Prognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study

BackgroundNivolumab and pembrolizumab are the standard treatments for patients with advanced non-small-cell lung cancer (NSCLC). While there are reports on several inflammatory indices and the prognosis of patients with cancer, no study has combined baseline medication with the neutrophil-to-lymphoc...

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Autores principales:	Toshiki Ogiwara, Hitoshi Kawazoe, Saeka Egami, Hironobu Hashimoto, Yoshimasa Saito, Naomi Sakiyama, Yuichiro Ohe, Masakazu Yamaguchi, Tetsuya Furukawa, Azusa Hara, Yui Hiraga, Aya Jibiki, Yuta Yokoyama, Sayo Suzuki, Tomonori Nakamura
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	nivolumab pembrolizumab baseline medications neutrophil-to-lymphocyte ratio prognostic score Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/b197c72349844806ab490770dcad20f3
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spelling	oai:doaj.org-article:b197c72349844806ab490770dcad20f32021-11-08T05:27:15ZPrognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study2234-943X10.3389/fonc.2021.770268https://doaj.org/article/b197c72349844806ab490770dcad20f32021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.770268/fullhttps://doaj.org/toc/2234-943XBackgroundNivolumab and pembrolizumab are the standard treatments for patients with advanced non-small-cell lung cancer (NSCLC). While there are reports on several inflammatory indices and the prognosis of patients with cancer, no study has combined baseline medication with the neutrophil-to-lymphocyte ratio (NLR) to predict clinical outcomes. This study investigated the efficacy of baseline medications plus NLR to predict the effectiveness of nivolumab and pembrolizumab in a real-world clinical setting.MethodsWe conducted a single-center retrospective observational study of consecutive patients with advanced NSCLC who received nivolumab or pembrolizumab as first-line, second-line, or beyond treatment between December 2015 and November 2018 at the National Cancer Center Hospital in Japan. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. The drug-based prognostic score for baseline medications plus NLR was weighed based on the regression β coefficients. The multivariable Cox proportional hazard model was used to assess the association between the prognostic score-stratified groups and survival outcomes.ResultsIn total, 259 patients were evaluated in this study. A prognostic score calculated from the baseline medications plus NLR was used to categorize the patients into good (score 0), intermediate (scores 1–2), and poor (scores 3–6) -prognosis groups. The multivariable Cox proportional hazard model revealed a significant association between the poor-prognosis group and reduced OS. The hazard ratio of OS was 1.75 (95% confidence interval: 1.07–2.99; P = 0.031). In contrast, no association between these prognosis groups and PFS was observed.ConclusionsThe findings suggest that the baseline medications with nivolumab or pembrolizumab plus NLR could lead to progressively shorter survival outcomes in patients with advanced NSCLC and could be used as a prognostic index for poor outcomes. However, to ascertain the clinical application of these findings, these concomitant medications need further validation in a large-scale multicenter study.Toshiki OgiwaraHitoshi KawazoeHitoshi KawazoeSaeka EgamiHironobu HashimotoYoshimasa SaitoNaomi SakiyamaYuichiro OheMasakazu YamaguchiTetsuya FurukawaAzusa HaraYui HiragaAya JibikiYuta YokoyamaYuta YokoyamaSayo SuzukiSayo SuzukiTomonori NakamuraTomonori NakamuraFrontiers Media S.A.articlenivolumabpembrolizumabbaseline medicationsneutrophil-to-lymphocyte ratioprognostic scoreNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	nivolumab pembrolizumab baseline medications neutrophil-to-lymphocyte ratio prognostic score Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	nivolumab pembrolizumab baseline medications neutrophil-to-lymphocyte ratio prognostic score Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Toshiki Ogiwara Hitoshi Kawazoe Hitoshi Kawazoe Saeka Egami Hironobu Hashimoto Yoshimasa Saito Naomi Sakiyama Yuichiro Ohe Masakazu Yamaguchi Tetsuya Furukawa Azusa Hara Yui Hiraga Aya Jibiki Yuta Yokoyama Yuta Yokoyama Sayo Suzuki Sayo Suzuki Tomonori Nakamura Tomonori Nakamura Prognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study
description	BackgroundNivolumab and pembrolizumab are the standard treatments for patients with advanced non-small-cell lung cancer (NSCLC). While there are reports on several inflammatory indices and the prognosis of patients with cancer, no study has combined baseline medication with the neutrophil-to-lymphocyte ratio (NLR) to predict clinical outcomes. This study investigated the efficacy of baseline medications plus NLR to predict the effectiveness of nivolumab and pembrolizumab in a real-world clinical setting.MethodsWe conducted a single-center retrospective observational study of consecutive patients with advanced NSCLC who received nivolumab or pembrolizumab as first-line, second-line, or beyond treatment between December 2015 and November 2018 at the National Cancer Center Hospital in Japan. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. The drug-based prognostic score for baseline medications plus NLR was weighed based on the regression β coefficients. The multivariable Cox proportional hazard model was used to assess the association between the prognostic score-stratified groups and survival outcomes.ResultsIn total, 259 patients were evaluated in this study. A prognostic score calculated from the baseline medications plus NLR was used to categorize the patients into good (score 0), intermediate (scores 1–2), and poor (scores 3–6) -prognosis groups. The multivariable Cox proportional hazard model revealed a significant association between the poor-prognosis group and reduced OS. The hazard ratio of OS was 1.75 (95% confidence interval: 1.07–2.99; P = 0.031). In contrast, no association between these prognosis groups and PFS was observed.ConclusionsThe findings suggest that the baseline medications with nivolumab or pembrolizumab plus NLR could lead to progressively shorter survival outcomes in patients with advanced NSCLC and could be used as a prognostic index for poor outcomes. However, to ascertain the clinical application of these findings, these concomitant medications need further validation in a large-scale multicenter study.
format	article
author	Toshiki Ogiwara Hitoshi Kawazoe Hitoshi Kawazoe Saeka Egami Hironobu Hashimoto Yoshimasa Saito Naomi Sakiyama Yuichiro Ohe Masakazu Yamaguchi Tetsuya Furukawa Azusa Hara Yui Hiraga Aya Jibiki Yuta Yokoyama Yuta Yokoyama Sayo Suzuki Sayo Suzuki Tomonori Nakamura Tomonori Nakamura
author_facet	Toshiki Ogiwara Hitoshi Kawazoe Hitoshi Kawazoe Saeka Egami Hironobu Hashimoto Yoshimasa Saito Naomi Sakiyama Yuichiro Ohe Masakazu Yamaguchi Tetsuya Furukawa Azusa Hara Yui Hiraga Aya Jibiki Yuta Yokoyama Yuta Yokoyama Sayo Suzuki Sayo Suzuki Tomonori Nakamura Tomonori Nakamura
author_sort	Toshiki Ogiwara
title	Prognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study
title_short	Prognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study
title_full	Prognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study
title_fullStr	Prognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study
title_full_unstemmed	Prognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study
title_sort	prognostic value of baseline medications plus neutrophil-to-lymphocyte ratio in the effectiveness of nivolumab and pembrolizumab in patients with advanced non-small-cell lung cancer: a retrospective study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b197c72349844806ab490770dcad20f3
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Prognostic Value of Baseline Medications Plus Neutrophil-to-Lymphocyte Ratio in the Effectiveness of Nivolumab and Pembrolizumab in Patients With Advanced Non-Small-Cell Lung Cancer: A Retrospective Study

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