ArticlePloS one2014
An inflammation based score can optimize the selection of patients with advanced cancer considered for early phase clinical trials.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Localized and Advanced Prostate Cancer: A Systematic Review and Meta-Analysis.PloS one · 2016Pooled it
- Anti-Inflammatory Effects of Metformin Irrespective of Diabetes Status.Circulation research · 2016Trial
- Thymosin α1 Elevates Lymphocyte Counts and Improves Immunoradiotherapy Outcomes in Patients with Advanced Cancer.Cancer management and research · 2025Article
- Systemic immune-inflammation index and lymphocyte-to-monocyte ratio predict recurrence after radical surgery for stage I/II endometrial cancer.American journal of cancer research · 2025Article
- Principal Investigators' Perceptions on Factors Associated with Successful Recruitment in Clinical Trials.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2023Article
- Clinical Predictors of Early Trial Discontinuation for Patients Participating in Phase I Clinical Trials in Oncology.Cancers · 2021Article
- Systemic immune-inflammation index, serum albumin, and fibrinogen impact prognosis in castration-resistant prostate cancer patients treated with first-line docetaxel.International urology and nephrology · 2019Article
- Article
- α-Lipoic Acid Mitigates Arsenic-Induced Hematological Abnormalities in Adult Male Rats.Iranian journal of medical sciences · 2017Article
- Dynamics of Neutrophils-to-Lymphocyte Ratio Predict Outcomes of PD-1/PD-L1 Blockade.BioMed research international · 2017Article
- Challenges Facing Early Phase Trials Sponsored by the National Cancer Institute: An Analysis of Corrective Action Plans to Improve Accrual.Clinical cancer research : an official journal of the American Association for Cancer Research · 2016Review
- Review
- The neutrophil-lymphocyte ratio and its utilisation for the management of cancer patients in early clinical trials.British journal of cancer · 2015Article
- Cytokine profile and prognostic significance of high neutrophil-lymphocyte ratio in colorectal cancer.British journal of cancer · 2015Article
- Neutrophil-to-lymphocyte ratio may be associated with the outcome in patients with prostate cancer.SpringerPlus · 2015Article
- Comment on 'Existing prognostic models, but not neutrophil-to-lymphocyte ratio, are prognostic in malignant mesothelioma'.British journal of cancer · 2014Article
- Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer.British journal of cancer · 2014Article
- Unraveling the clinical significance and prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: An extensive literature review.Turkish journal of emergency medicineReview
- Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in chronic periodontitis before and after nonsurgical therapy.Journal of Indian Society of PeriodontologyArticle
- Serum C-reactive protein/albumin ratio as a prognostic marker in oral squamous cell carcinoma.Journal of oral and maxillofacial pathology : JOMFPArticle
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundAdequate organ function and good performance status (PS) are common eligibility criteria for phase I trials. As inflammation is pathogenic and prognostic in cancer we investigated the prognostic performance of inflammation-based indices including the neutrophil (NLR) and platelet to lymphocyte ratio (PLR).
methodsWe studied inflammatory scores in 118 unselected referrals. NLR normalization was recalculated at disease reassessment. Each variable was assessed for progression-free (PFS) and overall survival (OS) on uni- and multivariate analyses and tested for 90 days survival (90DS) prediction using receiving operator curves (ROC).
resultsWe included 118 patients with median OS 4.4 months, 23% PS>1. LDH≥450 and NLR≥5 were multivariate predictors of OS (p<0.001). NLR normalization predicted for longer OS (p<0.001) and PFS (p<0.05). PS and NLR ranked as most accurate predictors of both 90DS with area under ROC values of 0.66 and 0.64, and OS with c-score of 0.69 and 0.60. The combination of NLR+PS increased prognostic accuracy to 0.72. The NLR was externally validated in a cohort of 126 subjects.
conclusionsWe identified the NLR as a validated and objective index to improve patient selection for experimental therapies, with its normalization following treatment predicting for a survival benefit of 7 months. Prospective validation of the NLR is warranted.
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