Baseline neutrophil-to- ratio combined with the change during treatment provides risk stratification for metastatic malignant melanoma patients treated with PD-1 inhibitors in a Chinese population

BackgroundPrevious studies have suggested that an elevated baseline neutrophil-to-lymphocyte ratio (BLNLR) and elevated relative change of NLR (Delta NLR%) is associated with worse outcomes in patients with a variety of cancers. This study aims to investigate the value of BLNLR and Delta NLR% before the third cycle of treatment on the prognosis of patients with metastatic malignant melanoma treated with PD-1 inhibitors. MethodsA total of 63 patients with metastatic malignant melanoma treated with PD-1 inhibitors in the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2021 were retrospectively analyzed. BLNLR and Delta NLR% before the third cycle of treatment were collected. The Kaplan-Meier method was used to draw survival curves and Log-Rank test was used for survival analysis. Univariate and multivariate Cox regression analysis were used to analyze the relationship between BLNLR, Delta NLR% and clinical characteristics with progression-free survival (PFS) and overall survival (OS). ResultsUnivariate analysis showed that PFS and OS were associated with BLNLR, Delta NLR%, BMI and number of metastatic organs (P < 0.05). Multivariate analysis showed that BLNLR, Delta NLR%, BMI and number of metastatic organs were independent predictors of OS and BLNLR and Delta NLR% were independent predictors of PFS. Patients were divided into four groups according to BLNLR (<3, >= 3) and Delta NLR% (< 30%, >= 30%): low-BLNLR + low-Delta NLR% group, low-BLNLR + high-Delta NLR% group, high-BLNLR + low-Delta NLR% group, high-BLNLR + high-Delta NLR% group. The median OS was 20 months, 8 months, 9 months, 5 months and the median PFS was 8 months, 3 months, 2 months, 2 months, respectively. ConclusionBLNLR combined with Delta NLR% can be used to predict the prognosis of PD-1 inhibitors in patients with metastatic malignant melanoma.

Automated summary

This study aimed to investigate the value of baseline neutrophil-to-lymphocyte ratio (BLNLR) and relative change of NLR (Delta NLR%) before the third cycle of treatment on the prognosis of patients with metastatic malignant melanoma treated with PD-1 inhibitors. The results showed that BLNLR and Delta NLR% were associated with progression-free survival (PFS) and overall survival (OS) in patients. Patients can be stratified based on BLNLR and Delta NLR% to predict their prognosis.