The association between early changes in neutrophil-lymphocyte ratio and survival in patients treated with immunotherapy

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dc.authoridSaadettin Kılıçkap / 0000-0003-1637-7390en_US
dc.authorscopusidSaadettin Kılıçkap / 8665552100
dc.authorwosidSaadettin Kılıçkap / AAP-3732-2021en_US
dc.contributor.authorGüven, Deniz Can
dc.contributor.authorŞahin, Taha Koray
dc.contributor.authorErul, Enes
dc.contributor.authorÇakır, İbrahim Yahya
dc.contributor.authorÜçgül, Enes
dc.contributor.authorYıldırım, Hasan Çağrı
dc.contributor.authorAktepe, Oktay Halit
dc.contributor.authorErman, Mustafa
dc.contributor.authorKılıçkap, Saadettin
dc.contributor.authorAksoy, Sercan
dc.contributor.authorYalçın, Suayib
dc.date.accessioned2022-08-17T06:36:23Z
dc.date.available2022-08-17T06:36:23Z
dc.date.issued2022en_US
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractDynamic changes in the blood-based biomarkers could be used as a prognostic biomarker in patients treated with immune checkpoint inhibitors (ICIs), although the data are limited. We evaluated the association between the neutrophil-lymphocyte ratio (NLR) and early NLR changes with survival in ICI-treated patients. We retrospectively evaluated the data of 231 patients with advanced-stage cancer. We recorded baseline clinical characteristics, baseline NLR and fourth-week NLR changes, and survival data. A compound prognostic score, the NLR2-CEL score, was developed with the following parameters: baseline NLR (<5 vs. ?5), ECOG status (0 vs. ?1), Charlson Comorbidity Index (CCI, <9 vs. ?9), LDH (N vs. ?ULN), and fourth-week NLR change (10% or over NLR increase). In the multivariable analyses, higher NLR (HR: 1.743, p = 0.002), 10% or over NLR increase in the fourth week of treatment (HR: 1.807, p = 0.001), higher ECOG performance score (HR: 1.552, p = 0.006), higher LDH levels (HR: 1.454, p = 0.017), and higher CCI (HR: 1.400, p = 0.041) were associated with decreased OS. Compared to patients with the lowest scores, patients in the highest score group had significantly lower OS (HR: 7.967, 95% CI: 3.531-17.979, p < 0.001) and PFS. The composite score had moderate success for survival prediction, with an AUC of 0.702 (95% CI: 0.626-0.779, p < 0.001). We observed significantly lower survival in patients with higher baseline NLR values and increased NLR values under treatment.en_US
dc.identifier.citationGuven DC, Sahin TK, Erul E, Cakir IY, Ucgul E, Yildirim HC, Aktepe OH, Erman M, Kilickap S, Aksoy S, Yalcin S. The Association between Early Changes in Neutrophil-Lymphocyte Ratio and Survival in Patients Treated with Immunotherapy. J Clin Med. 2022 Aug 3;11(15):4523. doi: 10.3390/jcm11154523. PMID: 35956139; PMCID: PMC9369683.en_US
dc.identifier.doi10.3390/jcm11154523en_US
dc.identifier.issn2077-0383en_US
dc.identifier.issue15en_US
dc.identifier.pmid9369683en_US
dc.identifier.scopus2-s2.0-85136967089en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttp://doi.org/10.3390/jcm11154523
dc.identifier.urihttps://hdl.handle.net/20.500.12713/3100
dc.identifier.volume11en_US
dc.identifier.wosWOS:000839133300001en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorKılıçkap, Saadettin
dc.language.isoenen_US
dc.publisherMDPIen_US
dc.relation.ispartofJournal of Clinical Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCharlson Comorbidity Indexen_US
dc.subjectNLR2-CELen_US
dc.subjectBiomarkeren_US
dc.subjectCanceren_US
dc.subjectImmunotherapyen_US
dc.subjectNeutrophillymphocyte Ratioen_US
dc.titleThe association between early changes in neutrophil-lymphocyte ratio and survival in patients treated with immunotherapyen_US
dc.typeArticleen_US

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