Prognostic Values of Inflammatory Indexes in bevacizumab-treated Patients With Advanced non-small-cell Lung Cancer

Figures & data

Figure 1. X-tile analysis of overall survival based on neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index and platelet-to-lymphocyte ratio.

NLR: Neutrophil-to-lymphocyte ratio; LMR: Lymphocyte-to-monocyte ratio; PLR: Platelet-to-lymphocyte ratio; SII: Systemic immune-inflammation index.

Table 1. Characteristics of patients.

Characteristics	n (%), total = 119
Age (years)
Median (range)	61 (36–80)
<60	55 (46.2)
≥60	64 (53.8)
Gender
Female	52 (43.7)
Male	67 (56.3)
Smoking status
Yes	73 (61.3)
No	46 (38.7)
ECOG PS
0	33 (28)
1–2	86 (72)
EGFR status
Mutation	43 (36.1)
Negative	76 (63.9)
Metastatic sites
Brain	35 (29.4)
Bone	52 (43.7)
Liver	18 (15.1)

Table 2. Patients' baseline characteristics classified by neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (n = 119).

	NLR			PLR
	<3.7, n (%)	≥3.7, n (%)	p-value	<255.5, n (%)	≥255.5, n (%)	p-value
Age (years)
<60	35 (47.9)	20 (43.5)	0.71	48 (45.7)	7 (50.0)	0.78
≥60	38 (52.1)	26 (56.5)		57 (54.3)	7 (50.0)
Gender
Female	38 (52.1)	14 (30.4)	0.02	45 (42.9)	7 (50.0)	0.78
Male	35 (47.9)	32 (69.6)		60 (57.1)	7 (50.0)
Smoking status
No	27 (37)	18 (39.1)	0.8	38 (36.2)	7 (50.0)	0.38
Yes	46 (63)	28 (60.9)		67 (63.8)	7 (50.0)
ECOG PS
0	15 (20.5)	18 (39.1)	0.03	27 (25.7)	6 (42.9)	0.21
≥1	58 (79.5)	28 (60.9)		78 (74.3)	8 (57.1)
EGFR status
Wild-type	43 (58.9)	35 (76.1)	0.07	70 (66.7)	8 (57.1)	0.55
Mutation	30 (41.1)	11 (23.9)		35 (33.3)	6 (42.9)
Brain metastasis
No	51 (69.6)	33 (71.7)	1	74 (70.5)	10 (71.4)	1
Yes	22 (30.1)	13 (28.3)		31 (29.5)	4 (28.6)
Bone metastasis
No	36 (49.3)	31 (67.4)	0.06	56 (53.3)	11 (78.6)	0.09
Yes	37 (50.7)	15 (32.6)		49 (46.7)	3 (21.4)
Liver metastasis
No	61 (83.6)	39 (84.8)	1	88 (83.8)	12 (85.7)	1
Yes	12 (16.4)	7 (15.2)		17 (16.2)	2 (14.3)

ECOG PS: Eastern Co-operative Oncology Group performance status; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio.

Table 3. Patients' baseline characteristics classified by systemic immune-inflammation index and lymphocyte-to-monocyte ratio (n = 119).

	SII			LMR
	<755.2, n (%)	≥755.2, n (%)	p-value	<3, n (%)	≥3, n (%)	p-value
Age (years)
<60	28 (50.0)	27 (42.9)	0.47	36 (55.4)	19 (35.2)	0.04
≥60	28 (50.0)	36 (57.1)		29 (44.6)	35 (64.8)
Gender
Female	33 (58.9)	19 (30.2)	0.002	41 (63.1)	11 (20.4)	<0.01
Male	23 (41.1)	44 (69.8)		24 (36.9)	43 (79.6)
Smoking status
No	21 (37.5)	24 (38.1)	1	27 (41.5)	18 (33.3)	0.45
Yes	35 (62.5)	39 (61.9)		38 (58.5)	36 (66.7)
ECOG PS
0	13 (23.2)	20 (31.7)	0.31	13 (20.0)	20 (37.0)	0.04
≥1	43 (76.8)	43 (68.3)		52 (80.0)	34 (63.0)
EGFR status
Wild-type	33 (58.9)	45 (71.4)	0.18	41 (63.1)	37 (68.5)	0.57
Mutation	23 (41.1)	18 (28.6)		24 (36.9)	17 (31.5)
Brain metastasis
No	40 (71.4)	44 (69.8)	1	45 (69.2)	39 (72.2)	0.84
Yes	16 (28.6)	19 (30.2)		20 (30.8)	15 (27.8)
Bone metastasis
No	27 (48.2)	40 (63.5)	0.1	31 (47.7)	36 (66.7)	0.04
Yes	29 (51.8)	23 (36.5)		34 (52.3)	18 (33.3)
Liver metastasis
No	48 (85.7)	52 (82.5)	0.8	57 (87.7)	43 (79.6)	0.32
Yes	8 (14.3)	11 (17.5)		8 (12.3)	11 (20.4)

