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Tumori. 2017 Sep 18;103(5):443-448. doi: 10.5301/tj.5000632. Epub 2017 Jul 14.

Significance of neutrophil-to-lymphocyte ratio in Western advanced EGFR-mutated non-small cell lung cancer receiving a targeted therapy.

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Oncology Department, Poliambulanza Foundation, Brescia - Italy.
Surgery Department, Poliambulanza Foundation, Brescia -Italy.
Oncology Department, Humanitas Gavazzeni, Bergamo - Italy.
Thoracic Department, Spedali Civili, Brescia - Italy.
Oncology Department, Azienda Ospedaliero-Universitaria, Cagliari - Italy.
Oncology Department, Casa di Cura Pederzoli, Peschiera del Garda (Verona) - Italy.



Lung cancer is one of the leading causes of cancer-related death worldwide and, although targeted therapy with tyrosine kinase inhibitors has dramatically improved the rates of response and survival in advanced EGFR-mutated adenocarcinoma, the overall outcome remains unsatisfactory. Therefore, new prognostic factors, preferably simple, inexpensive, and easy to reproduce on a large scale, are needed. We performed a retrospective analysis of our database including 63 western Caucasian patients with advanced EGFR-mutated lung adenocarcinoma and receiving gefitinib, erlotinib, or afatinib as first- or second-line therapy. Several studies demonstrated a strong link between elevated neutrophil-to-lymphocyte ratio (NLR) and poor prognosis both in early and advanced stages of non-small-cell lung cancer (NSCLC).


From January 2011 to December 2015, 63 consecutive elegible patients with advanced EGFR-mutated NSCLC were included in this analysis from 5 institutions. The NLR was derived from the absolute neutrophil and the absolute lymphocyte counts of a full blood count and the cutoff value was determined according to the mean NLR level.


Despite the small sample analyzed, we found that NLR has a prognostic role for progression-free survival (PFS) and overall survival (OS), reaching a statistically significant difference with a better PFS and OS in the lower NLR group.


Pretreatment NLR seems to represent a reliable, simple, and easy to reproduce laboratory tool to predict outcome and response to cancer therapies in this setting of Western Caucasian patients with EGFR-mutated NSCLC.

[Indexed for MEDLINE]

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