Role of combining neutrophil‑to‑lymphocyte ratio and pretreatment body mass index in predicting progression‑free survival in patients with non‑small cell lung cancer treated with nivolumab

Dragomir,Radu; Dragomir,Adelina Silvana; Negru,Alina; Săftescu,Sorin; Popovici,Dorel; Schenker,Michael; Lupușoru,Raluca; Negru,Șerban

doi:10.3892/etm.2021.9958

Role of combining neutrophil‑to‑lymphocyte ratio and pretreatment body mass index in predicting progression‑free survival in patients with non‑small cell lung cancer treated with nivolumab

Authors:
- Radu Dragomir
- Adelina Silvana Dragomir
- Alina Negru
- Sorin Săftescu
- Dorel Popovici
- Michael Schenker
- Raluca Lupușoru
- Șerban Negru
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Affiliations: Department of Obstetrics and Gynecology, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania, Department of Oncology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Cardiology, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania, Department of Oncology, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania, Department of Oncology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania, II Department of Internal Medicine, Gastroenterology and Hepatology Discipline, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
Published online on: March 22, 2021 https://doi.org/10.3892/etm.2021.9958
Article Number: 526
Copyright: © Dragomir et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Identifying markers capable of predicting outcomes in lung cancer patients treated with nivolumab represents a growing research interest. The combination of neutrophil‑to‑lymphocyte ratio (NLR) and body mass index (BMI) may help predict treatment efficacy. Thus, the present study aimed to investigate the influence of NLR and BMI on progression‑free survival (PFS) in non‑small‑cell lung cancer (NSCLC) patients treated with nivolumab. A retrospective study was made on 80 patients with NSCLC that were treated with nivolumab at the OncoHelp Oncology Center, Timisoara, Romania after platinum‑based chemotherapy, from January 2018 to April 2020. Patients were administered nivolumab at a dose of 3 mg/m² or 240 mg total dose, every 2 weeks. The predictive impact of NLR (baseline at 2 and 4 weeks after the start of nivolumab) and BMI for disease progression was assessed. Median PFS for subjects with NLR <3 before treatment was 18.5 weeks, while in subjects with NLR ≥3 was 14 weeks (P=0.50). Median PFS for subjects with NLR2 <3 at 2 weeks after treatment was 21 weeks, while in subjects with NLR2 ≥3, PFS was 14 weeks (P=0.17). Median PFS for subjects with NLR4 <3 at 4 weeks after treatment was 23 weeks, while in subjects with NLR4 ≥3, PFS was 19 weeks (P=0.33). Multivariate analysis for the association with PFS showed that baseline NLR, male sex and BMI were associated independently, thus we could develop a significant statistical model [AUROC=0.76, 95% CI (0.45‑0.89), P=0.03], a new predictive score for PFS. The assessment of NLR and BMI may represent simple and useful biomarkers; combining them and taking into consideration the male sex may predict PFS in patients with advanced NSCLC treated with nivolumab.

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