Thoracic Cancer (Oct 2024)

Relationship between the combination of platelet count and neutrophil‐lymphocyte ratio and prognosis of patients with advanced non‐small cell lung cancer treated with immune checkpoint inhibitors plus chemotherapy: A retrospective cohort study

  • Saeko Kashimura,
  • Miki Sato,
  • Takahito Inagaki,
  • Masaoki Kin,
  • Ryo Manabe,
  • Sojiro Kusumoto,
  • Atsushi Horiike,
  • Takuya Tsunoda,
  • Mari Kogo

DOI
https://doi.org/10.1111/1759-7714.15437
Journal volume & issue
Vol. 15, no. 28
pp. 2049 – 2060

Abstract

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Abstract Background The relationship between the combination of platelet count and neutrophil‐lymphocyte ratio (COP‐NLR) and prognosis in patients with advanced non‐small cell lung cancer (NSCLC) treated with immune checkpoint inhibitor (ICI) combination therapy with chemotherapy remains unclear. Thus, we investigated prognostic factors, including the COP‐NLR, to identify patients who could benefit from the therapeutic efficacy of ICI combination therapy for advanced NSCLC. Furthermore, we evaluated the relationship between the COP‐NLR score during ICI combination therapy and treatment response. Methods We conducted a retrospective cohort study of 88 patients with NSCLC who initially received ICI combination therapy. The primary outcome was overall survival (OS). The prognostic factors were extracted using the Cox proportional hazards model. The relationship between COP‐NLR score at 3 weeks after starting ICI combination therapy and a good response (complete response [CR] and partial response [PR]) to treatment was analyzed using the chi‐square test. Results The median OS was 15.7 months. In the multivariable analysis, Eastern Cooperative Oncology Group Performance Status (ECOG PS) 2, distant metastatic sites ≥2, and baseline COP‐NLR scores of 1, 2 were extracted as significant poor prognostic factors. The proportion of patients with CR and PR in the 3‐week COP‐NLR score of 0 group was significantly higher than that in scores of 1, 2 group. Conclusions Baseline COP‐NLR, ECOG PS, and number of distant metastatic sites were prognostic factors in patients with NSCLC with ICI combination therapy. A lower 3‐week COP‐NLR was associated with a good response to treatment.

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