Evidence map›Paper›PMID 31314761›Full record

ArticlePloS one2019

Neutrophil-to-lymphocyte ratio evolution is an independent predictor of early progression of second-line nivolumab-treated patients with advanced non-small-cell lung cancers.

Matthieu Dusselier, Elise Deluche, Nellie Delacourt, Julia Ballouhey, Thomas Egenod, Boris Melloni, Charlotte Vergnenègre, Rémi Veillon, Alain Vergnenègre

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 8 pooled it
4.6field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 8 syntheses or guidelines pooled it, 57 citations in OpenAlex.

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  20. Is lung resection appropriate for late octogenarians? Surgical outcomes of patients aged ≥ 80 years with lung cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Matthieu DusselierService de Pneumologie, CHU, Limoges, France.ORCID 0000-0001-5421-7254
Elise DelucheService d'Oncologie Médicale, CHU, Limoges, France.
Nellie DelacourtService de Pneumologie, CHU, Limoges, France.
Julia BallouheyService de Pneumologie, CHU, Limoges, France.
Thomas EgenodService de Pneumologie, CHU, Limoges, France.
Boris MelloniService de Pneumologie, CHU, Limoges, France.
Charlotte VergnenègreCHU Bordeaux, service des maladies respiratoires, Bordeaux, France.
Rémi VeillonCHU Bordeaux, service des maladies respiratoires, Bordeaux, France.
Alain VergnenègreService de Pneumologie, CHU, Limoges, France.
Centre Hospitalier Universitaire de Limoges · FRCentre Hospitalier Universitaire de Bordeaux · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAlthough second-line immunotherapy obtained better outcomes than chemotherapy for patients with advanced non-small-cell lung cancers (NSCLCs), it is expensive and only a minority of patients seem to benefit, based on early tumor progression post-immunotherapy. Notable host inflammation, characterized by biomarkers (e.g. neutrophil-to-lymphocyte ratio (NLR])), prolongs overall survival (OS) of surgery-, chemotherapy- and immunotherapy-treated patients. To our knowledge, no previous studies used biomarker evolution to analyze the immunotherapy impact on host inflammation. Immunotherapy mainly exerts its activity by lymphocyte reactivation.

methodsThis retrospective study was conducted on patients, selected by their progression status just before their 4th nivolumab injection, and treated at Bordeaux and Limoges University Hospitals. A comparative group of at least 1-year responders was also selected. Clinical parameters and hematological data just before the 1st (baseline) and 4th nivolumab infusions were collected to calculate the NLR change (ΔNLR) between those two infusions. The combined impact of the different known prognostic factors was also analyzed with multivariable analyses.

resultsFifty-nine patients were included. The 29 early progressors had significantly more frequent ΔNLR > 1 (p = 0.0007), OR 18.08 [95% CI 2.96-246.24] with progressive disease as best response to prior treatment line (p = 0.0014). ΔNLR < 1 prolonged OS (HR 0.001 [0.0007-0.18], p = 0.001); as did a partial response to prior line of systemic treatment (HR 0.14 [0.03--0.56], p = 0.005).

conclusionBased on selected early progressors given second-line immunotherapy for advanced NSCLC, progression as best response to prior treatment and ΔNLR > 1 characterized the early progressors and shortened OS after starting nivolumab. This phenomenon questions nivolumab utility in patients with a major host neutrophil inflammation.

Indexed as

AdultAgedAged, 80 and overAntineoplastic Agents, ImmunologicalCarcinoma, Non-Small-Cell LungDisease ProgressionFemaleHumansKaplan-Meier EstimateLung NeoplasmsLymphocytesMaleMiddle AgedNeutrophilsNivolumabPrognosisAntineoplastic Agents, ImmunologicalNivolumab

Identifiers

PMID31314761
PMCPMC6636729
OpenAlexW2959622004

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.