Association of Pretreatment Neutrophil-to-Eosinophil Ratio with Clinical Outcomes in Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma Treated with Nivolumab

Figures & data

Table 1 Patients’ Characteristics

Characteristics (n = 47)
Age (years), median (range)	67 (29–84)
Sex	n	%
Male	39	83
Female	8	17
ECOG PS score	n	%
0	9	19.1
1	27	57.4
2	7	14.9
3	4	8.5
Primary tumor site	n	%
Oral cavity	11	23.4
Nasopharynx	1	2.1
Oropharynx	11	23.4
Hypopharynx	9	19.1
Larynx	2	4.3
Others	13	27.7
Evaluation lesion site	n	%
Locoregional	37	78.7
Distant metastasis	10	21.3
Pretreatment peripheral blood biomarkers
AEC, median (range)	1.0 (0.1–5.0)
REC, median (range)	1.9 (0.1–10.4)
NER, median (range)	32 (5.5–672)

Figure 1 Clinical outcomes of the whole group analysis (n = 47). BOR (A), OS (B), and PFS (C).

Abbreviations: BOR, best overall response; CR, complete response; PR, partial response; SD, stationary disease; PD, progressive disease; OS, overall survival; PFS, progression-free survival.

Figure 2 Best overall response of the patients divided by AEC (A), REC (B), and NER (C). (A) AEC ≥0.9 × 10³/μL: CR 12.5%, PR 21.9%, SD 12.5%, and PD 53.1%. AEC <0.9 × 10³/μL: CR 6.7%, PR 6.7%, SD 20.0%, and PD 66.7%. Odds ratio for ORR and DCR was 0.294 (p = 0.147) and 0.567 (p = 0.384), respectively. (B) REC ≥2.2%: CR 15.0%, PR 25.0%, SD 20.0%, and PD 40.0%. REC <2.2%: CR 7.4%, PR 11.1%, SD 11.1%, and PD 70.4%. Odds ratio for ORR and DCR was 0.341 (p = 0.110) and 0.281 (p = 0.041), respectively. (C) NER ≥32: CR 4.3%, PR 8.7%, SD 13.0%, and PD 73.9%. NER <32: CR 16.7%, PR 25.0%, SD 16.7%, and PD 41.7%. Odds ratio for ORR and DCR was 4.76 (p = 0.361) and 3.97 (p = 0.0287), respectively.

Abbreviations: CR, complete response; PR, partial response; SD, stationary disease; PD, progressive disease.

Figure 3 The overall survival (OS) of the patients divided by AEC (A), REC (B), and NER (C). (A) The median OS was 9.0 months in patients with AEC <0.9 × 10³/μL vs 12.0 months in those with AEC ≥0.9 × 10³/μL (p = 0.046). (B) The median OS was 9.0 months in patients with REC <2.2% vs unreached in those with REC ≥2.2% (p = 0.027). (C) The median OS was unreached in patients with NER <32 vs 6.0 months in those with NER ≥32 (p = 0.035).

Figure 4 The progression-free survival (PFS) of the patients divided by AEC (A), REC (B), and NER (C). (A) The median PFS was 2.0 months in patients with AEC <0.9 × 10³/μL vs 4.0 months in those with AEC ≥0.9 × 10³/μL (p = 0.206). (B) The median PFS was 2.0 months in patients with REC <2.2% vs 4.0 months in those with REC ≥2.2% (p = 0.052). (C) The median PFS was 4.5 months in patients with NER <32 vs 2.0 months in those with REC ≥32 (p = 0.013).

Table 2 Univariate and Multivariate Analyses of the Factors Associated with the Overall Survival of Patients Treated with Nivolumab

Variable		Univariate		Multivariate
		HR (95% CI)	p-value	HR (95% CI)	p-value
Age (years)	<65	1
	≥65	0.958 (0.448–2.052)	0.914
Sex	Male	1
	Female	0.697 (0.209–2.325)	0.557
EOCG PS	0, 1	1		1
	2, 3	7.606 (3.084–18.76)	<0.001	8.724 (3.356–22.68)	<0.001
Primary tumor site	Oral, pharynx, larynx	1
	Others	0.847 (0.358–2.006)	0.706
Disease site	Locoregional	1
	Distant metastasis	0.543 (0.188–1.574)	0.261
AEC	<0.9	1
	≥0.9	0.672 (0.337–1.338)	0.258
REC	<2.2	1
	≥2.2	0.506 (0.227–1.129)	0.096
NER	<32	1		1
	≥32	2.178 (1.008–4.709)	0.048	2.474 (1.109–5.518)	0.027