Prognostic role of the platelet to lymphocyte ratio (PLR) in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy: A systematic review and meta-analysis
BackgroundIt remains controversial whether the platelet to lymphocyte ratio (PLR) serves as a potential indicator for the efficacy of immunotherapy in advanced lung cancer. This meta-analysis aimed to address this concern.MethodsUp to March 2022, we searched PubMed, Embase, Web of Science and the Co...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.962173/full |
| _version_ | 1811339756752076800 |
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| author | Ke Zhou Ke Zhou Jie Cao Jie Cao Huahang Lin Huahang Lin Linchuan Liang Linchuan Liang Zhongzhong Shen Lei Wang Zhiyu Peng Zhiyu Peng Jiandong Mei Jiandong Mei |
| author_facet | Ke Zhou Ke Zhou Jie Cao Jie Cao Huahang Lin Huahang Lin Linchuan Liang Linchuan Liang Zhongzhong Shen Lei Wang Zhiyu Peng Zhiyu Peng Jiandong Mei Jiandong Mei |
| author_sort | Ke Zhou |
| collection | DOAJ |
| description | BackgroundIt remains controversial whether the platelet to lymphocyte ratio (PLR) serves as a potential indicator for the efficacy of immunotherapy in advanced lung cancer. This meta-analysis aimed to address this concern.MethodsUp to March 2022, we searched PubMed, Embase, Web of Science and the Cochrane Library to retrieve potentially eligible articles. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to assess the relationship between PLR and progression-free survival (PFS) as well as overall survival (OS), while the combined odds ratios (ORs) and 95% CIs were estimated to evaluate the relationship between PLR and the objective response rate (ORR) as well as the disease control rate (DCR). Subgroup analyses were further performed to detect the source of heterogeneity and potential predictive value of PLR in different groups in terms of OS and PFS.ResultsA total of 21 included studies involving 2312 patients with advanced lung cancer receiving immunotherapy were included. The combined results suggested that elevated PLR was associated with poorer OS (HR=2.24; 95% CI: 1.87-2.68; I² =44%; P=0.01) and PFS (HR=1.66; 95% CI: 1.36-2.04; I² =64%; P<0.01). Furthermore, elevated PLR showed a lower ORR (OR= 0.61; 95% CI: 0.43-0.87, I²=20%; P=0.29) and DCR (OR= 0.44; 95% CI: 0.27-0.72, I²=61%; P=0.02). In subgroup analyses, pretreatment PLR was significantly associated with adverse OS and PFS. The same results were observed in different PLRs in terms of cutoff value (>200 vs. ≤200). Furthermore, high PLR was significantly associated with poor OS and PFS in advanced non-small cell lung cancer (NSCLC); however, PLR was not associated with OS and PFS in advanced small cell lung cancer (SCLC). In addition, PLR predicted poor OS irrespective of regions and types of immune checkpoint inhibitors (ICIs).ConclusionOn the whole, patients with low PLR had better OS and PFS, as well as higher ORR and DCR when receiving immunotherapy in advanced lung cancer especially for advanced NSCLC. And further investigations are warranted to confirm the prognostic value of PLR in advanced SCLC.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022315976. |
| first_indexed | 2024-04-13T18:31:20Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-13T18:31:20Z |
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| series | Frontiers in Oncology |
| spelling | doaj.art-3d93594624e34bef8b70039b616920a02022-12-22T02:35:05ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-08-011210.3389/fonc.2022.962173962173Prognostic role of the platelet to lymphocyte ratio (PLR) in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy: A systematic review and meta-analysisKe Zhou0Ke Zhou1Jie Cao2Jie Cao3Huahang Lin4Huahang Lin5Linchuan Liang6Linchuan Liang7Zhongzhong Shen8Lei Wang9Zhiyu Peng10Zhiyu Peng11Jiandong Mei12Jiandong Mei13Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaWestern China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaWestern China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaWestern China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaWestern China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaWestern China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaWestern China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, ChinaBackgroundIt remains controversial whether the platelet to lymphocyte ratio (PLR) serves as a potential indicator for the efficacy of immunotherapy in advanced lung cancer. This meta-analysis aimed to address this concern.MethodsUp to March 2022, we searched PubMed, Embase, Web of Science and the Cochrane Library to retrieve potentially eligible articles. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to assess the relationship between PLR and progression-free survival (PFS) as well as overall survival (OS), while the combined odds ratios (ORs) and 95% CIs were estimated to evaluate the relationship between PLR and the objective response rate (ORR) as well as the disease control rate (DCR). Subgroup analyses were further performed to detect the source of heterogeneity and potential predictive value of PLR in different groups in terms of OS and PFS.ResultsA total of 21 included studies involving 2312 patients with advanced lung cancer receiving immunotherapy were included. The combined results suggested that elevated PLR was associated with poorer OS (HR=2.24; 95% CI: 1.87-2.68; I² =44%; P=0.01) and PFS (HR=1.66; 95% CI: 1.36-2.04; I² =64%; P<0.01). Furthermore, elevated PLR showed a lower ORR (OR= 0.61; 95% CI: 0.43-0.87, I²=20%; P=0.29) and DCR (OR= 0.44; 95% CI: 0.27-0.72, I²=61%; P=0.02). In subgroup analyses, pretreatment PLR was significantly associated with adverse OS and PFS. The same results were observed in different PLRs in terms of cutoff value (>200 vs. ≤200). Furthermore, high PLR was significantly associated with poor OS and PFS in advanced non-small cell lung cancer (NSCLC); however, PLR was not associated with OS and PFS in advanced small cell lung cancer (SCLC). In addition, PLR predicted poor OS irrespective of regions and types of immune checkpoint inhibitors (ICIs).ConclusionOn the whole, patients with low PLR had better OS and PFS, as well as higher ORR and DCR when receiving immunotherapy in advanced lung cancer especially for advanced NSCLC. And further investigations are warranted to confirm the prognostic value of PLR in advanced SCLC.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022315976.https://www.frontiersin.org/articles/10.3389/fonc.2022.962173/fullplatelet to lymphocyte ratioadvanced lung cancerimmune checkpoint inhibitorprognosisimmunotherapybiomarker |
| spellingShingle | Ke Zhou Ke Zhou Jie Cao Jie Cao Huahang Lin Huahang Lin Linchuan Liang Linchuan Liang Zhongzhong Shen Lei Wang Zhiyu Peng Zhiyu Peng Jiandong Mei Jiandong Mei Prognostic role of the platelet to lymphocyte ratio (PLR) in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy: A systematic review and meta-analysis Frontiers in Oncology platelet to lymphocyte ratio advanced lung cancer immune checkpoint inhibitor prognosis immunotherapy biomarker |
| title | Prognostic role of the platelet to lymphocyte ratio (PLR) in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy: A systematic review and meta-analysis |
| title_full | Prognostic role of the platelet to lymphocyte ratio (PLR) in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy: A systematic review and meta-analysis |
| title_fullStr | Prognostic role of the platelet to lymphocyte ratio (PLR) in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy: A systematic review and meta-analysis |
| title_full_unstemmed | Prognostic role of the platelet to lymphocyte ratio (PLR) in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy: A systematic review and meta-analysis |
| title_short | Prognostic role of the platelet to lymphocyte ratio (PLR) in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy: A systematic review and meta-analysis |
| title_sort | prognostic role of the platelet to lymphocyte ratio plr in the clinical outcomes of patients with advanced lung cancer receiving immunotherapy a systematic review and meta analysis |
| topic | platelet to lymphocyte ratio advanced lung cancer immune checkpoint inhibitor prognosis immunotherapy biomarker |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.962173/full |
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