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Association of baseline neutrophil-to-lymphocyte ratio and prognosis in melanoma patients treated with PD-1/PD-L1 blockade: a systematic review and meta-analysis

  • 0Lutheran University of Brazil, Canoas, Rio Grande do Sul, Brazil.
Melanoma Research +

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November 11, 2024

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November 11, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

The neutrophil-lymphocyte ratio (NLR) can predict outcomes for metastatic melanoma patients receiving immunotherapy. A low baseline NLR indicates better overall survival and progression-free survival in patients treated with PD-1/PD-L1 blockade.

Area Of Science

  • Oncology
  • Immunology
  • Biomarker Research

Background

  • Immunotherapy targeting programmed cell death receptor-1 (PD-1) or its ligand (PD-L1) has transformed metastatic melanoma treatment.
  • Identifying reliable and cost-effective biomarkers for predicting treatment response remains a challenge.

Purpose Of The Study

  • To systematically review and meta-analyze the predictive value of the baseline neutrophil-lymphocyte ratio (NLR) for disease progression and overall survival in metastatic melanoma patients undergoing PD-1/PD-L1 blockade therapy.

Main Methods

  • A systematic literature search was conducted across PubMed, Scopus, and Web of Science for studies comparing high versus low NLR in melanoma patients.
  • A meta-analysis was performed using RStudio v4.4.2, including 20 studies with 2691 patients.
  • Outcomes analyzed included overall survival (OS) and progression-free survival (PFS).

Main Results

  • Patients with a low baseline NLR demonstrated significantly better overall survival (HR, 2.07; P < 0.00001) and progression-free survival (HR, 1.59; P < 0.00001) compared to those with high NLR.
  • The analysis included 2691 patients, with a majority being male (84.65%).
  • Median OS ranged from 5.0 to 44.4 months, and median PFS ranged from 1.8 to 15.0 months.

Conclusions

  • Elevated baseline NLR is associated with significantly lower overall survival in metastatic melanoma patients treated with PD-1/PD-L1 inhibitors.
  • A lower baseline NLR is linked to improved progression-free survival.
  • The neutrophil-lymphocyte ratio (NLR) is highlighted as a valuable prognostic biomarker for selecting metastatic melanoma patients for PD-1/PD-L1 immunotherapy.