Abstract
BackgroundPatients with early-stage lung cancer who have a high baseline lymphocyte-to-monocyte ratio (LMR) have a favorable prognosis. However, the prognostic significance of LMR in patients with advanced-stage EGFR-mutant non-small cell lung cancer (NSCLC) receiving first-line epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) has not been established. We conducted a retrospective analysis to investigate the influence of LMR on clinical outcomes including progression-free survival (PFS) and overall survival (OS) in EGFR-mutant patients with NSCLC.Materials and MethodsOf 1310 lung cancer patients diagnosed between January 2011 and October 2013, 253 patients receiving first-line EGFR-TKIs for EGFR-mutant NSCLC were included. The cut-off values for baseline and the 1-month-to-baseline ratio of LMR (MBR), determined by using receiver operating characteristic curves, were 3.29 and 0.63, respectively. Patients were divided into 3 prognostic groups: high LMR and MBR, high LMR or MBR, and low LMR and MBR.ResultsThe mean patient age was 65.2 years, and 41% were men. The median PFS and OS were 10.3 and 22.0 months, respectively. The PFS in patients with high LMR and MBR, high LMR or MBR, and low LMR and MBR were 15.4, 7.1, and 2.0 months, respectively (p < 0.001), whereas the OS were 32.6, 13.7, and 5.1 months, respectively (p < 0.001).ConclusionA combination of baseline and trend of LMR can be used to identify patients with a high mortality risk in EGFR-mutant NSCLC patients receiving first-line EGFR-TKIs.
Highlights
lymphocyte-to-monocyte ratio (LMR) as a Prognostic Factor in Patients Treated with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs)
Presence of EGFR mutation is a robust predictor of EGFR-TKIs responsiveness, 17–29% of TKI-naïve patients do not respond to first-line TKIs.[9, 10]
Because lymphocytes play an important role in tumor eradication[11] and macrophages are associated with tumor progression[12, 13], we presumed that patients with higher lymphocyteto-monocyte ratio (LMR) might have better prognosis in EGFR-mutant non-small cell lung cancer (NSCLC) patients receiving first-line EGFR-TKIs
Summary
Lung cancer is the leading cause of cancer-related death worldwide and in Taiwan, and the incidence of lung cancer in Taiwan is increasing.[1, 2] Epidermal growth factor receptor (EGFR) mutations are more common in Asian patients with non-small cell lung cancer (NSCLC) compared with non-Asians, in non-smokers compared with current or ex-smokers, and in adenocarcinoma compared with other cancer histologies.[3,4,5]In EGFR-mutant NSCLC patients, EGFR-tyrosine kinase inhibitors (TKIs) can improve progression-free survival (PFS), overall survival (OS), and quality of life, and they are less toxic when compared with platinum-based doublet chemotherapy.[6,7,8] presence of EGFR mutation is a robust predictor of EGFR-TKIs responsiveness, 17–29% of TKI-naïve patients do not respond to first-line TKIs.[9, 10] EGFR-TKIs response could be influenced by clinical characteristics; it is reasonable to determine the significance of these characteristics, which might affect patient survival.Because lymphocytes play an important role in tumor eradication[11] and macrophages are associated with tumor progression[12, 13], we presumed that patients with higher lymphocyteto-monocyte ratio (LMR) might have better prognosis in EGFR-mutant NSCLC patients receiving first-line EGFR-TKIs. In EGFR-mutant NSCLC patients, EGFR-tyrosine kinase inhibitors (TKIs) can improve progression-free survival (PFS), overall survival (OS), and quality of life, and they are less toxic when compared with platinum-based doublet chemotherapy.[6,7,8]. The prognostic significance of LMR in patients with advanced-stage EGFR-mutant non-small cell lung cancer (NSCLC) receiving first-line epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) has not been established. We conducted a retrospective analysis to investigate the influence of LMR on clinical outcomes including progression-free survival (PFS) and overall survival (OS) in EGFR-mutant patients with NSCLC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
