Abstract
The prognoses of patients with non-small-cell lung cancer (NSCLC) harboring anaplastic lymphoma kinase (ALK) gene rearrangement have dramatically improved with the use of ALK tyrosine kinase inhibitors. Although immunological and nutritional markers have been investigated to predict outcomes in patients with several cancers, their usefulness in targeted therapies is scarce, and their significance has never been reported in patients receiving first-line treatment with alectinib. Meanwhile, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) has been investigated during crizotinib treatment. This multicenter retrospective study evaluated 42 consecutive Japanese patients with ALK-positive NSCLC who received first-line treatment with alectinib. Immunological and nutritional markers were evaluated at baseline and 3 weeks after alectinib introduction, and their significance in predicting progression-free survival (PFS) was explored. PFS duration was significantly associated with baseline PLR (hazard ratio (HR): 2.49, p = 0.0473), systemic immune-inflammation index (SII; HR: 2.65, p = 0.0337), prognostic nutrition index (PNI; HR: 4.15, p = 0.00185), and the 3-week values for SII (HR: 2.85, p = 0.0473) and PNI (HR: 3.04, p = 0.0125). Immunological and nutritional markers could be useful in predicting the outcomes of first-line treatment with alectinib. Since PLR and SII consist of platelet counts, platelet count could be an important constituent of these markers.
Highlights
Our results demonstrated the importance of baseline platelet-to-lymphocyte ratio (PLR), systemic immuneinflammation index (SII), and prognostic nutrition index (PNI) values
The present study revealed that the progression-free survival (PFS) of Japanese patients with Anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC)
PLR and SII at baseline and SII after 3 weeks were significantly associated with PFS
Summary
Lung cancer remains the leading cause of mortality in cancer patients, and non-smallcell lung cancer (NSCLC) accounts for approximately 80% of all lung cancers [1]. The discovery of oncogenic driver genes and introduction of appropriate tyrosine kinase inhibitors (TKIs) has revolutionized the treatment strategy and outcomes of relevant NSCLC with oncogenic driver genes [2,3]. Crizotinib was the first ALK-TKI to show superior efficacy over platinum-based chemotherapy [5]. Thereafter, second-generation ALK-TKIs, consisting of ceritinib, alectinib, and brigatinib, and third-generation lorlatinib, were developed. In the first-line setting, ceritinib demonstrated superior efficacy over platinum-based chemotherapy [6], while alectinib [7,8], brigatinib [9], and lorlatinib [10] confirmed longer progression-free survival (PFS) than crizotinib
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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.
