Evidence map›Paper›PMID 31584709›Full record

ArticleCancer2020

High neutrophil-to-lymphocyte ratio (NLR) is associated with treatment failure and death in patients who have melanoma treated with PD-1 inhibitor monotherapy.

Edmund K Bartlett, Jessica R Flynn, Katherine S Panageas, Richard A Ferraro, Jessica M Sta Cruz, Michael A Postow, Daniel G Coit, Charlotte E Ariyan

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

99 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  12. Dynamic blood-based biomarkers predict early response to ipilimumab and nivolumab in advanced melanoma.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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39 more citing papers are in PubMed but not listed here.

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

8 authors.

Edmund K BartlettDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.ORCID 0000-0002-0923-153X
Jessica R FlynnDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
Katherine S PanageasDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
Richard A FerraroDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Jessica M Sta CruzDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Michael A PostowDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.ORCID 0000-0002-3367-7961
Daniel G CoitDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Charlotte E AriyanDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundAn elevated neutrophil-to-lymphocyte ratio (NLR) is associated with poor survival in patients with cancer, including those who receive immunotherapies. The authors sought to investigate NLR as a biomarker of treatment outcomes in patients with melanoma who were treated with PD-1 inhibition.

methodsPatients undergoing initial treatment with PD-1 inhibitor monotherapy for stage IV melanoma at a single center from 2012 to 2015 were included. Clinical characteristics and the NLR at baseline and before subsequent treatment cycles were collected. The time to treatment failure (TTF) and overall survival (OS) were evaluated using Kaplan-Meier and landmark analyses.

resultsAmong 224 study patients, 63 (28%) had a baseline NLR ≥5. The baseline NLR was significantly associated with Eastern Cooperative Oncology Group performance status and the number of involved metastatic sites. With a median follow-up of 39 months in survivors, a baseline NLR ≥5 was independently associated with shorter OS (hazard ratio, 2.0; 95% CI, 1.3-2.9) and TTF (hazard ratio, 1.7; 95% CI, 1.2-2.4). An NLR increase ≥30% during the first 2 cycles of treatment was associated with worse OS (median, 47 vs 13.5 months; P < .001) and a trend toward shorter TTF (12.8 vs 5.9 months; P = .05). A combined baseline NLR ≥5 and an NLR increase ≥30% identified a small cohort with markedly shortened OS (median, 5.8 months) and TTF (median, 1.8 months).

conclusionsElevated baseline NLR and an increased NLR early during treatment are prognostic for TTF and OS in patients who have melanoma treated with PD-1 inhibitor monotherapy. Combined, these biomarkers can widely risk-stratify patients for treatment failure and survival.

Indexed as

PrognosisAdultAgedAged, 80 and overAntineoplastic Agents, ImmunologicalDisease-Free SurvivalFemaleHumansKaplan-Meier EstimateLymphocyte CountLymphocytesMaleMelanomaMiddle AgedNeoplasm StagingNeutrophilsAntineoplastic Agents, ImmunologicalPDCD1 protein, humanProgrammed Cell Death 1 Receptorcheckpoint inhibitormelanomaneutrophil-to-lymphocyte ratioPD-1 inhibitor

Identifiers

PMID31584709
PMCPMC6906249

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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.