TY - JOUR
T1 - Baseline neutrophil-to-lymphocyte ratio (NLR) is associated with outcome of patients treated with BRAF inhibitors
AU - Cocorocchio, E.
AU - Martinoli, C.
AU - Gandini, S.
AU - Pala, L.
AU - Conforti, F.
AU - Stucchi, S.
AU - Mazzarol, G.
AU - Ferrucci, P.
N1 - Publisher Copyright:
© 2020, Federación de Sociedades Españolas de Oncología (FESEO).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Purpose: The aim of this study is to verify if baseline hematological markers, in patients with advanced melanoma receiving BRAF inhibitor (BRAFi)-based therapies, are independently associated with progression free survival (PFS) and overall survival (OS). Methods: We retrospectively analyzed 90 patients with metastatic melanoma harboring BRAF V600 mutation, who received treatment with either BRAFi alone or combined with a MEK inhibitor (MEKi) at the recommended dosages. Study population included 28 women and 62 men. Median age was 53 years. Seventy-three (82%) patients presented with M1c disease, 49 (56%) had elevated LDH and 54 (60%) had three or more metastatic sites. Results: The median PFS was 9.1 and 3.5 months, respectively, for patients with baseline NLR < 5 and NLR ≥ 5, while median OS was 17.2 and 5.5 months, respectively, for patients with NLR < 5 and NLR ≥ 5. Multivariate analysis confirmed that baseline NLR < 5 was significantly associated with half risk of relapse (HR = 0.49; 95% CI = 0.28–0.85; p = 0.01) and half risk of death (HR = 0.46; 95% CI = 0.23–0.76; p = 0.004), independent of age, sex, stage, LDH > 2xULN, previous treatments, concomitant use of steroids and type of therapy. In patients with LDH ≥ ULN, NLR < 5 remained significantly and independently associated with improved PFS (HR = 0.28; 95% CI = 0.13–0.62; p = 0.002,) and OS (HR = 0.23; 95% CI = 0.10–0.55; p = 0.001). Conclusions: These biomarkers are easily reproducible, affordable and costless and NLR could help to identify patients who have the best benefit from BRAF inhibitors.
AB - Purpose: The aim of this study is to verify if baseline hematological markers, in patients with advanced melanoma receiving BRAF inhibitor (BRAFi)-based therapies, are independently associated with progression free survival (PFS) and overall survival (OS). Methods: We retrospectively analyzed 90 patients with metastatic melanoma harboring BRAF V600 mutation, who received treatment with either BRAFi alone or combined with a MEK inhibitor (MEKi) at the recommended dosages. Study population included 28 women and 62 men. Median age was 53 years. Seventy-three (82%) patients presented with M1c disease, 49 (56%) had elevated LDH and 54 (60%) had three or more metastatic sites. Results: The median PFS was 9.1 and 3.5 months, respectively, for patients with baseline NLR < 5 and NLR ≥ 5, while median OS was 17.2 and 5.5 months, respectively, for patients with NLR < 5 and NLR ≥ 5. Multivariate analysis confirmed that baseline NLR < 5 was significantly associated with half risk of relapse (HR = 0.49; 95% CI = 0.28–0.85; p = 0.01) and half risk of death (HR = 0.46; 95% CI = 0.23–0.76; p = 0.004), independent of age, sex, stage, LDH > 2xULN, previous treatments, concomitant use of steroids and type of therapy. In patients with LDH ≥ ULN, NLR < 5 remained significantly and independently associated with improved PFS (HR = 0.28; 95% CI = 0.13–0.62; p = 0.002,) and OS (HR = 0.23; 95% CI = 0.10–0.55; p = 0.001). Conclusions: These biomarkers are easily reproducible, affordable and costless and NLR could help to identify patients who have the best benefit from BRAF inhibitors.
KW - Metastatic melanoma
KW - NLR
KW - Targeted therapy
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U2 - 10.1007/s12094-020-02320-y
DO - 10.1007/s12094-020-02320-y
M3 - Article
C2 - 32108276
AN - SCOPUS:85080149524
VL - 22
SP - 1818
EP - 1824
JO - Clinical and Translational Oncology
JF - Clinical and Translational Oncology
SN - 1699-048X
IS - 10
ER -