Neutrophil-to-lymphocyte ratio and lactate dehydrogenase as biomarkers for urothelial cancer treated with immunotherapy

Clin Transl Oncol. 2020 Nov;22(11):2130-2135. doi: 10.1007/s12094-020-02337-3. Epub 2020 Mar 30.

Abstract

Purpose: To identify patients with metastatic urothelial cancer (mUC) unlikely to benefit from immune-checkpoint inhibitors (ICIs).

Methods/patients: We explored the predictive and prognostic values of baseline neutrophil-to-lymphocyte ratio (NLR), with cut-offs ≥ 3 and ≥ 5, and of a urothelial immune prognostic index (UIPI, based on increased NLR and LDH), on 146 patients.

Results: NLR and UIPI significantly predicted progressive disease and progression-free survival with both cut-offs (p = 0.0069, p = 0.0034, p = 0.0160, p = 0.0063; p < 0.001, p = 0.021, p = 0.014, p = 0.026; for NLR-3, NLR-5, UIPI-3, UIPI-5, respectively) and overall survival when NLR cut-off was ≥ 5 (p = 0.03 and p = 0.024, for NLR-5 and UIPI-5, respectively).

Conclusions: NLR-5 deserves prospective validation to identify mUC patients with poor prognosis following ICIs.

Keywords: Biomarker; Immunotherapy; LDH; Neutrophil-to-lymphocyte ratio; Prognostic; Urothelial cancer.

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Female
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • L-Lactate Dehydrogenase / blood*
  • Lymphocytes*
  • Male
  • Middle Aged
  • Neutrophils*
  • Urologic Neoplasms / drug therapy*
  • Urologic Neoplasms / immunology
  • Urologic Neoplasms / mortality
  • Urothelium / pathology*

Substances

  • Biomarkers
  • Immune Checkpoint Inhibitors
  • L-Lactate Dehydrogenase