The Predictive Value of Neutrophil-To-Lymphocyte Ratio (NLR) for Response to Neoadjuvant Immunochemotherapy in
Di Meng1, Jiacong Liu1, Gaoqi Ye1
1Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Objective:
A significant clinical challenge remains the identification of non-small cell lung cancer (NSCLC) patients who will derive maximum benefit from neoadjuvant immunochemotherapy. The neutrophil-to-lymphocyte ratio (NLR) may offer critical insights into the host's capacity to mount an effective anti-tumor response.
Methods:
This retrospective study consecutively included patients with stage IIA-IIIB NSCLC who received 2-4 cycles of platinum-based immunochemotherapy prior to planned resection at the Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine from 2017 to 2022.
Results:
A total of 317 patients were included in our study and divided into two groups according to the median baseline NLR (3.27) of the whole population: low NLR (< 3.27) group (160 patients) and high NLR (≥ 3.27) group (157 patients). The rate of MPR in the low NLR group was significantly higher than that in the high NLR group (58.3% vs. 38.5%, p = 0.008). The median PFS in the low NLR group was not reached and 21.6 months (95% confidence interval [CI], 16.9 to 26.3) in the high NLR group (hazard ratio [HR] for disease progression, disease recurrence, or death, 0.431; 95% CI, 0.312 to 0.594; p < 0.001). The median OS in the low NLR group was not reached and 33.2 months (95% CI, 18.8 to 47.6) in the high NLR group (HR for death, 0.416; 95% CI, 0.295 to 0.586; p < 0.001).
Conclusions:
A low pre-treatment NLR is a predictive marker of enhanced pathological response and improved survival outcomes in IIA-IIIB NSCLC patients undergoing neoadjuvant immunochemotherapy.