Cited by 441Cancer Immunotherapy and BiomarkersInflammatory Biomarkers in Disease PrognosisFerroptosis and cancer prognosis

Pretreatment neutrophil-to-lymphocyte ratio and mutational burden as biomarkers of tumor response to immune checkpoint inhibitors

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Valero, Cristina, Lee, Mark, Hoen, Douglas, Weiss, Kate, Kelly, Daniel W., Adusumilli, Prasad S., Paik, Paul K., Plitas, George +21 more·2021·Nature Communications

Abstract

Treatment with immune checkpoint inhibitors (ICI) has demonstrated clinical benefit for a wide range of cancer types. Because only a subset of patients experience clinical benefit, there is a strong need for biomarkers that are easily accessible across diverse practice settings. Here, in a retrospective cohort study of 1714 patients with 16 different cancer types treated with ICI, we show that higher neutrophil-to-lymphocyte ratio (NLR) is significantly associated with poorer overall and progression-free survival, and lower rates of response and clinical benefit, after ICI therapy across multiple cancer types. Combining NLR with tumor mutational burden (TMB), the probability of benefit from ICI is significantly higher (OR = 3.22; 95% CI, 2.26-4.58; P < 0.001) in the NLR low/TMB high group compared to the NLR high/TMB low group. NLR is a suitable candidate for a cost-effective and widely accessible biomarker, and can be combined with TMB for additional predictive capacity.

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  1. [57]Amin, M. B. et al. AJCC Cancer Staging Manual (Springer, 2017).

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Authors
Valero, C., Lee, M., Hoen, D., Weiss, K., Kelly, D. W., Adusumilli, P. S., Paik, P. K., Plitas, G., Ladanyi, M., Postow, M. A., Ariyan, C. E., Shoushtari, A. N., Balachandran, V. P., Hakimi, A. A., Crago, A. M., Long Roche, K. C., Smith, J. J., Ganly, I., Wong, R. J., Patel, S. G., Shah, J. P., Lee, N. Y., Riaz, N., Wang, J., Zehir, A., Berger, M. F., Chan, T. A., Seshan, V. E., & Morris, L. G. T.
Affiliations
Memorial Sloan Kettering Cancer Center (US)
Corresponding author
  • Chan, Timothy A.
  • Seshan, Venkatraman E.
  • Morris, Luc G. T.
Venue
Nature Communications
Published
2021-02-01
Volume
12
Issue
1
Pages
729-729
ISSN
2041-1723 (ISSN-L)
OpenAlex
W3127371144
Cited by
441
References
57
Citations by year
2026: 53 · 2025: 74 · 2024: 116 · 2023: 92 · 2022: 80 · 2021: 26
FWCI
28.60
Type
journal article
Language
en
Open access
Locations
  • Nature Communications (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Fundación Alfonso Martín Escudero (N/A)
  • U.S. Department of Health & Human Services | NIH | National Cancer Institute (R01 CA205426, R35 CA232097)
Topics
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Ferroptosis and cancer prognosis
Keywords
immune checkpoint inhibitors, neutrophil-to-lymphocyte ratio, tumor mutational burden, predictive biomarkers, tumor response, overall survival, progression-free survival, cancer immunotherapy, prognostic factors
MeSH terms
Progression-Free Survival, Immune Checkpoint Inhibitors, Aged, Female, Follow-Up Studies, Humans, Lymphocytes, Male, Middle Aged, Neoplasms, Neutrophils, Predictive Value of Tests, Retrospective Studies, Lymphocyte Count, Drug Resistance, Neoplasm, Mutation Rate

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