251P - Prognostic value of pre-treatment neutrophil to lymphocyte ratio in patients (pts) with metastatic solid tumors: Results of an observational cohort...

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Yann-Alexandre Vano
Citation Annals of Oncology (2014) 25 (suppl_4): iv58-iv84. 10.1093/annonc/mdu326
Authors Y. Vano1, F. Scotte2, P. Combe1, A. Angelergues1, M. Auvray1, P. Leroy2, E. Tartour3, S. Oudard1, R. Elaidi4
  • 1Dept. Medical Oncology, Hopital European George Pompidou, 75015 - Paris/FR
  • 2Functional Unit Of Supportive Care, Hopital European George Pompidou, 75015 - Paris/FR
  • 3Parcc-european Georges Pompidou Hospital, INSERM U970, Paris/FR
  • 4Medical Oncology, Association pour la Recherche sur les Therapeutiques Innovantes en Cancerologie, 75015 - Paris/FR



Pre-treatment Neutrophil to Lymphocyte Ratio (NLR), an index of systemic inflammation, has been reported as a prognostic factor in some metastatic solid tumors (mST). Whether the NLR prognostic value depends on primary tumor site (PTS) has never been investigated. This study aimed to assess the prognostic value of pre-treatment NLR in pts with various mST treated with chemotherapy.


Using the PROCHE program we included all metastatic pts with an available NLR before the start of chemotherapy in the Oncology day hospital of Georges Pompidou European Hospital between 2008 and 2011. The NLR value was used as a continuous variable. Primary endpoint was overall survival (OS) from start of chemotherapy until patient's death/last contact. Results were adjusted with the following variables: Age, Eastern Cooperative Oncology Group Performance Status (PS) (0–1 vs. ≥2), and primary tumor site (PTS): breast (BC), lung (LC), urogenital (UG) ovarian (OC), head and neck (HNC) and others (O).


467 mST pts, median (range) age = 64y (16-91), sex-ratio = 1.5 were included. PTS were distributed as follows: LC = 137pts (29.3%), UG = 133pts (28.5%), HNC = 61 (13%), OC = 55 (11.8%), BC = 54pts (11.6%), and O = 27 (5.8%). PS ≤ 1 = 340pts (72.8%) and PS ≥ 2 = 127 (27.2%). Median (range) NLR was 2.43 (0.06-48.5). Continuous NLR at baseline was significantly associated with OS in univariate analysis: HR (for 1 standard deviation unit = 5.07) = 1.15 (95%CI = 1.04-1.27; p = 0.007). Comparison of last (T3) and first terciles (T1) of NLR (157 and 152 pts, respectively) revealed that OS was shorter for pts with the highest NLR: 12.3m (95%CI = 10.4-17.3) vs. 20m (95%CI = 16.0-28.5), HR (T3/T1) = 1.58, 95%CI = 1.17-2.12 (p = 0.003). The highest NLR remains independently correlated with a worse OS after adjustment in multivariate analysis (HR = 1.46 (95%CI = 1.07-1.98), p = 0.01), as well as OC localization (p = 0.015).


High pre-treatment NLR is an independent prognostic factor for mST pts treated with chemotherapy whatever the primary tumor site. These results must be validated prospectively.


Y. Vano: Pfizer, Novartis, GSK, Sanofi, Astellas: advisory board Sandoz, Teva: funding for observational studies. No conflicts of interest directly related to this study; S. Oudard: Consultant or Advisory Role: Bayer, Janssen, Novartis, Pfizer, Sanofi, Takeda Honoraria: Bayer, Janssen, Novartis, Pfizer, Sanofi, Takeda No financial interest related to this study; All other authors have declared no conflicts of interest.