Clinical implications of neutrophil-to-lymphocyte ratio and MDSC kinetics in gastric cancer patients treated with ramucirumab plus paclitaxel

作     者：Hyung-Don Kim Min-Hee Ryu Sangsoon Yoon Young-Soon Na Meesun Moon Hyungeun Lee Hyung Geun Song Yoon-Koo Kang Hyung-Don Kim;Min-Hee Ryu;Sangsoon Yoon;Young-Soon Na;Meesun Moon;Hyungeun Lee;Hyung Geun Song;Yoon-Koo Kang

作者机构：Department of OncologyAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505Republic of Korea Asan Institute for Life ScienceAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505Republic of Korea DiNonA IncSeoul 05505Korea 

出 版 物：《Chinese Journal of Cancer Research》 (中国癌症研究（英文版）)

年 卷 期：2020年第32卷第5期

页      面：621-630页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Gastric cancer ramucirumab plus paclitaxel neutrophil-to-lymphocyte ratio myeloid-derived suppressor cells 

摘      要：Objective: We aimed to investigate the prognostic value of neutrophil-to-lymphocyte ratio(NLR) and myeloidderived suppressor cells(MDSCs) in gastric cancer patients treated with second-line ramucirumab plus ***: A total of 116 patients with advanced or metastatic gastric cancer who receive ramucirumab plus paclitaxel were prospectively enrolled. Fresh blood samples were collected before and after treatment, and flow cytometry was performed to assess the proportions of monocytic(m MDSCs) and granulocytic MDSCs(g MDSCs).Results: Median age was 58 years and 71(61.2%) patients were male. A baseline NLR≥2.94 was associated with significantly poorer progression-free survival(PFS) and overall survival(OS) vs. an NLR2.94(P=0.011 and P=0.002, respectively). In multivariate analysis, an NLR≥2.94 was independently associated with poorer PFS[hazard ratio(HR)=1.58;95% confidence interval(95% CI): 1.01-2.49, P=0.046] and OS(HR=1.77;95% CI:1.04-3.04, P=0.036). While m MDSC counts did not significantly change following two cycles of therapy(P=0.530),g MDSC counts decreased significantly after two treatment cycles(P=0.025) but tended to increase in patients with progressive disease after two treatment cycles(P=0.098). A progressive increase in g MDSC counts(≥44%) was associated with a significantly shorter PFS and OS vs. a g MDSC count increase 44%(P=0.001 and P=0.003,respectively).Conclusions: The baseline NLR may help guide clinical decisions during ramucirumab plus paclitaxel therapy for gastric cancer. Our g MDSC kinetics data warrant further clinical validation and mechanistic investigation.