Abstract 1663P
Background
Recently, NLR has been attracting attention as a prognostic factor for various cancers. However, its usefulness has not been well reviewed about advanced SCLC. Furthermore, its examination of NLR has been limited to first-line chemotherapy. Therefore, we retrospectively examined not only NLR at the start of first-line chemotherapy but its dynamic change during treatment.
Methods
Advanced SCLC patients who received first-line chemotherapy between January 2008 and April 2021, were registered for analysis. Blood test to measure NLR was performed within a week prior to the initiation for each line of chemotherapy and at the end of the final regimen. To evaluate the prognostic impact of NLR, background factors such as age, sex, ECOG-PS, platinum combination therapy, ICI treatment, NLR1(baseline NLR) and NLR2 (NLR at the start of second-line chemotherapy or end of first-line chemotherapy in the case treated with no second-line one) were adjusted using multivariate Cox proportional hazards model analysis.
Results
217 cases were reviewed, 147 cases of which met the eligibility criteria, including 100 cases (68.0%) in the NLR1-low (NLR < 5) group and 47 cases (32.0%) in the NLR1-high (NLR ≥ 5) group. Median survival times (MSTs) of NLR1-low and NLR1-high groups were 14.8 months and 8.0 months, respectively (p < 0.001). In multivariate analysis, elevated NLR1 (NLR≥ 5) was independent factor for worse OS (hazard ratio [HR]; 1.67, 95% confidence interval [CI]; 1.05 to 2.66, p = 0.03). Furthermore, in a multivariate model that reflect NLR2, the prognosis of NLR1-high and NLR2-high (NLR ≥ 5) group was worse compared to NLR1-low and NLR2-low (NLR < 5) group (HR; 17.6, 95% CI; 6.09 to 50.93, p < 0.01).
Conclusions
Baseline NLR are prognostic for OS in advanced SCLC. However, it become a better predictor considering the combination of NLR1 and NLR2.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Tanzawa: Financial Interests, Institutional, Funding: AstraZeneca. N. Seki: Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Chugai Pharma; Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim; Financial Interests, Personal, Invited Speaker: Taiho Pharmaceutical; Financial Interests, Personal and Institutional, Invited Speaker: Daiichi Sankyo; Financial Interests, Personal, Invited Speaker: Ono Pharmaceutical; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: MSD Oncology; Financial Interests, Personal, Invited Speaker: Nihon Medi-Physics; Financial Interests, Personal, Invited Speaker: Lilly Japan; Financial Interests, Personal, Invited Speaker: Pfizer Japan. All other authors have declared no conflicts of interest.