but a decrease in NLR after three cycles correlated with better response.
• Post-NACT levels of CRP, IL-6, ferritin, and mGPS were associated with clinical response.
• Low NLR after three cycles, not at baseline, significantly predicted higher PFS.

Conclusions:

• NLR change during NACT is a potential predictive marker for treatment response in advanced HGS ovarian cancer.
• Monitoring NLR dynamics allows for early identification of non-responsive patients.
• This facilitates timely treatment adjustments for improved patient outcomes.