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BIOMARKER:

High NLR

4ms
Efficacy and Safety of First-line Pembrolizumab Plus Platinum and Pemetrexed in Elderly Patients with Non-squamous Non-small-cell Lung Cancer. (PubMed, Intern Med)
The OS for low and high NLR values was 32.8 and 2.6 months, respectively. Conclusion First-line pemb-Plt-PEM therapy is effective and feasible in elderly patients with non-squamous NSCLC.
Journal • PD(L)-1 Biomarker
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PD-L1 (Programmed death ligand 1)
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PD-L1 expression • High NLR
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Keytruda (pembrolizumab) • pemetrexed
4ms
Utility of neutrophil-to-lymphocyte ratio as an indicator of tumor immune status in non-small cell lung cancer. (PubMed, Jpn J Clin Oncol)
NLR might potentially reflect the immune status of tumor microenvironment, explaining its impact on prognosis of patients with NSCLC.
Journal
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CD8 (cluster of differentiation 8) • FOXP3 (Forkhead Box P3)
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High NLR
4ms
Absolute lymphocyte count and neutrophil-to-lymphocyte ratio as predictors of CDK 4/6 inhibitor efficacy in advanced breast cancer. (PubMed, Sci Rep)
There was no significant difference in efficacy between abemaciclib and palbociclib and both had good safety profiles. We demonstrated that ALC and NLR might predict the outcomes of CDK4/6i treatment in patients with ER + HER2 - ABC.
Retrospective data • Journal • Metastases
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HER-2 (Human epidermal growth factor receptor 2) • ER (Estrogen receptor)
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ER positive • HER-2 negative • High NLR • High ALC
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Ibrance (palbociclib) • Verzenio (abemaciclib)
5ms
Serum inflammatory markers as prognostic marker for nasopharyngeal carcinoma with liver metastasis: a multi-center retrospective study. (PubMed, Eur Arch Otorhinolaryngol)
This study highlights the prognostic significance of TNF-α and NLR in NPC patients, especially in those with liver metastasis. These inflammatory markers could serve as valuable indicators for assessing the prognosis of NPC patients. Further research is warranted to validate their clinical utility and explore potential therapeutic implications.
Retrospective data • Journal
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TNFA (Tumor Necrosis Factor-Alpha)
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High NLR
6ms
Systemic and local immunosuppression in glioblastoma and its prognostic significance. (PubMed, Front Immunol)
High NLR is one of the most repeatedly confirmed independent prognostic factors for shorter overall survival in patients with glioblastoma and carcinoma, and its combination with other markers of the immune response or systemic inflammation significantly improves the accuracy of prediction; however, more prospective studies are needed to confirm the prognostic/predictive power of NLR. We call for the inclusion of dynamic assessment of NLR and other blood inflammatory markers (e.g., absolute/total lymphocyte count, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, and systemic immune response index) in all neuro-oncology studies for rigorous evaluation and comparison of their individual and combinatorial prognostic/predictive significance and relative superiority.
Review • Journal • IO biomarker
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CD8 (cluster of differentiation 8) • CD4 (CD4 Molecule)
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High NLR
6ms
Predictive value of platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio in HCC treated with sorafenib and radioembolization. (PubMed, JHEP Rep)
However, not all patients respond well to these treatments. In our analysis, using blood test parameters showing systemic inflammation status, we were able to identify patients who would benefit more from combined treatment with a locoregional treatment of radioembolization (or selective internal radiation therapy).
Journal
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AFP (Alpha-fetoprotein)
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High NLR • High PLR
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sorafenib
6ms
High linoleic acid levels in red blood cells predict a poor response to neoadjuvant chemotherapy in human epidermal growth factor receptor type 2-positive breast cancer patients. (PubMed, Nutrition)
Pending further validation, red blood cell membrane linoleic acid might serve as a predictor biomarker of poorer response to neoadjuvant chemotherapy in non-metastatic human epidermal growth factor receptor type 2-positive breast cancer. Measuring fatty acids in red blood cell membrane could offer a convenient, minimally invasive strategy to identifying patients more likely to respond or those with chemoresistance.
