Neutrophil-to-lymphocyte ratio as a predictive or prognostic factor for gastric cancer treated with nivolumab: a multicenter retrospective study

INTRODUCTION: The neutrophil-to-lymphocyte ratio (NLR) is effective as a predictive factor for lung cancer treated with nivolumab. The objective of this study was to determine the effectiveness of NLR for patients with advanced gastric cancer (AGC) treated with nivolumab. METHODS: This was a multicenter, retrospective study of patients with AGC treated with nivolumab from June 2017 to December 2017. The NLRs were calculated before the first cycle (NLR(pre)) and two weeks after the first administration (NLR(post)). RESULTS: Twenty-six patients were enrolled (males 19, females 7) with a median age of 64 years. The overall response rate was 15%. The median PFS was 80 days (range, 11 – 265) and the median OS was 290 days (range, 21 – 332). Stratified with high NLR (≥5) and low NLR (<5), the median PFS was shorter in the high NLR(pre) arm (87 vs. 45 days; p=0.066) and significantly shorter in the high NLR(post) arm (94 vs. 28 days; p=0.014). The median OS was significantly shorter in the high NLR(pre) arm (290 vs. 175 days; p=0.008) and in the high NLR(post) arm (290 vs. 69 days; p<0.001). CONCLUSION: NLR may be an effective prognostic factor in patients with AGC treated with nivolumab.