Abstract
Background: Small cell lung cancer (SCLC) is an aggressive malignancy that is characterized by a lack of a durable response to available therapies. Several biomarkers have been studied that may help predict outcomes in patients with SCLC.
Methods: A systematic review that explored the significance of pretreatment hematologic markers in the prognosis of SCLC. These included NLR, PLR, hemoglobin, platelet, lymphocyte, RBC and novel indices. Twenty studies with a total of 5,668 patients were included. Outcomes of interest were Overall Survival (OS) and Progression Free Survival (PFS). Subgroup analyses were planned based on stage, region of study, and cut off value.
Results: High NLR was associated with shorter OS (HR 1.40 95%CI 1.24-1.58; p<0.00001) and PFS (HR, 1.36 95%CI 1.05–1.67; p=0.02). Subgroup analyses associated high NLR with poor OS among studies with a cutoff value of NLR>4 (HR 1.44, 95%CI 1.13-1.83; p=0.003) and those with a cutoff value of NLR<4 (HR 1.55, 95%CI 1.28–1.88; p<0.00001). Analysis of region of study, (Non-Asian HR 1.64, 95%CI 1.32–2.58; p<0.00001; Asian HR 1.35, 95%CI 1.17–1.54; p<0.0001), displayed similar results.
High PLR was associated with shorter OS (HR 1.28, 95%CI 1.06–1.55; p=0.01) but does not predict prognosis in terms of PFS (HR 1.0, 95%CI 1.0-1.01; p=0.04). Subgroup analyses associated high PLR with shorter OS in Limited Disease (HR 1.63, 95%CI 1.26–2.11; p=0.0002); non-Asians (HR 1.28, 95%CI 1.11–1.49; p=0.02) and studies with cutoff value <160 (HR 1.54, CI95% 1.27-1.86; p<0.00001).
Conclusion: High NLR and PLR may be used as prognostic biomarkers of poor outcome in patients with SCLC.
Prospective studies may confirm these findings.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3661.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019