Pretreatment neutrophil-to-lymphocyte ratio and mutational burden as biomarkers of tumor response to immune checkpoint inhibitors

Cristina Valero, Mark Lee, Douglas Hoen, Kate Weiss, Daniel W. Kelly, Prasad S. Adusumilli, Paul K. Paik, George Plitas, Marc Ladanyi, Michael A. Postow, Charlotte E. Ariyan, Alexander N. Shoushtari, Vinod P. Balachandran, A. Ari Hakimi, Aimee M. Crago, Kara C. Long Roche, J. Joshua Smith, Ian Ganly, Richard J. Wong, Snehal G. Patel, Jatin P. Shah, Nancy Y. Lee, Nadeem Riaz, Jingming Wang, Ahmet Zehir, Michael F. Berger, Timothy A. Chan (), Venkatraman E. Seshan () and Luc G. T. Morris ()
Additional contact information
Cristina Valero: Memorial Sloan Kettering Cancer Center
Mark Lee: Memorial Sloan Kettering Cancer Center
Douglas Hoen: Memorial Sloan Kettering Cancer Center
Kate Weiss: Memorial Sloan Kettering Cancer Center
Daniel W. Kelly: Memorial Sloan Kettering Cancer Center
Prasad S. Adusumilli: Memorial Sloan Kettering Cancer Center
Paul K. Paik: Memorial Sloan Kettering Cancer Center
George Plitas: Memorial Sloan Kettering Cancer Center
Marc Ladanyi: Memorial Sloan Kettering Cancer Center
Michael A. Postow: Memorial Sloan Kettering Cancer Center
Charlotte E. Ariyan: Memorial Sloan Kettering Cancer Center
Alexander N. Shoushtari: Memorial Sloan Kettering Cancer Center
Vinod P. Balachandran: Memorial Sloan Kettering Cancer Center
A. Ari Hakimi: Memorial Sloan Kettering Cancer Center
Aimee M. Crago: Memorial Sloan Kettering Cancer Center
Kara C. Long Roche: Memorial Sloan Kettering Cancer Center
J. Joshua Smith: Memorial Sloan Kettering Cancer Center
Ian Ganly: Memorial Sloan Kettering Cancer Center
Richard J. Wong: Memorial Sloan Kettering Cancer Center
Snehal G. Patel: Memorial Sloan Kettering Cancer Center
Jatin P. Shah: Memorial Sloan Kettering Cancer Center
Nancy Y. Lee: Memorial Sloan Kettering Cancer Center
Nadeem Riaz: Memorial Sloan Kettering Cancer Center
Jingming Wang: Memorial Sloan Kettering Cancer Center
Ahmet Zehir: Memorial Sloan Kettering Cancer Center
Michael F. Berger: Memorial Sloan Kettering Cancer Center
Timothy A. Chan: Memorial Sloan Kettering Cancer Center
Venkatraman E. Seshan: Memorial Sloan Kettering Cancer Center
Luc G. T. Morris: Memorial Sloan Kettering Cancer Center

Nature Communications, 2021, vol. 12, issue 1, 1-9

Abstract: Abstract Treatment with immune checkpoint inhibitors (ICI) has demonstrated clinical benefit for a wide range of cancer types. Because only a subset of patients experience clinical benefit, there is a strong need for biomarkers that are easily accessible across diverse practice settings. Here, in a retrospective cohort study of 1714 patients with 16 different cancer types treated with ICI, we show that higher neutrophil-to-lymphocyte ratio (NLR) is significantly associated with poorer overall and progression-free survival, and lower rates of response and clinical benefit, after ICI therapy across multiple cancer types. Combining NLR with tumor mutational burden (TMB), the probability of benefit from ICI is significantly higher (OR = 3.22; 95% CI, 2.26-4.58; P

Date: 2021
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DOI: 10.1038/s41467-021-20935-9

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