ECOG PS: Eastern Co-operative Oncology Group performance status; LMR: Lymphocyte-to-monocyte ratio; SII: Systemic immune-inflammation index.

Figure 2. Kaplan–Meier curves comparing progression-free survival and overall survival according to neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index and lymphocyte-to-monocyte ratio.

(A) PFS–NLR. (B) PFS–PLR. (C) PFS–SII. (D) PFS–LMR. (E) OS–NLR. (F) OS–PLR. (G) OS–SII. (H) OS–LMR.

LMR: Lymphocyte-to-monocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; OS: Overall survival; PFS: Progression-free survival; PLR: Platelet-to-lymphocyte ratio; SII: Systemic immune-inflammation index.

Table 4. Univariate and multivariable analysis of variables correlated to progression-free survival.

	Univariable model			Multivariable model
	HR	95% CI	p-value	HR	95% CI	p-value
Age (≥60 vs <60)	1.172	0.800–1.716	0.415
Gender (male vs female)	1.736	1.167–2.584	0.007	–	–	0.119
Smoking status (ever vs never)	1.254	0.845–1.861	0.261
ECOG PS (≥1 vs <1)	1.083	0.707–1.660	0.714
EGFR mutation (yes vs no)	0.843	0.566–1.256	0.401
Bone metastasis (yes vs no)	0.915	0.624–1.342	0.649
Brain metastasis (yes vs no)	1.150	0.759–1.742	0.509
Liver metastasis (yes vs no)	2.226	1.321–3.752	0.003	2.080	1.232–3.509	0.006
Baseline NLR (≥3.7 vs <3.7)	1.881	1.251–2.827	0.002	–	–	0.767
Baseline PLR (≥255.5 vs <255.5)	2.274	1.279–4.041	0.005	–	–	0.181
Baseline SII (≥775.2 vs <775.2)	2.407	1.061–3.619	<0.001	2.338	1.554–3.518	<0.001
Baseline LMR (<3 vs ≥3)	1.831	1.220–2.749	0.004	–	–	0.378

ECOG PS: Eastern Co-operative Oncology Group performance status; HR: Hazard ratio; LMR: Lymphocyte-to-monocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; SII: Systemic immune-inflammation index.

Table 5. Univariate and multivariable analysis of variables correlated to overall survival.

	Univariable model			Multivariable model
	HR	95% CI	p-value	HR	95% CI	p-value
Age (≥60 vs <60)	1.107	0.755–1.622	0.604
Gender (male vs female)	1.948	1.308–2.902	0.001	–	–	0.280
Smoking status (ever vs never)	1.556	1.032–2.349	0.035
ECOG PS (≥1 vs <1)	1.028	0.670–1.577	0.901
EGFR mutation (yes vs no)	0.414	0.265–0.647	<0.001	0.385	0.234–0.609	<0.001
Bone metastasis (yes vs no)	0.926	0.630–1.362	0.696
Brain metastasis (yes vs no)	1.746	1.140–2.675	0.010	1.582	1.027–2.436	0.037
Liver metastasis (yes vs no)	1.756	1.062–2.904	0.028	–	–	0.357
Baseline NLR (≥3.7 vs <3.7)	2.584	1.709–3.908	<0.001	–	–	0.711
Baseline PLR (≥255.5 vs <255.5)	1.965	1.111–3.474	0.020	–	–	0.662
Baseline SII (≥775.2 vs <775.2)	2.799	1.850–4.233	<0.001	1.846	1.165–2.923	0.009
Baseline LMR (<3 vs ≥3)	2.998	1.969–4.565	<0.001	2.619	1.631–4.205	<0.001

ECOG PS: Eastern Co-operative Oncology Group performance status; HR: Hazard ratio; LMR: Lymphocyte-to-monocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; SII: Systemic immune-inflammation index.