Baseline neutrophil-to-lymphocyte ratio (NLR) is associated with clinical outcome in recurrent or metastatic head and neck cancer patients treated with nivolumab

Abstract

Background: Nivolumab has been approved for recurrent or metastatic head and neck cancer (R/M HNC) on March 2017 in Japan. Recently, many researchers have been actively studying the prognostic and predictive markers. However, they have not been clarified. In this study, we evaluate the prognostic and predictive markers of the anticancer effect of nivolumab.

Objective: This study assessed baseline neutrophil-to-lymphocyte ratio (NLR) as a prognostic and predictive marker for nivolumab efficacy in patients with recurrent/metastatic head and neck cancer (R/M HNC).

Material and methods: This retrospective cohort study used medical records of patients with R/M HNC treated with nivolumab from May 2017 to January 2018 at a university hospital in Japan.

Results: Twenty-nine patients (median age, 64 years) were included. In univariate analyses, baseline NLR ≥5 was significantly associated with overall survival (HR 4.88; p = .045) and progressive disease (HR 5.0; p = .046). More patients with baseline NLR ≥5 changed from nivolumab to best supportive care, compared to patients with baseline NLR <5 (64.3% vs 26.7%, respectively).

Conclusions and significance: Baseline NLR was associated with clinical benefit from nivolumab in patients with R/M HNC. We propose that baseline NLR be used as a predictive or prognostic marker for nivolumab efficacy in these patients.

Chinese abstract

背景：Nivolumab已于2017年3月在日本获准用于复发性或转移性头颈癌（R/M HNC）。近年来, 许多研究者一直在积极研究预后指标和预测指标。不过, 这些问题尚未得到澄清。在本研究中, 我们评估了nivolumab的抗癌效果的预后和预测指标。

目的：探讨基线中性粒细胞与淋巴细胞比值（NLR）作为对头颈癌复发/转移患者施行nivolumab的疗效的预测指标。

材料与方法：这项回顾性队列研究使用了2017年5月至2018年1月在日本一所大学医院接受nivolumab治疗的R/M HNC患者的病历。

结果：共包括29例患者（中位年龄64岁）。在单变量分析中, 基线NLR≥5与总生存率（HR 4.88；p = .045）和进行性疾病（HR 5.0；p = .046）显著相关。与基线NLR<5的患者相比, 基线NLR≥5的患者更多地从nivolumab治疗转为最佳支持性治疗（分别为26.7%和64.3%）。

结论和意义：基线NLR与R/M HNC患者nivolumab的临床疗效相关。我们建议将基线NLR作为这些患者nivolumab疗效的预测或预后指标。

Keywords:

• Nivolumab
• head and neck cancer
• neutrophil-lymphocyte ratio
• immunotherapy
• survival rate
• PD-1 receptor

Disclosure statement

The authors declare no conflict of interest.