Predictive value of early dynamic changes of NLR and PLR for the efficacy of immune checkpoint inhibitor in head and neck squamous cell carcinoma

Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Dec;138(6):763-771. doi: 10.1016/j.oooo.2024.07.014. Epub 2024 Aug 10.

Abstract

Objective: We analyzed the predictive value of dynamic changes in neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with immune checkpoint inhibitors (ICIs).

Study design: A total of 104 patients with R/M HNSCC treated with ICIs during August 2018 to June 2023 were included. Dynamic changes were defined as the difference between NLR and PLR on day 1 of cycles 1 and 2.

Results: Patients with increased NLR or PLR had an independently increased risk of disease progression at the first response evaluation (odds ratio [OR] 5.26, P = .005; OR 2.29, P = .042), disease progression (hazard ratio [HR] 2.29, P = .003; HR 1.68, P = .027), and death (HR 1.86, P = .027; HR 1.68, P = .037). Furthermore, patients with a decrease in NLR showed longer progression-free survival, with HRs of 0.36 (P < .001) for those with low pre-ICI NLR and 0.52 (P = .041) for those with high pre-ICI NLR, compared to those with increased NLR.

Conclusions: Increased NLR or PLR was associated with adverse outcomes after ICI treatment in patients with R/M HNSCC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Platelets
  • Disease Progression
  • Female
  • Head and Neck Neoplasms* / drug therapy
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Immune Checkpoint Inhibitors* / therapeutic use
  • Lymphocyte Count
  • Lymphocytes
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neutrophils*
  • Platelet Count
  • Predictive Value of Tests*
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck* / drug therapy
  • Squamous Cell Carcinoma of Head and Neck* / immunology
  • Squamous Cell Carcinoma of Head and Neck* / pathology

Substances

  • Immune Checkpoint Inhibitors