ArticleScientific reports2021
Neutrophil to lymphocyte ratio influences impact of steroids on efficacy of immune checkpoint inhibitors in lung cancer brain metastases.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers, 4 of them syntheses 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.
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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
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Impact of glucocorticoid administration on therapeutic outcomes of immune checkpoint inhibitors in non-small cell lung cancer: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Brain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions.Neuro-oncology · 2022Guideline
- The Impact of Neutrophil-Lymphocyte Ratio in Febrile Seizures: A Systematic Review and Meta-Analysis.BioMed research international · 2022Pooled it
- Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Poststroke Depression: A Systematic Review and Meta-Analysis.Disease markers · 2022Pooled it
- Prednisolone modulates CD8⁺ and regulatory T-cell activity to dampen response to immune checkpoint inhibitor therapy in melanoma.Oncoimmunology · 2026Article
- Baseline neutrophil-to-lymphocyte ratio predicts survival time after the initiation of nintedanib in patients with interstitial lung disease.BMC pulmonary medicine · 2026Article
- Linoleoyl-lysophosphatidylcholine drives non-inflammatory apoptosis in neutrophils via lipid rafts.Frontiers in immunology · 2026Article
- The Evaluation of Diagnostic, Prognostic, and Predictive Role of Hematologic Inflammatory Indices NLR, PLR, and LMR in Common Solid Tumors.Cancer reports (Hoboken, N.J.) · 2025Review
- Monocyte-Platelet-Hemoglobin-Hematocrit score and the role of hematological parameters in predicting treatment response to immune checkpoint inhibitors and survival outcomes in non-small cell lung cancer patients-a retrospective study.Translational lung cancer research · 2025Article
- Article
- Tumour immune infiltration is independent of peripheral circulation of white blood cells in glioblastoma.Scientific reports · 2025Article
- The effect of baseline versus early glucocorticoid use on immune checkpoint inhibitor efficacy in patients with advanced NSCLC.Frontiers in oncology · 2025Article
- Negative association of steroids with immunotherapy efficacy in a multi-tumor cohort: time and dose-dependent.Cancer immunology, immunotherapy : CII · 2024Article
- Article
- Society for Immunotherapy of Cancer (SITC) consensus definitions for resistance to combinations of immune checkpoint inhibitors with targeted therapies.Journal for immunotherapy of cancer · 2023Article
- Preoperative neutrophil-to-lymphocyte ratio (preNLR) for the assessment of tumor characteristics in lung adenocarcinoma patients with brain metastasis.Translational oncology · 2022Article
- Prognostic value of hematologic parameters in advanced non-small cell lung cancer patients receiving anti-PD-1 inhibitors.Frontiers in immunology · 2022Article
- Impact of baseline glucocorticoid use on the efficacy of immunotherapy combined with intracranial radiotherapy in NSCLC patients with brain metastases.Neuro-oncology advancesArticle
Corrections and comments
- Erratum issued
- Erratum issued
Authors and funding
18 authors at 8 institutions in 1 country.
Funding
Abstract
Steroids are often utilized to manage patients with non-small cell lung cancer brain metastases (NSCLCBM). Steroids and elevated neutrophil-to-lymphocyte ratio (NLR) have been associated with decreased overall survival (OS) in patients treated with immune checkpoint inhibitors (ICI). We retrospectively investigated patients treated with ICI after the diagnosis of NSCLCBM at a single tertiary care institution examing the impact of steroids and NLR. Overall survival (OS) and intracranial progression-free survival (PFS) were analyzed. 171 patients treated with ICI for NSCLCBM were included. Thirty-six received steroids within 30 days of the start of ICI, and 53 patients had an NLR ≥ 5 before the start of ICI. Upfront steroids was associated with decreased OS on multivariable analysis (median OS 10.5 vs. 17.9 months, p = .03) and intracranial PFS (5.0 vs. 8.7 months, p = .045). NLR ≥ 5 was indicative of worse OS (10.5 vs. 18.4 months, p = .04) but not intracranial PFS (7.2 vs. 7.7 months, p = .61). When NLR and upfront steroids are modeled together, there is a strong interaction (p = .0008) indicating that the impact of steroids depended on the patient's NLR. In a subgroup analysis, only in patients with NLR < 4 was there a significant difference in OS with upfront steroids (26.1 vs. 15.6 months, p = .032). The impact of steroids on the efficacy of ICI in patients with NSCLCBM is dependent on the patient's NLR underscoring its importance in these patients. Patients with a low NLR, steroid use decreases the efficacy of ICI. These results can inform clinicians about the impact of steroids in patients treated with ICI.
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Registered trials
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.