Dynamic Changes of Peripheral Blood Markers Predict Prognosis of Patients with Advanced Non-Small Cell Lung Cancer Receiving Anti-PD-1/PD-L1 Treatment

Abstract Background Immune checkpoint inhibitors have been routinely used in the treatment of advanced non- small-cell lung cancer (aNSCLC) with significantly improved survival rate. However, the identification of reliable prognositic and predictive biomarkers is lacking. The aim of the study was to investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and their dynamic changes for aNSCLC. Methods We retrospectively analyzed 60 patients with aNSCLC who received immunotherapy. The NLR and PLR were assessed at baseline (NLR0 and PLR0) and after 4 cycles of treatment (NLR4c and PLR4c). Results Of all aNSCLC patients on immunotherapy, 47 (78.3%) cases were in the response group. Whether at baseline or after 4 cycles of treatment, the levels of NLR and PLR in the response group were both significantly lower than those in the non-response group (p < 0.05). Patients with a high NLR4c had poor progression-free survival (PFS) and overall survival (OS) independently in multivariate analysis (3.90 vs. 7.50 months, p = 0.005; 7.20 vs. 15.90 months, p = 0.041, respectively). Patients with high NLR0-highNLR4c were associated with poor PFS and OS (p = 0.009, p = 0.001 respectively). Results are similar for PLR. Conclutions NLR after 4 cycles of treatment and dynamic changes of NLR and PLR during immunotherapy might help to predict a more accurate prognosis in aNSCLC patients.