The prognostic values of systemic immune-inflammation index and derived neutrophil-lymphocyte ratio in EGFR-mutant advanced non-small cell lung cancer

Abstract

Introduction

Targeted therapy is the main treatment option for oncogene-addicted non-small cell lung cancer (NSCLC). It is known that inflammation can affect survival. Therefore, we aimed to evaluate the effect of host inflammation on survival and treatment outcome by using the derived neutrophil-lymphocyte ratio (dNLR) and systemic immune-inflammation index (SII).

Material and methods

The advanced epidermal growth factor receptor mutant NSCLC patients diagnosed between 2014 and 2019 were included. SII and dNLR were calculated from pretreatment blood samples. The estimated cutoff for SII and dNLR were 640 and 2, respectively. Progression-free survival and overall survival were calculated by using the Kaplan–Meier test.

Results

One hundred thirty six patients enrolled in the study. Of the total patients, 34.6% and 65.4% were SII-low and high, respectively. In addition, 58.1% and 41.9% of the patients were dNLR-low and high groups, respectively. The progression-free survival was better in low SII (22.4 vs. 13.01 months, HR: 0.50; 95% CI 0.32–0.80; P: 0.003) and low dNLR groups (16.9 vs. 13.01 months, HR, 0.58; 95% CI 0.38–0.88; P: 0.011). The overall survival was also significantly longer in SII-low and dNLR-low groups (32.4 vs. 20.4 months; HR, 0.47; 95% CI 0.27–0.81; P: 0.005 for SII and 32.4 vs. 18.4 months HR: 0.40; 95% CI 0.24–0.66; P < 0.001 for dNLR).

Conclusion

Based on the results of our study, both SII and dNLR can be routinely used as the simple, inexpensive and easily assessable prognostic markers in oncogene-addicted NSCLC.