Evidence map›Paper›PMID 33882890›Full record

ArticleBMC cancer2021

A composite biomarker of neutrophil-lymphocyte ratio and hemoglobin level correlates with clinical response to PD-1 and PD-L1 inhibitors in advanced non-small cell lung cancers.

Kristin L Ayers, Meng Ma, Gaspard Debussche, David Corrigan, Jonathan McCafferty, Kyeryoung Lee, Scott Newman, Xiang Zhou, Fred R Hirsch, Philip C Mack and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 2 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

30 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

14 authors.

Kristin L AyersSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
Meng MaSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
Gaspard DebusscheSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
David CorriganSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
Jonathan McCaffertySema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
Kyeryoung LeeSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
Scott NewmanSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
Xiang ZhouSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
Fred R HirschCenter of Thoracic Oncology/Tisch Cancer Institute and Icahn School of Medicine, Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
Philip C MackCenter of Thoracic Oncology/Tisch Cancer Institute and Icahn School of Medicine, Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
Jane J LiuSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA.
Eric E SchadtSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA. eric.schadt@sema4.com.
Rong ChenSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA. rong.chen@sema4.com.
Shuyu D LiSema4, a Mount Sinai Venture, 333 Ludlow Street, Stamford, CT, 06902, USA. shuyudanli@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune checkpoint inhibitors (ICIs) have been incorporated into various clinical oncology guidelines for systemic treatment of advanced non-small cell lung cancers (aNSCLC). However, less than 50% (and 20%) of the patients responded to the therapy as a first (or second) line of therapy. PD-L1 immunohistochemistry (IHC) is an extensively studied biomarker of response to ICI, but results from this test have equivocal predictive power. In order to identify other biomarkers that support clinical decision-making around whether to treat with ICIs or not, we performed a retrospective study of patients with aNSCLC who underwent ICI-based therapy in the Mount Sinai Health System between 2014 and 2019.

methodsWe analyzed data from standard laboratory tests performed in patients as a part of the routine clinical workup during treatment, including complete blood counts (CBC) and a comprehensive metabolic panel (CMP), to correlate test results with clinical response and survival.

resultsOf 11,138 NSCLC patients identified, 249 had been treated with ICIs. We found associations between high neutrophil-to-lymphocyte ratio (NLR ≥ 5) and poor survival in ICI-treated NSCLC. We further observed that sustained high NLR after initiation of treatment had a more profound impact on survival than baseline NLR, regardless of PD-L1 status. Hazard ratios when comparing patients with NLR ≥ 5 vs. NLR < 5 are 1.7 (p = 0.02), 3.4 (p = 4.2 × 10

conclusionsWe developed a novel composite biomarker for ICI-based therapy in NSCLC based on routine CBC tests, which may provide meaningful clinical utility to guide treatment decision. The results suggest that treatment of anemia to elevate HGB before initiation of ICI therapy may improve patient outcomes or the use of alternative non-chemotherapy containing regimens.

Indexed as

Erythrocyte IndicesLeukocyte CountAntineoplastic Agents, ImmunologicalB7-H1 AntigenBiomarkers, TumorCarcinoma, Non-Small-Cell LungFemaleHumansKaplan-Meier EstimateLung NeoplasmsLymphocytesMaleNeoplasm MetastasisNeoplasm StagingNeutrophilsOdds RatioAntineoplastic Agents, ImmunologicalB7-H1 AntigenBiomarkers, TumorCD274 protein, humanProgrammed Cell Death 1 ReceptorAnemiaBiomarkerImmune checkpoint inhibitorNeutrophil-lymphocyte ratioNon-small cell lung cancer

Identifiers

PMID33882890
PMCPMC8059160

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Registered trials

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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.