Journal
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HER-2 (Human epidermal growth factor receptor 2) • FASN (Fatty acid synthase)
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EGFR positive • High NLR
6ms
The need for paradigm shift: prognostic significance and implications of standard therapy-related systemic immunosuppression in glioblastoma for immunotherapy and oncolytic virotherapy. (PubMed, Front Immunol)
In clinical trials, immunotherapeutics are generally tested after standard therapy (radiation, temozolomide, and steroid dexamethasone) or concurrently with temozolomide and/or steroids. Steroid use, high neutrophil-to-lymphocyte ratio (NLR), and low post-treatment total lymphocyte count (TLC) are significant prognostic factors for shorter survival in patients with glioblastoma in retrospective studies; however, these clinically relevant variables are rarely reported and correlated with response and survival in immunotherapy studies (e.g., immune checkpoint inhibitors, vaccines, and oncolytic viruses). Our analysis should help in the development of a more rational clinical trial design and decision-making regarding the treatment to potentially improve the efficacy of immunotherapy or oncolytic virotherapy.
Retrospective data • Review • Journal • Oncolytic virus
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CD8 (cluster of differentiation 8) • CD4 (CD4 Molecule)
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High NLR
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temozolomide • dexamethasone
7ms
Neutrophil to lymphocyte ratio may predict efficacy of anti-PD-1 inhibitors in advanced EGFR-mutant non-small cell lung cancer: retrospective cohort study. (PubMed, Sci Rep)
Further investigation revealed that front-line TKIs exposure may contribute to the elevation or decrease of NLR, and finally lead to different efficacy outcomes by anti-PD-1 inhibitors. The findings suggest that a portion of advanced NSCLC patients with low NLR characteristics (NLR ≤ 4), even those harboring EGFR-sensitive mutations, could benefit from anti-PD-1 inhibitors as further line treatment after progression to EGFR-TKIs.
Retrospective data • Journal • PD(L)-1 Biomarker • IO biomarker • Metastases
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EGFR (Epidermal growth factor receptor)
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EGFR mutation • High NLR • Low NLR
7ms
Clinical and inflammatory response to antiviral treatments in dogs with parvoviral enteritis. (PubMed, J Vet Sci)
Antiviral drugs may be valuable in treating CPE to improve the clinical signs and survival. In addition, the decrease in NLR in favor of LYM may be an indicator of the early prognosis before the improvement of leukocytes, cytokines, and acute phase proteins in CPE.
Journal
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IFNG (Interferon, gamma) • TNFA (Tumor Necrosis Factor-Alpha) • IL1B (Interleukin 1, beta) • CRP (C-reactive protein)
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High NLR
7ms
Rad51 and Systemic Inflammatory Indicators as Novel Prognostic Markers in Esophageal Squamous Cell Carcinoma. (PubMed, Technol Cancer Res Treat)
Our study found a close correlation between elevated Rad51 expression and inflammatory markers. High Rad51 expression, high neutrophil-to-lymphocyte ratio, and low lymphocyte-to-monocyte ratio are associated with lower survival rates. The combined assessment of Rad51 and inflammatory markers can be useful for preoperative assessment and prognostic evaluation in esophageal squamous cell carcinoma patients.
Journal
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RAD51 (RAD51 Homolog A) • CRP (C-reactive protein)
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High NLR • RAD51 overexpression • Albumin-L
8ms
Preoperative Neutrophil-to-Lymphocyte Ratio in Postmenopausal Breast Cancer Patients. (PubMed, J Surg Res)
The preoperative NLR can be a useful prognostic marker, especially in postmenopausal breast cancer patients. The relationships between the NLR and breast cancer prognosis may be more evident when patients are assessed according to their menopausal status.
Journal
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HER-2 (Human epidermal growth factor receptor 2)
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HR positive • HER-2 negative • EGFR positive • High NLR
8ms
Prognostic value of baseline neutrophil/lymphocyte ratio in HER2-positive metastatic breast cancer: exploratory analysis of data from the CLEOPATRA trial. (PubMed, Breast Cancer Res)
A low baseline NLR is associated with better survival outcomes among HER2-positive MBC patients receiving docetaxel plus trastuzumab/pertuzumab as first-line therapy.
Journal • Metastases
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HER-2 (Human epidermal growth factor receptor 2)
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HER-2 positive • High NLR
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Herceptin (trastuzumab) • docetaxel • Perjeta (pertuzumab)
8ms
Circulating blood biomarkers correlated with the prognosis of advanced triple negative breast cancer. (PubMed, BMC Womens Health)
Before the initiation of ICIs, enriched peripheral lymphocytes and poor neutrophils and NLR contribute to the prediction of survivals.
