ArticleCancer immunology, immunotherapy : CII2022
Pre-pembrolizumab neutrophil-to-lymphocyte ratio (NLR) predicts the efficacy of second-line pembrolizumab treatment in urothelial cancer regardless of the pre-chemo NLR.
Article in Cancer immunology, immunotherapy : CII, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis.Scientific reports · 2025Pooled it
- Tumor-associated neutrophils suppress CD8British journal of cancer · 2024Pooled it
- Adjuvant nivolumab, capecitabine or the combination in patients with residual triple-negative breast cancer: the OXEL randomized phase II study.Nature communications · 2024Trial
- Real-world efficacy and safety of immune checkpoint blockades in advanced urothelial carcinoma with histologic variant subtypes: the pembroblad study.Cancer immunology, immunotherapy : CII · 2026Review
- Prognostic role of intramuscular adipose tissue content in patients with urothelial carcinoma treated with pembrolizumab.International urology and nephrology · 2026Article
- Combined neutrophil-to-lymphocyte ratio and nomogram for predicting progression-free survival in recurrent/metastatic cervical cancer treated with immune checkpoint inhibitors.Frontiers in immunology · 2026Article
- Extracellular vesicles-derived LncRNA MAFG-AS1 predicts clinical response to pembrolizumab in patients with advanced urothelial carcinoma.Molecular biology reports · 2025Article
- Response to First-Line Chemotherapy Predicts Response to Maintenance Avelumab Therapy in Japanese Patients With Advanced Urothelial Carcinoma.International journal of urology : official journal of the Japanese Urological Association · 2025Article
- Efficacy of cisplatin-based neoadjuvant chemotherapy and risk factors for residual extravesical disease in muscle-invasive bladder cancer: insights from a nationwide cohort.International journal of clinical oncology · 2025Article
- Utilizing Immuno-Oncology registry data for enhanced non-small cell lung cancer treatment predictions.JAMIA open · 2025Article
- Prognostic value of the neutrophil‑to‑lymphocyte ratio in renal cell carcinoma: A systematic review and meta‑analysis.Oncology letters · 2025Article
- The Predictive Value of NLR, PLR, LMR, NPAR and D-Dimer on the Efficacy and Prognosis of First-Line Immunotherapy for Extensive-Stage Small Cell Lung Cancer.Journal of inflammation research · 2025Article
- Immune Checkpoint Inhibitor Score Predicts Survival Benefit of Immunotherapy in Patients with Non-small Cell Lung Cancer.Tuberculosis and respiratory diseases · 2024Article
- Tumor-neutrophil cross talk orchestrates the tumor microenvironment to determine the bladder cancer progression.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Pre-first-line chemotherapy risk stratification for overall survival in advanced urothelial carcinoma in sequential therapy era.World journal of urology · 2024Article
- Real-world sequential treatment patterns and clinical outcomes among patients with advanced urothelial carcinoma in Japan.International journal of urology : official journal of the Japanese Urological Association · 2024Article
- Article
- Adjuvant nivolumab, capecitabine or the combination in patients with residual triple-negative breast cancer: the OXEL randomized phase II study.medRxiv : the preprint server for health sciences · 2023Article
- Correlations of baseline neutrophil-lymphocyte ratio with prognosis of patients with lupus nephritis: A single-center experience.Rheumatology and immunology research · 2023Article
- Prognostic nutritional index of early post-pembrolizumab therapy predicts long-term survival in patients with advanced urothelial carcinoma.Oncology letters · 2023Article
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24 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Neutrophil-to-lymphocyte ratio (NLR) was reported to be associated with prognosis of urothelial cancer (UC) patients receiving systemic chemotherapy or immunotherapy. However, it has not been elucidated how preceding first-line chemotherapy affects NLR and subsequent second-line pembrolizumab treatment. This multicenter study analyzed 458 patients with metastatic UC who received first-line chemotherapy and second-line pembrolizumab with regard to pre-chemotherapy and pre-pembrolizumab NLR in association with the efficacy of chemotherapy and pembrolizumab treatment. NLR was increased in 47% while decreased in 53% of patients before and after first-line chemotherapy. High pre-chemotherapy NLR (≥ 3) was significantly associated with unfavorable overall (OS, P = 0.0001) and progression-free (P < 0.0001) survivals after first-line chemotherapy. However, pre-chemotherapy NLR showed only modest influence on radiological response and survival after second-line pembrolizumab treatment, whereas pre-pembrolizumab NLR showed higher association. NLR decrease was associated with partial response or greater objective response by first-line chemotherapy, while NLR increase was associated with higher patient age. In conclusion, immediate pre-chemotherapy and pre-pembrolizumab NLR was significantly associated with efficacy of the following treatment, respectively. However, even patients with high pre-chemotherapy NLR achieved favorable OS if they had their NLR reduced by chemotherapy, whereas those with high pre-chemotherapy NLR yielded unfavorable OS if they had their NLR remained high after chemotherapy, suggesting that chemotherapy may have differential effect on the efficacy of subsequent pembrolizumab treatment in UC patients.
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