Prognostic value of the neutrophil-to-lymphocyte ratio in the ARQ 197-215 second-line study for advanced hepatocellular carcinoma

Nicola Personeni, Laura Giordano, Giovanni Abbadessa, Camillo Porta, Ivan Borbath, Bruno Daniele, Jean Luc Van Laethem, Hans Van Vlierberghe, Jörg Trojan, Enrico N. De Toni, Antonio Gasbarrini, Monica Lencioni, Maria E. Lamar, Yunxia Wang, Dale Shuster, Brian Schwartz, Armando Santoro, Lorenza Rimassa

Research output: Contribution to journalArticlepeer-review


The ARQ 197-215 study randomized patients to tivantinib or placebo and prespecified efficacy analyses indicated the predictive value of MET expression as a marker of benefit from tivantinib in hepatocellular carcinoma (HCC). We aimed to explore the neutrophil-to-lymphocyte ratio (NLR) in 98 ARQ 197-215 patients with available absolute neutrophil count and absolute lymphocyte count at baseline. The cut-off value used to define high versus low NLR was 3.0. In univariate analysis, high NLR was associated with hazard ratio (HR) for overall survival (OS) of 1.58 [95% confidence interval (CI) 1.01; 2.47; P < 0.046], corresponding to median OS of 5.1 months versus 7.8 months in patients with low NLR (P = 0.044). In contrast, time to progression was not significantly affected by NLR (P = 0.20). Multivariable model confirmed that both NLR >3 (P = 0.03) and presence of vascular invasion (P = 0.017) were negatively associated with OS. After adjustment for vascular invasion, NLR independently predicted survival in both the placebo and the tivantinib cohort. For OS, no interaction was detected between NLR status and treatment (Pinteraction = 0.40). Baseline NLR is an independent prognostic biomarker in patients with HCC and compensated liver function who are candidate for second-line treatments.

Original languageEnglish
Pages (from-to)14408-14415
Number of pages8
Issue number9
Publication statusPublished - Jan 1 2017


  • Hepatocellular carcinoma
  • MET
  • Neutrophil-to-lymphocyte ratio
  • Neutrophils
  • Tivantinib

ASJC Scopus subject areas

  • Oncology


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