International Journal of Clinical Oncology

, Volume 23, Issue 2, pp 368–374 | Cite as

Neutrophil-to-lymphocyte ratio after pazopanib treatment predicts response in patients with advanced soft-tissue sarcoma

  • Hiroshi KobayashiEmail author
  • Tomotake Okuma
  • Hiroyuki Oka
  • Toshihide Hirai
  • Takahiro Ohki
  • Masachika Ikegami
  • Ryoko Sawada
  • Yusuke Shinoda
  • Toru Akiyama
  • Kenji Sato
  • Satoshi Abe
  • Hirotaka Kawano
  • Takahiro Goto
  • Sakae Tanaka
Original Article



Pazopanib is a multi-tyrosine kinase inhibitor that is used to treat advanced soft-tissue sarcoma, and its efficacy has been confirmed in several clinical trials, although no clinically useful biomarkers have been identified. In other cancers, the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the lymphocyte-to-monocyte ratio (LMR) are associated with chemotherapy response and prognosis. Therefore, we aimed to evaluate the associations of pazopanib response with NLR, PLR, and LMR among patients with advanced soft-tissue sarcoma.


Data regarding NLR, PLR, and LMR were obtained for 25 patients who received pazopanib for soft-tissue sarcoma. The patients were categorized according to their values for NLR (≥3.8 vs. <3.8), PLR (≥230 vs. <230), and LMR (≥2.4 vs. <2.4), and we evaluated the associations of these markers with progression-free survival and overall survival using Kaplan–Meier curves and Cox proportional models.


No significant differences in progression-free survival or overall survival were observed based on the pre-treatment NLR, PLR, and LMR values. However, decreased NLR values after treatment using pazopanib were independently associated with significantly prolonged progression-free survival (hazard ratio: 0.07, p = 0.001) and overall survival (hazard ratio: 0.17, p = 0.0006).


Decreased NLR values after treatment using pazopanib may predict high efficacy and favorable outcomes among patients with advanced soft-tissue sarcoma.


Soft-tissue sarcoma Pazopanib Chemotherapy Neutrophil-to-lymphocyte ratio 


Compliance with ethical standards


This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflicts of interest

All authors declare that there are no conflicts of interest relevant to this manuscript.

Supplementary material

10147_2017_1199_MOESM1_ESM.pptx (50 kb)
Supplementary material 1 (PPTX 49 kb)


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Copyright information

© Japan Society of Clinical Oncology 2017

Authors and Affiliations

  • Hiroshi Kobayashi
    • 1
    Email author
  • Tomotake Okuma
    • 2
  • Hiroyuki Oka
    • 3
  • Toshihide Hirai
    • 1
  • Takahiro Ohki
    • 2
  • Masachika Ikegami
    • 1
  • Ryoko Sawada
    • 1
  • Yusuke Shinoda
    • 1
  • Toru Akiyama
    • 4
  • Kenji Sato
    • 5
  • Satoshi Abe
    • 5
  • Hirotaka Kawano
    • 5
  • Takahiro Goto
    • 2
  • Sakae Tanaka
    • 1
  1. 1.Department of Orthopaedic Surgery, Faculty of MedicineThe University of Tokyo HospitalTokyoJapan
  2. 2.Department of Musculoskeletal OncologyTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan
  3. 3.Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of MedicineThe University of Tokyo HospitalTokyoJapan
  4. 4.Department of Orthopaedic Surgery, Saitama Medical CenterJichi Medical UniversitySaitama-shiJapan
  5. 5.Department of Orthopaedic Surgery, Faculty of MedicineUniversity of TeikyoTokyoJapan

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