Background

In 2017, nivolumab monotherapy was shown to be effective as third- or later-line therapy in patients with advanced gastric or gastroesophageal junction cancer.

Objective

In this study, we investigated the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the outcomes of nivolumab monotherapy in patients with gastric or gastroesophageal junction cancer.

Patients and Methods

The long-term outcomes and treatment responses to nivolumab monotherapy were assessed in patients with gastric or gastroesophageal junction cancer. We compared patients with a NLR > 2.5 and those with a NLR ≤ 2.5 at the time of starting nivolumab monotherapy.

Results

The proportion of patients who have received three or more regimens was higher in the NLR > 2.5 group than in the NLR ≤ 2.5 group. The disease control rate was significantly worse in the NLR > 2.5 group than in the NLR ≤ 2.5 group (23% and 46%, respectively; p = 0.044). Overall survival was significantly better in the NLR ≤ 2.5 group than in the NLR > 2.5 group. Multivariate analysis showed that the macroscopic type, primary site resection, and the NLR were independent prognostic factors for overall survival (hazard ratio [95% confidence interval], 2.586 [1.286–5.203], 0.473 [0.260–0.861], and 1.736 [1.007–2.992], respectively).

Conclusions

This study demonstrates that the NLR is an independent prognostic factor in patients with gastric or gastroesophageal junction cancer treated with nivolumab monotherapy. Careful attention must be paid when nivolumab monotherapy is used to treat patients with gastric cancer with a NLR > 2.5.

中文翻译：

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中性粒细胞与淋巴细胞比率对用Nivolumab单药治疗的胃癌患者生存率的影响。

背景

2017年，nivolumab单一疗法被证明可有效治疗晚期胃癌或胃食管交界癌患者的三线或后期治疗。

目的

在这项研究中，我们调查了中性粒细胞与淋巴细胞之比（NLR）与胃或胃食管交界性癌患者nivolumab单药治疗结局之间的关系。

患者和方法

在胃癌或胃食管连接癌患者中评估了对nivolumab单药治疗的长期结果和治疗反应。我们比较了Nivolumab单药治疗开始时NLR> 2.5的患者和NLR≤2.5的患者。

结果

NLR> 2.5组的患者接受三种或更多方案的比例高于NLR≤2.5组的患者。NLR> 2.5组的疾病控制率明显低于NLR≤2.5组（分别为23％和46％；p  = 0.044）。NLR≤2.5组的总生存率明显高于NLR> 2.5组。多因素分析表明，宏观类型，主要部位切除和NLR是整体生存的独立预后因素（危险比[95％置信区间]，2.586 [1.286-5.203]，0.473 [0.260-0.861]和1.736 [1.007] –2.992]）。

结论

这项研究表明，Nivolumab单药治疗对患有胃癌或胃食管连接癌的患者而言，NLR是独立的预后因素。当Nivolumab单一疗法用于NLR> 2.5的胃癌患者时，必须格外注意。