Inflammatory indices help gauge efficacy of atezolizumab against NSCLC

24 Oct 2020

Inflammatory indices, such as the neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte (LMR) ratios, may help determine the efficacy of atezolizumab monotherapy in patients with nonsmall cell lung cancer (NSCLC), a recent study has found.

The researchers conducted a retrospective review of 81 NSCLC patients (median age, 71 years; 54.3 percent male) treated with atezolizumab. Most of the participants had stage IV (63.0 percent) and III (23.5 percent) disease; 11 patients (13.6 percent) had pot-surgery recurrence.

No patients had complete response to atezolizumab, as defined by the Response Evaluation Criteria in Solid Tumours. On the other hand, almost half (46.9 percent) achieved a stable disease, while 7.4 percent showed partial response. More than a third were deemed to have progressive disease.

The resulting objective response rate was low at 7.4 percent, though the disease control rate was 54.3 percent. The median progression-free (PFS) and overall survival (OS) values were 60 and 252 days, respectively.

Log-rank evaluation showed that patients with NLR >5 and LMR ≤1.5 saw significantly shorter PFS than counterparts with NLR ≤5 (42 vs 86 days; p<0.001) and LMR >1.5 (37 vs 84 days; p=0.0031). The same was true for those with platelet-to-lymphocyte ratio of >262 vs ≤262 (48.5 vs 90 days; p=0.033). Similarly, OS was significantly shortened when using the same cutoffs.

Multivariate analysis further confirmed that a high NLR at baseline was associated with significantly worse PFS (hazard ratio [HR], 2.50, 95 percent confidence interval [CI], 1.40–4.56; p=0.0018) and OS (HR, 2.91, 95 percent CI, 1.51–5.61; p=0.0014).

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