The Impact of Neutrophil-to-Lymphocyte Ratio after Two Courses of Pembrolizumab for Oncological Outcomes in Patients with Metastatic Urothelial Carcinoma
Risa Tomioka-Inagawa,
Keita Nakane,
Torai Enomoto,
Masayuki Tomioka,
Tomoki Taniguchi,
Takashi Ishida,
Kaori Ozawa,
Kimiaki Takagi,
Hiroki Ito,
Shinichi Takeuchi,
Makoto Kawase,
Kota Kawase,
Daiki Kato,
Manabu Takai,
Koji Iinuma,
Shigeaki Yokoi,
Masahiro Nakano,
Takuya Koie
Affiliations
Risa Tomioka-Inagawa
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Keita Nakane
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Torai Enomoto
Department of Urology, Matsunami General Hospital, Hashima-gun 5016062, Japan
Masayuki Tomioka
Department of Urology, Japanese Red Cross Takayama Hospital, Takayama 5068550, Japan
Tomoki Taniguchi
Department of Urology, Chuno Kosei Hospital, Seki 5013802, Japan
Takashi Ishida
Department of Urology, Gifu Municipal Hospital, Gifu 5008513, Japan
Kaori Ozawa
Department of Urology, Ogaki Municipal Hospital, Ogaki 5038502, Japan
Kimiaki Takagi
Department of Urology, Daiyukai Daiichi Hospital, Ichinomiya 4918551, Japan
Hiroki Ito
Department of Urology, Toyota Memorial Hospital, Toyota 4718513, Japan
Shinichi Takeuchi
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Makoto Kawase
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Kota Kawase
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Daiki Kato
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Manabu Takai
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Koji Iinuma
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
Shigeaki Yokoi
Department of Urology, Central Japan International Medical Center, Minokamo 5058510, Japan
Masahiro Nakano
Department of Urology, Gifu Prefectural General Medical Center, Gifu 5008717, Japan
Takuya Koie
Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan
We focused on the therapeutic effect of pembrolizumab for metastatic urothelial carcinoma (mUC) and evaluated predictive factors for improving clinical outcomes. We conducted a retrospective multicenter cohort study of patients with mUC who received pembrolizumab. The endpoint was to evaluate the association between clinicopathological features and oncological outcomes. A total of 160 patients were enrolled in this study and were divided into two groups: the responder and the non-responder group, according to the best response. They were followed up for a median period of 10 months. The median overall (OS) and progression-free survival (PFS) in this study were 17 and 4 months, respectively. The responder group did not achieve median OS and it was 10 months in the non-responder group (p p < 0.001). Regarding the neutrophil-to-lymphocyte ratio (NLR) after two courses of administration of pembrolizumab, patients with NLR < 3.24 had significantly better oncological outcomes than those with NLR ≥ 3.24. Multivariate analysis showed a significant association between NLR after two courses of pembrolizumab and OS. Therefore, the absolute value of NLR after two courses of pembrolizumab was a significant predictive factor for oncological outcomes.