Journal • IO biomarker • Metastases
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HER-2 (Human epidermal growth factor receptor 2)
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HER-2 expression • High NLR
8ms
Neutrophil-to-lymphocyte ratio is a prognostic factor reflecting immune condition of tumor microenvironment in squamous cell lung cancer. (PubMed, Sci Rep)
We then compared the tumor-infiltrating lymphocyte (TIL) profile with inflammatory markers in peripheral blood and found that the NLR was negatively correlated with the frequencies of T cells and B cells in LUSC tissues. Thus, the NLR is a useful predictive biomarker for postoperative recurrence and may reflect the immune condition of the TME in LUSC.
Retrospective data • Journal
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CRP (C-reactive protein)
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High NLR
8ms
Clinical factors associated with the therapeutic efficacy of atezolizumab plus bevacizumab in patients with unresectable hepatocellular carcinoma: A multicenter prospective observational study. (PubMed, PLoS One)
Severe adverse events (grade ≥3) were observed in 96 patients (36.0%), with proteinuria being the most frequent. In conclusion, patients with older age, lower number of intrahepatic tumors, absent macrovascular invasion, and lower neutrophil-to-lymphocyte ratio are expected to have better progression-free survival with atezolizumab plus bevacizumab therapy for unresectable hepatocellular carcinoma.
Observational data • Journal
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AFP (Alpha-fetoprotein)
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High NLR • Low NLR
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Avastin (bevacizumab) • Tecentriq (atezolizumab)
9ms
The Prognosis Performance of a Neutrophil- and Lymphocyte-Associated Gene Mutation Score in a Head and Neck Cancer Cohort. (PubMed, Biomedicines)
Using a multivariate binomial generalized linear model, we identified three candidate genes (MAP2K2, MAP2K4, and ABL1) that showed significant results and were used to create a gene mutation score (GMS). Using the NLR-GMS category, we noticed that the high-NLR-GMS group had significantly shorter relapse-free survival compared to the intermediate- or low-NLR-GMS groups.
Journal
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ABL1 (ABL proto-oncogene 1) • MAP2K2 (Mitogen-activated protein kinase kinase 2) • MAP2K4 (Mitogen-Activated Protein Kinase Kinase 4)
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High NLR
9ms
Stevens-Johnson syndrome and toxic epidermal necrolysis - 11-year retrospective experience in a high complexity tertiary hospital in Milan, Italy. (PubMed, Clin Dermatol)
The extent of affected body surface area (BSA) did not correlate significantly with mortality. This study provides insights into SJS/TEN management, revealing factors influencing mortality in a high-complexity tertiary hospital setting.
Retrospective data • Journal
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CCL22 (C-C Motif Chemokine Ligand 22)
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High NLR
10ms
Sarcopenia Is Associated with Changes in Circulating Markers of Antioxidant/Oxidant Balance and Innate Immune Response. (PubMed, Antioxidants (Basel))
Linear regression analysis resulted in a strong association between redox balance and immune response markers in the sarcopenic group. (4) These results support the interplay between redox homeostasis alteration and disruption of the innate immune response in the pathogenesis of sarcopenia.
Journal
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IL6 (Interleukin 6) • TNFA (Tumor Necrosis Factor-Alpha) • IL10 (Interleukin 10)
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High NLR
10ms
Association between platelet-to-lymphocyte ratio and outcomes in HER2-positive advanced breast cancer patients treated with pyrotinib: a retrospective study. (PubMed, Transl Cancer Res)
High PLR is associated with poor treatment response and is an independent unfavorable prognostic factor in HER2-positive advanced BC patients treated with pyrotinib. The findings herein indicate that patients with higher PLR are less likely to benefit from pyrotinib-based therapy and may be helpful in identifying the effective population in clinical practice.
Retrospective data • Journal • Metastases
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HER-2 (Human epidermal growth factor receptor 2)
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HER-2 positive • EGFR positive • High NLR • Low PLR
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Irene (pyrotinib)
10ms
Sequential high-intensity focused ultrasound treatment combined with chemotherapy for inoperable pancreatic cancer: a retrospective analysis for prognostic factors and survival outcomes. (PubMed, Int J Hyperthermia)
Early application of HIFU treatment improves the OS of patients with inoperable pancreatic cancer. CRP + CA125 and γGT are independent prognostic factors.
