Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis
Abstract This study aimed to systematically investigate the value of the pre-treatment neutrophil-to-lymphocyte ratio (NLR) in prognosticating the outcome of patients with advanced cancer receiving immunotherapy. We searched Embase, PubMed, Web of Science, and Cochrane Library to identify studies ab...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-01-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-84890-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559647024054272 |
|---|---|
| author | Jialin Su Yuning Li Shuhua Tan Tianli Cheng Yongzhong Luo Lemeng Zhang |
| author_facet | Jialin Su Yuning Li Shuhua Tan Tianli Cheng Yongzhong Luo Lemeng Zhang |
| author_sort | Jialin Su |
| collection | DOAJ |
| description | Abstract This study aimed to systematically investigate the value of the pre-treatment neutrophil-to-lymphocyte ratio (NLR) in prognosticating the outcome of patients with advanced cancer receiving immunotherapy. We searched Embase, PubMed, Web of Science, and Cochrane Library to identify studies about cancer patients with immunotherapy until November 29, 2024. Retrospective or prospective cohort studies with pretreatment NLR data were included. The odds ratio (OR) and 95% confidence interval (CI) were calculated to evaluate the predictive value of NLR in prognosis and immunotherapy efficacy. The random effect model was applied for meta-analysis and the risk of bias was assessed by Egger test and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. A total of 129 articles involving 18780 cases were finally selected. Most cases were advanced cancers with the median follow-up period ranged 2–48.6 months. The high pretreatment NLR level was associated with the significantly reduced OS (HR (95%CI) = 2.26 (2.03, 2.53)), PFS (HR (95% CI) = 1.83 (1.69, 1.98)), ORR (OR (95%CI) = 0.53 (0.46, 0.61)) and DCR (OR (95% CI) = 0.36 (0.29, 0.43)) in patients with advanced cancer receiving immunotherapy. The quality of evidence was low, attributed to the serious risk of bias and incon¬sistency. An elevated NLR before immunotherapy was significantly associated with poor clinical outcomes in patients with advanced cancer. |
| format | Article |
| id | doaj-art-2c3155b4fbd2455488995e2c4d68a0e1 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-2c3155b4fbd2455488995e2c4d68a0e12025-01-05T12:17:56ZengNature PortfolioScientific Reports2045-23222025-01-0115111710.1038/s41598-024-84890-3Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysisJialin Su0Yuning Li1Shuhua Tan2Tianli Cheng3Yongzhong Luo4Lemeng Zhang5Thoracic Medicine Department 1, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalThoracic Medicine Department 1, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalSchool of Life and Health Sciences, Hunan University of Science and TechnologyThoracic Medicine Department 1, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalThoracic Medicine Department 1, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalThoracic Medicine Department 1, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer HospitalAbstract This study aimed to systematically investigate the value of the pre-treatment neutrophil-to-lymphocyte ratio (NLR) in prognosticating the outcome of patients with advanced cancer receiving immunotherapy. We searched Embase, PubMed, Web of Science, and Cochrane Library to identify studies about cancer patients with immunotherapy until November 29, 2024. Retrospective or prospective cohort studies with pretreatment NLR data were included. The odds ratio (OR) and 95% confidence interval (CI) were calculated to evaluate the predictive value of NLR in prognosis and immunotherapy efficacy. The random effect model was applied for meta-analysis and the risk of bias was assessed by Egger test and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. A total of 129 articles involving 18780 cases were finally selected. Most cases were advanced cancers with the median follow-up period ranged 2–48.6 months. The high pretreatment NLR level was associated with the significantly reduced OS (HR (95%CI) = 2.26 (2.03, 2.53)), PFS (HR (95% CI) = 1.83 (1.69, 1.98)), ORR (OR (95%CI) = 0.53 (0.46, 0.61)) and DCR (OR (95% CI) = 0.36 (0.29, 0.43)) in patients with advanced cancer receiving immunotherapy. The quality of evidence was low, attributed to the serious risk of bias and incon¬sistency. An elevated NLR before immunotherapy was significantly associated with poor clinical outcomes in patients with advanced cancer.https://doi.org/10.1038/s41598-024-84890-3Advanced cancerNeutrophil-to-lymphocyte ratioImmunotherapyMeta-analysis |
| spellingShingle | Jialin Su Yuning Li Shuhua Tan Tianli Cheng Yongzhong Luo Lemeng Zhang Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis Scientific Reports Advanced cancer Neutrophil-to-lymphocyte ratio Immunotherapy Meta-analysis |
| title | Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis |
| title_full | Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis |
| title_fullStr | Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis |
| title_full_unstemmed | Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis |
| title_short | Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis |
| title_sort | pretreatment neutrophil to lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer a systematic review and meta analysis |
| topic | Advanced cancer Neutrophil-to-lymphocyte ratio Immunotherapy Meta-analysis |
| url | https://doi.org/10.1038/s41598-024-84890-3 |
| work_keys_str_mv | AT jialinsu pretreatmentneutrophiltolymphocyteratioisassociatedwithimmunotherapyefficacyinpatientswithadvancedcancerasystematicreviewandmetaanalysis AT yuningli pretreatmentneutrophiltolymphocyteratioisassociatedwithimmunotherapyefficacyinpatientswithadvancedcancerasystematicreviewandmetaanalysis AT shuhuatan pretreatmentneutrophiltolymphocyteratioisassociatedwithimmunotherapyefficacyinpatientswithadvancedcancerasystematicreviewandmetaanalysis AT tianlicheng pretreatmentneutrophiltolymphocyteratioisassociatedwithimmunotherapyefficacyinpatientswithadvancedcancerasystematicreviewandmetaanalysis AT yongzhongluo pretreatmentneutrophiltolymphocyteratioisassociatedwithimmunotherapyefficacyinpatientswithadvancedcancerasystematicreviewandmetaanalysis AT lemengzhang pretreatmentneutrophiltolymphocyteratioisassociatedwithimmunotherapyefficacyinpatientswithadvancedcancerasystematicreviewandmetaanalysis |