Koichiro Ogihara1, Eiji Kikuchi2, Keisuke Shigeta1, Takashi Okabe3, Seiya Hattori4, Ryo Yamashita5, Shunsuke Yoshimine6, Suguru Shirotake3, Ryuto Nakazawa7, Kazuhiro Matsumoto1, Ryuichi Mizuno1, Satoshi Hara4, Masafumi Oyama3, Takeshi Masuda6, Masashi Niwakawa5, Mototsugu Oya1. 1. Department of Urology, Keio University School of Medicine, Tokyo, Japan. 2. Department of Urology, Keio University School of Medicine, Tokyo, Japan; Department of Urology, St. Marianna University School of Medicine, Kanagawa, Japan. Electronic address: eiji-k@kb3.so-net.ne.jp. 3. Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan. 4. Department of Urology, Kawasaki Municipal Hospital, Kanagawa, Japan. 5. Department of Urology, Shizuoka Cancer Center, Shizuoka, Japan. 6. Department of Urology, Saitama City Hospital, Saitama, Japan. 7. Department of Urology, St. Marianna University School of Medicine, Kanagawa, Japan.
Abstract
PURPOSE: We investigated the relationship between pretreatment neutrophil-to-lymphocyte ratio (pre-NLR) levels just before the initiation of treatment with pembrolizumab and clinical outcomes in platinum-resistant metastatic urothelial carcinoma (UC) patients treated with pembrolizumab. METHODS: Our study population comprised 78 patients diagnosed with metastatic UC and treated with pembrolizumab after platinum-based chemotherapy at our institutions between December 2017 and April 2019. We examined the relationships between pre-NLR levels just before pembrolizumab treatment and clinical outcomes. A pre-NLR level of ≥3.35 was defined as elevated according to a calculation by a receiver-operating curve analysis. RESULTS: The high pre-NLR group consisted of 33 patients (42.3%). Overall, 29.5% of patients had a clinical response and the sum of the target lesion longest diameter was decreased in 18.8% of the high pre-NLR group, which was significantly lower than that in the low pre-NLR group (58.1%, P = 0.005). Six-month progression-free survival and cancer-specific survival rates for the high pre-NLR group were 9.1 and 58.0%, which were significantly lower than those for their counterpart (45.9 and 89.1%, P < 0.001 and P = 0.002, respectively). The pre-NLR level was an independent indicator of disease progression and cancer-specific death (P < 0.001 and P = 0.003). Furthermore, patients with a postpembrolizumab NLR level that had decreased ≥25% from the pre-NLR level had significantly lower disease progression and cancer-specific death rates than their counterparts (P = 0.01 and P = 0.022, respectively). CONCLUSIONS: Elevated pre-NLR may be a novel biomarker for identifying poor responders to pembrolizumab among platinum-resistant metastatic UC patients.
PURPOSE: We investigated the relationship between pretreatment neutrophil-to-lymphocyte ratio (pre-NLR) levels just before the initiation of treatment with pembrolizumab and clinical outcomes in platinum-resistant metastatic urothelial carcinoma (UC) patients treated with pembrolizumab. METHODS: Our study population comprised 78 patients diagnosed with metastatic UC and treated with pembrolizumab after platinum-based chemotherapy at our institutions between December 2017 and April 2019. We examined the relationships between pre-NLR levels just before pembrolizumab treatment and clinical outcomes. A pre-NLR level of ≥3.35 was defined as elevated according to a calculation by a receiver-operating curve analysis. RESULTS: The high pre-NLR group consisted of 33 patients (42.3%). Overall, 29.5% of patients had a clinical response and the sum of the target lesion longest diameter was decreased in 18.8% of the high pre-NLR group, which was significantly lower than that in the low pre-NLR group (58.1%, P = 0.005). Six-month progression-free survival and cancer-specific survival rates for the high pre-NLR group were 9.1 and 58.0%, which were significantly lower than those for their counterpart (45.9 and 89.1%, P < 0.001 and P = 0.002, respectively). The pre-NLR level was an independent indicator of disease progression and cancer-specific death (P < 0.001 and P = 0.003). Furthermore, patients with a postpembrolizumab NLR level that had decreased ≥25% from the pre-NLR level had significantly lower disease progression and cancer-specific death rates than their counterparts (P = 0.01 and P = 0.022, respectively). CONCLUSIONS: Elevated pre-NLR may be a novel biomarker for identifying poor responders to pembrolizumab among platinum-resistant metastatic UCpatients.
Authors: Ronald Kool; Gautier Marcq; Surashri Shinde-Jadhav; José João Mansure; Ramy Saleh; Raghu Rajan; Armen Aprikian; Simon Tanguay; Fabio L Cury; Fadi Brimo; Luis Souhami; Wassim Kassouf Journal: Eur Urol Open Sci Date: 2021-12-23
Authors: Maria Pallozzi; Natalia Di Tommaso; Valeria Maccauro; Francesco Santopaolo; Antonio Gasbarrini; Francesca Romana Ponziani; Maurizio Pompili Journal: Cancers (Basel) Date: 2022-09-23 Impact factor: 6.575