Prognostic Correlation Between NLR And Immune Checkpoint Inhibitor Therapy For Lung Cancer

Objective:To investigate the predictive effect of neutrophil-to-lymphocyte ratio(NLR)and its dynamics 、lymphocyte-monocyte-to ratio(LMR)、platelet-to-lymphocyte ratio(PLR)and systemic immune inflammation index(SII)on prognosis of patients with advanced non-small cell lung cancer(NSCLC)treated with immune checkpoint inhibitors(ICIs).Methods:The clinical data of patients with advanced NSCLC who were treated with immune checkpoint inhibitors in The Second Affiliated Hospital of Nanchang University and First Affiliated Hospital of Nanchang University from January 2019 to October 2022 were collected.A total of 72 eligible patients were screened through the Naturalization and Exclusion criteria.NLR1、LMR、PLR、SII were collected before the first cycle of immunotherapy,and NLR2 were collected before the second cycle of immunotherapy.Kaplan-Meier survival curve was applied to analyze progression free survival(PFS)and overall survival(OS),and the Cox proportional hazards model was used to explore the factors affecting the prognosis of patients with advanced NSCLC treated with ICIs.Results:Kaplan-Meier univariate survival analysis was used to analyze the factors affecting PFS and OS of patients.The results showed that:(1)NLR1,LMR,PLR,SII,pathological stage,number of treatment lines,and number of metastasis were significantly correlated with PFS of patients.The median PFS of High NLR1 and low NLR1,high LMR and low LMR,high PLR and low PLR,high SII and low SII,receiving line 1 and ≥ 2 treatment,number of metastasis sites<3 and ≥ 3 were 7.40 vs16.10 months,16.43 vs 8.40 months,9.07 vs 16.43 months,9.07 vs 16.10 months,12.63 vs 7.67 months,12.63 vs 7.63 months,respectively.(2)The risk factors of OS include high NLR1,high SII and receiving second-line treatment,high LMR is the protective factor of PFS.The median OS of high NLR1 and low NLR1,high LMR and low LMR,high SII and low SII,and receiving first-line and ≥ second-line treatment were 13.73 vs 22.27 months,21.17 vs 15.43 months,15.43 vs 22.70 months,20.80 vs 13.60 months,respectively.Cox proportional risk model multi-factor analysis was performed for the indicators with significant statistical differences in the univariate analysis: high NLR1(≥ 5.73),receiving second-line treatment and ≥ 3 metastatic sites were hazard factors independently related to the shorter PFS,high LMR(≥2.48)is the protective factor;Indicators significantly related to shorter OS include high NLR1(≥ 5.73)and second-line treatment.Conclusions:(1)NLR1,LMR,receiving second-line treatment,and ≥ 3 metastatic sites are independent prognostic factors for patients with advanced NSCLC who are receiving ICIs treatment.(2)NLR1 ≥ 5.73,receiving second-line treatment,and ≥ 3 metastatic sites are related to shorter PFS.And NLR1≥5.73,receiving second-line treatment are associated with shorter OS.LMR is a protective factor for prognosis.LMR ≥ 2.48 before treatment is associated with longer PFS and OS.