KEY TAKEAWAYS
- The study aimed to assess ICI response, focusing on EGFR, ALK, ROS1 alterations, and pre-treatment NLR in patients with NSCLC.
- The results showed elevated pre-treatment NLR linked to lower survival in EGFR/ALK/ROS1-NSCLC with ICI.
Non-small cell lung cancer (NSCLC) studies have suggested that tumors with specific genetic mutations may exhibit reduced responsiveness to immune checkpoint inhibitors (ICI).
Arpeet T. Shah and team aimed to assess the clinical characteristics of patients who experienced durable clinical benefit (DCB) versus those who did not (NDB) from ICI therapy, focusing on molecular alterations in EGFR, ALK, and ROS1, and the pre-treatment neutrophil-to-lymphocyte ratio (NLR).
Researchers observed retrospective clinical data and outcomes for patients with advanced NSCLC who initiated ICI monotherapy at Stanford University from April 2015 to May 2018. Patients were categorized based on their response: DCB if they received ICI for ≥180 days, or NDB if <180 days. They assessed outcomes, including the best radiographic response during ICI treatment and overall survival (OS) after the initiation of ICI therapy.
The results showed that of 123 patients with NSCLC who were treated with ICI, 28 (23%) had DCB), while 95 (77%) did not (NDB). Patients with EGFR (n=31), ALK, or ROS1 mutations and NLR ≥ 5.9 had a median OS of 2.0 months versus 8.1 months for those with these mutations and NLR < 5.9. Patients without these mutations and NLR ≥ 5.9 had a median survival of 4.3 months, compared to 12.1 months for those with NLR <5.9 (P=0.023).
The study concluded that a high pre-treatment NLR significantly reduces median survival in patients with NSCLC starting ICI, especially when combined with EGFR, ALK, or ROS1 mutations. Given its routine availability in blood tests, NLR could be a practical biomarker in clinical settings.
No funding information was provided.
Source: https://www.clinical-lung-cancer.com/article/S1525-7304(24)00133-5/abstract#%20
Shah AT, Blanchard I, Padda SK, et al. (2024). “Molecular Characteristics and Pre-Treatment Neutrophil-to-Lymphocyte Ratio as Predictors of Durable Clinical Benefit from Immune Checkpoint Inhibition in Non-Small Cell Lung Cancer.” https://doi.org/10.1016/j.cllc.2024.06.006
