Neutrophil-to-lymphocyte ratio as a predictive or prognostic factor for gastric cancer treated with nivolumab: a multicenter retrospective study

// Takatsugu Ogata 1 , Hironaga Satake 2 , Misato Ogata 1 , Yukimasa Hatachi 1 , Kentaro Inoue 3 , Madoka Hamada 3 and Hisateru Yasui 1 1 Department of Medical Oncology, Kobe City Medical Center General Hospital, Chuo-ku, Kobe City, Hyogo, 650-0047, Japan 2 Cancer Treatment Center, Kansai Medical University Hospital, Shinmachi, Hirakata City, Osaka, 573-1191, Japan 3 Department of Surgery, Kansai Medical University Hospital, Shinmachi, Hirakata City, Osaka, 573-1191, Japan Correspondence to: Hironaga Satake, email: takeh1977@gmail.com Keywords: advanced gastric cancer; nivolumab; neutrophil-to-lymphocyte ratio; predictive factors; prognostic factors Received: May 28, 2018     Accepted: September 08, 2018     Published: October 02, 2018 ABSTRACT Introduction: The neutrophil-to-lymphocyte ratio (NLR) is effective as a predictive factor for lung cancer treated with nivolumab. The objective of this study was to determine the effectiveness of NLR for patients with advanced gastric cancer (AGC) treated with nivolumab. Methods: This was a multicenter, retrospective study of patients with AGC treated with nivolumab from June 2017 to December 2017. The NLRs were calculated before the first cycle (NLR pre ) and two weeks after the first administration (NLR post ). Results: Twenty-six patients were enrolled (males 19, females 7) with a median age of 64 years. The overall response rate was 15%. The median PFS was 80 days (range, 11 – 265) and the median OS was 290 days (range, 21 – 332). Stratified with high NLR (≥5) and low NLR (<5), the median PFS was shorter in the high NLR pre arm (87 vs. 45 days; p=0.066) and significantly shorter in the high NLR post arm (94 vs. 28 days; p=0.014). The median OS was significantly shorter in the high NLR pre arm (290 vs. 175 days; p=0.008) and in the high NLR post arm (290 vs. 69 days; p<0.001). Conclusion: NLR may be an effective prognostic factor in patients with AGC treated with nivolumab.