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SYSTEMATIC REVIEW article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1393925
This article is part of the Research Topic Biomarkers of Immunotoxicity from Immune Checkpoint Inhibitors View all 9 articles

Neutrophil-to-lymphocyte ratio as a predictive biomarker for hyperprogressive disease mediated by immune checkpoint inhibitors: A Systematic Review and Meta-Analysis

Provisionally accepted
Bo Pei Bo Pei 1Jue Zhang Jue Zhang 2Lin Lai Lin Lai 3*Hui Chen Hui Chen 4*
  • 1 Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Wuhan University, Enshi, China
  • 2 Tianmen First People's Hospital, Tianmen, Hubei Province, China
  • 3 Enshi Center Hospital, Enshi, Hubei Province, China
  • 4 Department of Immunology, School of Basic Medical Sciences, Wuhan University, Wuhan, Hubei Province, China

The final, formatted version of the article will be published soon.

    Background: Hyperprogressive disease (HPD) is a novel pattern of paradoxically rapid tumor progression, which often leads to early death, mostly in the first two months of treatment with immune checkpoint inhibitors (ICIs). Currently, there is no validated biomarker to assess patients at risk of HPD.Aim: To systematically evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) in HPD and establish a reliable variable to support clinicians in defining personalized treatment strategies.Methods: PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases were searched for studies published before December 31st, 2023.Newcastle-Ottawa scale (NOS) was used to evaluate the quality of eligible studies.The pooled odds ratios (ORs) and 95% confidence interval (CI) were calculated using random effects or fixed effects model to evaluate the association between NLR and the risk of HPD.Results: A total of 17 studies with 2964 patients were included for meta-analysis. The incidence of HPD across different types of tumors ranged from 6.3% to 35.6%. In the pooled analysis of the NLR and HPD, we identified NLR significantly associated with the risk of HPD (OR = 0.65; 95% CI: 0.46 to 0.91; p= 0.01) (I 2 = 52%, p = 0.007).In the future, NLR may serve as a remarkable biomarker for predicting the risk of HPD in clinical practice.

    Keywords: Hyperprogressive disease, Immunotherapy, immune checkpoint inhibitors, Meta-analysis, Neutrophil to lymphocyte ratio

    Received: 29 Feb 2024; Accepted: 27 Aug 2024.

    Copyright: © 2024 Pei, Zhang, Lai and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Lin Lai, Enshi Center Hospital, Enshi, 445000, Hubei Province, China
    Hui Chen, Department of Immunology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430072, Hubei Province, China

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