- In patients with platinum-resistant metastatic urothelial cancer, pretreatment neutrophil-to-lymphocyte ratio (pre-NLR) levels before pembrolizumab initiation are independent predictors of disease progression and cancer-specific mortality.
- At least 25% reduction in NLR after treatment is associated with improved PFS and cancer-specific survival.
Why this matters
- Elevated pre-NLR may be a novel biomarker for identifying poor pembrolizumab responders.
- 78 patients with metastatic urothelial carcinoma received pembrolizumab after platinum-based chemotherapy between December 2017 and April 2019.
- Funding: None disclosed.
- 42.3% of patients had elevated pre-NLR (≥3.35).
- 29.5% of patients had a clinical response.
- In high vs low pre-NLR group:
- Significant decrease in the sum of the target lesion longest diameter (18.8% vs 58.1%; P=.005).
- Lower 6-month PFS rates (9.1% vs 45.9%; P<.001>
- Lower 6-month cancer-specific survival rates (58.0% vs 89.1%; P=.002).
- Retrospective design.