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Impact of the Neutrophil-to-Lymphocyte Ratio on the Survival of Patients with Gastric Cancer Treated with Nivolumab Monotherapy

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Abstract

Background

In 2017, nivolumab monotherapy was shown to be effective as third- or later-line therapy in patients with advanced gastric or gastroesophageal junction cancer.

Objective

In this study, we investigated the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the outcomes of nivolumab monotherapy in patients with gastric or gastroesophageal junction cancer.

Patients and Methods

The long-term outcomes and treatment responses to nivolumab monotherapy were assessed in patients with gastric or gastroesophageal junction cancer. We compared patients with a NLR > 2.5 and those with a NLR ≤ 2.5 at the time of starting nivolumab monotherapy.

Results

The proportion of patients who have received three or more regimens was higher in the NLR > 2.5 group than in the NLR ≤ 2.5 group. The disease control rate was significantly worse in the NLR > 2.5 group than in the NLR ≤ 2.5 group (23% and 46%, respectively; p = 0.044). Overall survival was significantly better in the NLR ≤ 2.5 group than in the NLR > 2.5 group. Multivariate analysis showed that the macroscopic type, primary site resection, and the NLR were independent prognostic factors for overall survival (hazard ratio [95% confidence interval], 2.586 [1.286–5.203], 0.473 [0.260–0.861], and 1.736 [1.007–2.992], respectively).

Conclusions

This study demonstrates that the NLR is an independent prognostic factor in patients with gastric or gastroesophageal junction cancer treated with nivolumab monotherapy. Careful attention must be paid when nivolumab monotherapy is used to treat patients with gastric cancer with a NLR > 2.5.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakano Asahi, Yokohama, Kanagawa, Japan

    Takanobu Yamada, Tsutomu Hayashi, Hayato Watanabe, Keisuke Komori, Kazuki Kano, Yota Shimoda, Hirohito Fujikawa, Manabu Shiozawa, Soichiro Morinaga, Takashi Ogata & Takashi Oshima

  2. Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan

    Yasuhiro Inokuchi & Kimihiro Hayashi

  3. Department of Surgery, Yokohama City University, Yokohama, Kanagawa, Japan

    Yasushi Rino & Munetaka Masuda

Authors
  1. Takanobu Yamada
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  2. Tsutomu Hayashi
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  3. Yasuhiro Inokuchi
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  14. Takashi Ogata
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  15. Takashi Oshima
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Takanobu Yamada and Tsutomu Hayashi. The first draft of the manuscript was written by Takanobu Yamada and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takanobu Yamada.

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Funding

No external funding was used in the preparation of this article.

Conflict of Interest

Takanobu Yamada, Tsutomu Hayashi, Yasushi Rino, and Takashi Oshima received speaker honoraria from Ono Pharmaceutical and Bristol-Myers Squibb. Takashi Oshima received research grants from Ono Pharmaceutical. Yasuhiro Inokuchi, Kimihiro Hayashi, Hayato Watanabe, Keisuke Komori, Kazuki Kano, Yota Shimoda, Hirohito Fujikawa, Manabu Shiozawa, Soichiro Morinaga, Munetaka Masuda, and Takashi Ogata have no conflicts of interest that are directly relevant to the content of this article.

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Yamada, T., Hayashi, T., Inokuchi, Y. et al. Impact of the Neutrophil-to-Lymphocyte Ratio on the Survival of Patients with Gastric Cancer Treated with Nivolumab Monotherapy. Targ Oncol 15, 317–325 (2020). https://doi.org/10.1007/s11523-020-00716-y

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  • DOI: https://doi.org/10.1007/s11523-020-00716-y

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