Retrospective data • Journal
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CRP (C-reactive protein)
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High NLR
10ms
Prognostic Impact of Tumor-Infiltrating Lymphocytes, Tertiary Lymphoid Structures, and Neutrophil-to-Lymphocyte Ratio in Pulmonary Metastases from Uterine Leiomyosarcoma. (PubMed, Ann Surg Oncol)
CD3-positive TILs, CD8-positive TILs, TLSs, and NLR are correlated with the prognosis, respectively. The combination of CD8-positive TILs or TLSs and NLR may be the indicators to predict the prognosis of patients with pulmonary metastases from uterine leiomyosarcoma.
Retrospective data • Journal • Tumor-infiltrating lymphocyte
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CD8 (cluster of differentiation 8) • FOXP3 (Forkhead Box P3) • ITGAE (Integrin Subunit Alpha E)
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CD8 positive • High NLR • CD8-H
10ms
Pretreatment PLR Is Preferable to NLR and LMR as a Predictor in Locally Advanced and Metastatic Bladder Cancer. (PubMed, Cancer Diagn Progn)
The multivariate Cox regression analysis identified a high PLR as an independent predictive factor of worse OS (hazard ratio=2.774, 95% confidence interval=1.486-5.178, p=0.001) but not NLR or LMR. PLR, C-reactive protein-to-albumin ratio, and serum LDH levels, but not NLR and LMR, may function as independent predictors in patients with advanced BC prior to systemic treatment.
Journal • Metastases
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CRP (C-reactive protein)
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High NLR
10ms
Significance of neutrophil-to-lymphocyte ratio in atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma (PubMed, Nihon Shokakibyo Gakkai Zasshi)
The high NLR group demonstrated a shorter PFS than the low NLR group. NLR may be a useful predictive biomarker of the first-line Atezo/Bev treatment for unresectable HCC.
Journal • PD(L)-1 Biomarker
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CRP (C-reactive protein)
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High NLR
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Avastin (bevacizumab) • Tecentriq (atezolizumab)
10ms
Prognostic value of systemic inflammation response index in hepatoblastoma patients receiving preoperative neoadjuvant chemotherapy. (PubMed, Front Oncol)
SIRI is an independent prognostic factor of hepatoblastoma patients receiving neoadjuvant chemotherapy. The OS nomogram based on SIRI, POSTTEXT staging, MiVI, and AFP can be used to assess the prognosis of those patients.
Journal
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AFP (Alpha-fetoprotein)
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High NLR
11ms
Peripheral blood neutrophil-to-lymphocyte ratio correlated with serum IL-8 level and predict the outcome of hepatocellular carcinoma patients treated with immune-targeted combination therapy (ESMO Asia 2023)
Conclusions NLR is an independent prognostic factor for aHCC, the combination of dynamic change and baseline NLR may assist in screening out patients who are difficult to benefit from immune-targeted therapy. High baseline NLR may correlate with high baseline serum IL-8.
Clinical • Combination therapy • PD(L)-1 Biomarker • IO biomarker
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CXCL8 (Chemokine (C-X-C motif) ligand 8)
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High NLR
12ms
CD39 affect the prognostic role of NLR via N2 neutrophils in metastatic melanoma patients treated with immunotherapy (SITC 2023)
This could explain the prognostic role of NLR. Further investigations are needed to get additional information.
Clinical • PD(L)-1 Biomarker • IO biomarker • Metastases
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PTEN (Phosphatase and tensin homolog) • MYD88 (MYD88 Innate Immune Signal Transduction Adaptor) • LDHA (Lactate dehydrogenase A) • MMP9 (Matrix metallopeptidase 9) • ENTPD1 (Ectonucleoside Triphosphate Diphosphohydrolase 1) • CCNA1 (Cyclin A1)
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High NLR • ENTPD1 expression
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nCounter® PanCancer IO 360™ Panel
1year
Microsatellite instability and its relationship with systemic inflammation as prognostic factors in localised colorectal cancer (ESMO 2023)
Conclusions MSI-H was significantly associated with high NLR, and its prognostic effect outweighed that of MSI-H, especially in stage II CRC. Therefore, we should consider more about factors of tumor microenvironment such as high NLR, as one of criteria to classify high-risk stage II CRC, which needs adjuvant chemotherapy.
Microsatellite instability • MSi-H Biomarker
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MSI (Microsatellite instability)
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MSI-H/dMMR • High NLR