Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor of Survival Outcomes in Head and Neck Squamous Cell Carcinoma Receiving Neoadjuvant Immunotherapy
Abstract
Purpose: The neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker in cancers treated with immune checkpoint inhibitors (ICI), reflecting the link between inflammation and cancer immune response. This study examines NLR's prognostic value in head and neck squamous cell carcinoma (HNSCC) patients receiving neoadjuvant ICI therapy, focusing on its potential as an independent predictor of overall survival (OS) and disease-free survival (DFS).
Methods: We conducted a retrospective cohort study including three neoadjuvant trials: durvalumab ± metformin, nivolumab ± tadalafil, or nivolumab ± BMS-986205 from 2017 to 2022. Pre-treatment NLR was calculated using absolute neutrophil and absolute lymphocyte counts obtained before neoadjuvant ICI initiation. The optimal pre-treatment NLR cut-off was identified using receiver operating characteristic (ROC) curve analysis. OS and DFS were assessed using Kaplan-Meier and multivariable Cox proportional hazards regression models.
Results: A total of 97 patients met inclusion criteria. NLR < 4.14 was associated with improved overall survival (HR 0.07, 95% CI 0.01-0.30, p < 0.001) and DFS (HR 0.21, 95% CI 0.08-0.54, p = 0.001) compared to NLR ≥ 4.14. NLR < 4.14 remained independently associated with improved OS (HR 0.14, 95% CI 0.02-0.78, p = 0.025) and DFS (HR 0.25, 95% CI 0.07-0.87, p = 0.030) on multivariable Cox regression. The survival benefit of NLR < 4.14 persisted after sub-stratification for p16 status, ICI pathologic response…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 97 participants or records.
Read the paper
Related studies
- Protective effects of tadalafil and N-acetyl cysteine therapy on cisplatin-induced testicular toxicity
- The Use of Generative AI for Scientific Literature Searches for Systematic Reviews: ChatGPT and Microsoft Bing AI Performance Evaluation
- Sildenafil as a Candidate Drug for Alzheimer’s Disease: Real-World Patient Data Observation and Mechanistic Observations from Patient-Induced Pluripotent Stem Cell-Derived Neurons
- Ozone-modified properties of pumpkin seed oil as anti-H. pylori, anticancer, anti-diabetic and anti-obesity agent
- Effectiveness of Low-Intensity Extracorporeal Shock Wave Therapy in Erectile Dysfunction: An Analysis of Sexual Function and Penile Hardness at Erection: An Umbrella Review
- Molecular Docking of Silymarin as a Ligand for Aromatase Enzyme and HIV-1 Reverse Transcriptase Using Molegro Virtual Docker
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.