Systemic inflammation promotes angiogenesis and cell proliferation, which play key roles during carcinogenesis. Several studies have shown a strong link between inflammation index and prognosis in non-small cell lung cancer (NSCLC). The aim of our study is to investigate the role of NLR at diagnosis in the outcome of NSCLC EGFR mutated.
Our retrospective analysis included 103 eligible patients (pts), including 40 pts with EGFR wild type (wt) NSCLC and 63 pts with EGFR mutated NSCLC. Inclusion criteria were over 18 years of age, diagnosis of NSCLC, availability of a pre-treatment complete blood count. Exclusion criteria were active infections, autoimmune diseases, use of corticosteroids. The NLR was derived from the absolute neutrophil and the absolute lymphocyte counts. The cutoff value was determined through the use of ROC curves and through the distinction, based on overall survival (OS) at 12 months, between pts with good and bad prognosis. For each subgroup of mts, median OS was assessed. Statistical processing was performed with the aim of correlating the haematological data collected with the clinical outcome.
In pts EGFR wt the NLR cut-off obtained was 3.18., in pts EGFR mutaded the cut-off was 3,5. Pts who have a value less than or equal to cut-off have a better prognosis, compared to pts who have a NLR higher than have a worse prognosis. As a pts EGFR wt the median best OS was 41.33 months, while the worst OS was a median of 10.33 months, with a difference of 31 months (p = 0.0003). In case of pts EGFR mutaded the best median OS was 21 and the worst 8,3 months, with a difference of 13 months (p = 0,013). There were no significant differences in age, ECOG PS, histology, size, therapies or treatment line.
The NLR remains a prognostic factor in both diseases, with or without EGFR mutation, but appear to have less impact on the outcome of EGFR mutated patients. In NSCLC EGFR mutated maybe inflammatory index could have implications on therapeutic choice, especially subsequent lines and his role deserves further study.
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Has not received any funding.
All authors have declared no conflicts of interest.