Changes in Neutrophil-to-lymphocyte ratio (NLR) in response to immune checkpoint blockade for metastatic renal cell carcinoma @lalaniMD - 102191

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Changes in Neutrophil-to-lymphocyte ratio (NLR) in response to immune checkpoint blockade for metastatic renal cell carcinoma @lalaniMD

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Description: Dr. Aly-Khan A. Lalani, MD discusses the impact of Neutrophil-to-lymphocyte ratio (NLR) in mRCC and it's effect on outcomes.

BACKGROUND:
• Inflammation is a hallmark of solid tumors, where neutrophilia occurs as an inflammatory response and may suppress the cytolytic activity of immune cells such as lymphocytes, natural killer cells, and activated T cells1
• Elevated NLR is associated with worse outcomes in several malignancies, including metastatic renal cell carcinoma (mRCC) patients treated with oral tyrosine kinase inhibitors (VEGF-TKIs)2
• However, the utility of NLR in mRCC patients treated with conventional immune checkpoint blockade is not well characterized

OBJECTIVES:
• To evaluate the association of baseline NLR, and changes during treatment, with outcomes in mRCC patients treated with immune checkpoint blockade

METHODS:
• Retrospective cohort study of mRCC patients treated with PD-1/PD-L1 immune checkpoint blockade (ICB) at Dana-Farber Cancer Institute from 2009-2017 with NLR measured at baseline and 6 (±2) weeks on therapy
• We first investigated the impact of baseline NLR (natural log-transformed [LnNLR]) on objective response rate (ORR, complete response or partial response), progression free survival (PFS, time from start of ICB to radiographic or clinical progression, or death), and overall survival (OS, time from start of ICB to death/last follow up)
• Landmark analysis at 6 weeks was also conducted to explore the prognostic value of LnNLR at 6 (±2) weeks or relative NLR change (calculated as % change ({[NLR week 6 / NLR week 0] - 1}*100) and subsequently grouped in three groups (≥25% decrease, no change, ≥25% increase) on ORR, PFS, and OS
• Cox or logistic regression models allowed for adjustment of line of therapy, number of IMDC risk factors, RCC histology (clear cell vs. non-clear cell), and baseline NLR
Shared By : Cancer-News
Posted on : 10/12/17
Added : 1 year ago
Category : Kidney Cancer