Prognostic value of the neutrophil/lymphocyte ratio in enteropancreatic neuroendocrine tumors

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Tal Grenader
  • ,
  • Marianne E. Pavel
  • ,
  • Philippe B. Ruszniewski
  • ,
  • J. Ćwikła
  • ,
  • Alexandria T. Phan
  • ,
  • Markus Raderer
  • ,
  • E. Sedláčková
  • ,
  • G. Cadiot
  • ,
  • Edward M. Wolin
  • ,
  • J. Capdevila
  • ,
  • Lucy Wall
  • ,
  • Guido Rindi
  • ,
  • Xuan Mai Truong Thanh
  • ,
  • Martyn E. Caplin
  • ,
  • CLARINET Study Group

Accessible prognostic tools are needed to individualize treatment of neuroendocrine tumors (NETs). Data suggest neutrophil/lymphocyte ratios (NLRs) have prognostic value in some solid tumors, including NETs. In the randomized double-blind CLARINET study (NCT00353496; EudraCT 2005-004904-35), the somatostatin analog lanreotide autogel/depot increased progression-free survival (PFS) compared with placebo in patients with inoperable or metastatic intestinal and pancreatic NETs (grades 1–2, Ki-67<10%). The exploratory post-hoc analyses presented here evaluated the prognostic value of NLR in the CLARINET study cohort, in the context of and independently from treatment. Kaplan–Meier PFS plots were generated for patients with available NLR data, in subgroups based on NLR values, and 24-month survival rates were calculated. P values and hazard ratios for prognostic effects were generated using Cox models. 31216222Baseline characteristics were balanced between lanreotide autogel/depot 120mg (n=100) and placebo (n=101) arms. Irrespective of treatment, raw 24-month PFS rates were comparable across subgroups based on NLR tertiles [37.3% (low), 38.8% (middle), 38.8% (high); n=67 per group] and NLR cutoff of 4 [38.1% (NLR≤4; n=176), 40.0% (NLR>4; n=25)]. Furthermore, NLRs were not prognostic in Cox models, irrespective of subgroups used. The therapeutic effect of lanreotide autogel/ depot 120mg was independent of NLRs (P>0.1). These exploratory post-hoc analyses in patients with advanced intestinal and pancreatic NETs contrast with previous data suggesting NLR has prognostic potential in NETs. This may reflect the inclusion of patients with lower-grade tumors or use of higher NLR cutoff values in the current analysis.

Original languageEnglish
JournalAnti-Cancer Drugs
Volume31
Issue3
Pages (from-to)216-222
Number of pages7
ISSN0959-4973
DOIs
Publication statusPublished - Mar 2020

    Research areas

  • Lanreotide autogel/depot, Neuroendocrine tumors, Neutrophil/lymphocyte ratio, Prognosis, Progression-free survival, Somatostatin analog

See relations at Aarhus University Citationformats

ID: 196393004