Prognostic value of pre-treatment risk stratification and post-treatment neutrophil/lymphocyte ratio change for pembroli
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ORIGINAL ARTICLE
Prognostic value of pre‑treatment risk stratification and post‑treatment neutrophil/lymphocyte ratio change for pembrolizumab in patients with advanced urothelial carcinoma Yoshiaki Yamamoto1 · Junji Yatsuda2 · Mototsugu Shimokawa3 · Nakanori Fuji4 · Akihiko Aoki5 · Shigeru Sakano6 · Mitsutaka Yamamoto7 · Akinobu Suga8 · Yasuhide Tei9 · Satoru Yoshihiro10 · Seiji Kitahara11 · Kazuhiro Nagao12 · Kimio Takai13 · Yoriaki Kamiryo14 · Jumpei Akao15 · Shiro Yamaguchi16 · Kazuo Oba17 · Tomoyuki Shimabukuro18 · Hiroaki Matsumoto1 · Tomomi Kamba2 · Hideyasu Matsuyama1 Received: 29 January 2020 / Accepted: 31 August 2020 © Japan Society of Clinical Oncology 2020
Abstract Background Pembrolizumab is effective in a limited number of patients with advanced urothelial carcinoma (UC). Therefore, we evaluated the prognostic value of clinical biomarkers following pembrolizumab treatment in patients with advanced UC. Methods We retrospectively reviewed the medical records of 121 patients with platinum-refractory advanced UC who received pembrolizumab. Inflammation-based prognostic scores before and 6 weeks after the treatment were recorded. The categorical variables influencing overall survival (OS) and objective response rate (ORR) were analyzed. Results Multivariate analyses showed that pretreatment Eastern Cooperative Oncology Group (ECOG) performance score (PS), presence of only lymph node metastasis (only LN mets), C-reactive protein (CRP), and neutrophil/lymphocyte ratio (NLR) were independent prognostic factors for OS (P = 0.0077; RR = 2.42, P = 0.0049; RR = 0.36, P = 0.0047; RR = 2.53, and P = 0.0079; RR = 2.33, respectively). The pretreatment risk stratification using ECOG PS, only LN mets, CRP, and NLR was used for estimating the OS (P
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