Evidence map›Paper›PMID 34795912›Full record

ArticleJournal of thoracic disease2021

Pretreatment neutrophil-to-lymphocyte ratio as an important prognostic marker in stage III locally advanced non-small cell lung cancer: confirmatory results from the PROCLAIM phase III clinical trial.

Tithi Biswas, Rohin Gawdi, Charulata Jindal, Sharanya Iyer, Kylie H Kang, David Bajor, Mitchell Machtay, Yuk Ming Choi, Jimmy T Efird

Registry-linked trialOpen access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thoracic disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00686959 (Phase 3 Study of Pemetrexed, Cisplatin, and Radiotherapy Followed by Consolidation Pemetrexed Versus Etoposide, Cisplatin, and Radiotherapy Followed by Consolidation Cytotoxic Chemotherapy of Choice in Patients With Unresectable, Locally Advanced, Stage III Non-Small Cell Lung Cancer Other Than Predominantly Squamous Cell Histology), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 28% 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.

NCT00686959 phase3completednot on this map

Phase 3 Study of Pemetrexed, Cisplatin, and Radiotherapy Followed by Consolidation Pemetrexed Versus Etoposide, Cisplatin, and Radiotherapy Followed by Consolidation Cytotoxic Chemotherapy of Choice in Patients With Unresectable, Locally Advanced, Stage III Non-Small Cell Lung Cancer Other Than Predominantly Squamous Cell Histology

TypeinterventionalSponsorEli Lilly and CompanyRan2008 to 2014Enrolled598ConditionsNon Small Cell Lung CancerArmsPemetrexed, Cisplatin, Etoposide, Vinorelbine, Paclitaxel
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. 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

9 authors at 6 institutions in 1 country.

Tithi BiswasDepartment of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, OH, USA.
Rohin GawdiWake Forest School of Medicine, Winston-Salem, NC, USA.
Charulata JindalHarvard Medical School, Harvard University, Boston, MA, USA.
Sharanya IyerDepartment of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, OH, USA.
Kylie H KangDepartment of Radiation Oncology, Washington University School of Medicine and Alvin J. Siteman Comprehensive Cancer Center, St. Louis, MO, USA.
David BajorMedical Oncology, Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
Mitchell MachtayDepartment of Radiation Oncology, Penn State University, Hershey, PA, USA.
Yuk Ming ChoiSignify Health, Dallas, TX, USA.
Jimmy T EfirdCooperative Studies Program Epidemiology Center, Health Services Research and Development, DVAHCS, Durham, NC, USA.
Case Western Reserve University · USHarvard University · USHealth Services Research & Development · USPenn State Milton S. Hershey Medical Center · USUniversity Hospitals of Cleveland · USWake Forest University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeutrophil-to-lymphocyte ratio (NLR) is an important pretreatment marker of systemic inflammation and tumor aggressiveness. Increased levels of this ratio have been associated with reduced survival in several observational studies of lung cancer. However, supporting analyses from large clinical trial data are lacking.

methodsTo validate the prognostic role of NLR, the current study evaluated data from a randomized phase III study (PROCLAIM; clinicaltrial.gov ID: NCT00686959) of patients with stage IIIA/B, unresectable, non-squamous, non-small cell lung cancer (NSCLC), originally comparing combination pemetrexed-cisplatin chemoradiotherapy with etoposide-cisplatin chemoradiotherapy. Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for survival were estimated using a Cox proportional hazards model. Models were adjusted for age, race, sex, stage, treatment, and body mass index (BMI). Patients were followed for a median of 24 months.

resultsIncreased NLR levels at baseline were associated with reduced overall (

conclusionsThese findings provide substantiating evidence that NLR, which is routinely available from standard blood testing of patients diagnosed with NSCLC, is an important inflammation-based prognostic marker for survival among patients with locally advanced disease undergoing chemoradiation. Future research will benefit by assessing the prognostic potential of NLR in the context of genetic mutations and molecular markers.

Indexed as

Lung cancerlymphopenianeutrophilianeutrophil-to-lymphocyte ratio (NLR)radiation

Identifiers

PMID34795912
PMCPMC8575807
OpenAlexW3205742531

What OpenQuestion holds

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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.