Monocytes-to-lymphocytes ratio increases the prognostic value of circulating tumor cells in non-small cell lung cancer: a prospective study

Yun Huangfu ¹, Fangfang Chang ¹, Fengjuan Zhang ¹

⁰Department of Clinical Medicine, Henan Medical College, Zhengzhou, China.

Translational Cancer Research +

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August 15, 2024

View abstract on PubMed

Summary

Combining circulating tumor cells (CTCs) with the monocytes-to-lymphocytes ratio (MLR) significantly improves prognostic value in non-small cell lung cancer (NSCLC). This combined approach aids in patient stratification and monitoring immunotherapy response.

Area Of Science

Oncology
Biomarkers
Cancer Research

Background

Circulating tumor cells (CTCs) hold prognostic significance in non-small cell lung cancer (NSCLC).
Current CTC detection sensitivity limits clinical utility.
This study investigates combining inflammation-based scores with CTCs to enhance prognostic capabilities in NSCLC.

Purpose Of The Study

To explore the feasibility of integrating peripheral blood cell (PBC)-derived inflammation scores with CTC analysis.
To improve the prognostic value of CTCs in NSCLC patients.
To assess the potential for better patient stratification and personalized treatment strategies.

Main Methods

Sixty NSCLC patients were enrolled.
CTC counts and six inflammation-based scores, including monocytes-to-lymphocytes ratio (MLR), were analyzed.
Association with progression-free survival (PFS) and overall survival (OS) was evaluated, alongside changes in CTC counts post-immunotherapy.

Main Results

Elevated CTCs (>7) and MLR (>0.2) were independently associated with shorter OS and PFS in NSCLC.
Patients with both high CTCs and MLR faced significantly increased risks of death and disease progression.
Decreased CTC counts post-immunotherapy correlated with disease control.

Conclusions

CTCs and MLR are independent prognostic factors in NSCLC.
Combining CTCs with MLR substantially enhances prognostic accuracy, aiding in patient stratification.
Dynamic CTC monitoring effectively predicts immunotherapy response in NSCLC.

Keywords:

Circulating tumor cells (CTCs) immunotherapy monocyte-to-lymphocyte ratio (MLR) non-small cell lung cancer (NSCLC) survival