Prognostic value of the pretreatment neutrophil‑to‑lymphocyte ratio in patients with advanced gastrointestinal stromal tumors treated with sunitinib after imatinib failure

  • Authors:
    • Paweł Sobczuk
    • Paweł Teterycz
    • Iwona Lugowska
    • Anna Klimczak
    • Elżbieta Bylina
    • Anna M. Czarnecka
    • Hanna Kosela‑Paterczyk
    • Czesław Osuch
    • Joanna Streb
    • Piotr Rutkowski
  • View Affiliations

  • Published online on: July 16, 2019     https://doi.org/10.3892/ol.2019.10622
  • Pages: 3373-3380
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The neutrophil‑to lymphocyte ratio (NLR) has been proven to be correlated with outcomes in various cancer types, including gastrointestinal stromal tumors (GIST). There is limited data regarding the clinical value of NLR during second line therapy after failure of imatinib and there is an urgent need for more precise predictive factors for therapy. The aim of this study was to assess the association of the pretreatment NLR with progression free survival (PFS) and overall survival (OS) in patients with unresectable/metastatic GIST treated with sunitinib in a second line of treatment. In this analysis 146 out of 230 patients with unresectable/metastatic GIST were included, who were treated between 2005 and 2016 with sunitinib after failure of imatinib, with complete clinical data. In all patients, the NLR was assessed at baseline. The NLR cutoff of 2.4 was selected. The Kaplan‑Meier method with the long‑rank test and Cox proportional hazards model were applied for statistical analysis. Median PFS was 12.4 months with a 2‑year rate of 27.1% and a 5‑year rate of 4.8%. Median OS was 22.8 months, whereas 2‑ and 5‑year rates were 47.8 and 13.8%, respectively. Patients with NLR>2.4 had significantly shorter OS: Median OS was 30 months for NLR≤2.4 vs. 16.4 months for NLR>2.4 (P=0.002); median PFS was 18.2 vs. 9.6 (P=0.075), respectively. In a multivariate model adjusted for mitotic index, primary location of tumor and driver mutation in KIT exon 11, NLR was proven to be independently associated with OS (HR 1.92, 95% CI 1.27‑2.9, P=0.002) but not PFS (HR 1.31, 95%CI 0.89‑1.93, P=0.17). The present data demonstrate that NLR can serve as an independent prognostic factor for patients with advanced GIST treated with sunitinib.

Related Articles

Journal Cover

September 2019
Volume 18 Issue 3

Print ISSN: 1792-1074
Online ISSN:1792-1082

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Sobczuk, P., Teterycz, P., Lugowska, I., Klimczak, A., Bylina, E., Czarnecka, A.M. ... Rutkowski, P. (2019). Prognostic value of the pretreatment neutrophil‑to‑lymphocyte ratio in patients with advanced gastrointestinal stromal tumors treated with sunitinib after imatinib failure. Oncology Letters, 18, 3373-3380. https://doi.org/10.3892/ol.2019.10622
MLA
Sobczuk, P., Teterycz, P., Lugowska, I., Klimczak, A., Bylina, E., Czarnecka, A. M., Kosela‑Paterczyk, H., Osuch, C., Streb, J., Rutkowski, P."Prognostic value of the pretreatment neutrophil‑to‑lymphocyte ratio in patients with advanced gastrointestinal stromal tumors treated with sunitinib after imatinib failure". Oncology Letters 18.3 (2019): 3373-3380.
Chicago
Sobczuk, P., Teterycz, P., Lugowska, I., Klimczak, A., Bylina, E., Czarnecka, A. M., Kosela‑Paterczyk, H., Osuch, C., Streb, J., Rutkowski, P."Prognostic value of the pretreatment neutrophil‑to‑lymphocyte ratio in patients with advanced gastrointestinal stromal tumors treated with sunitinib after imatinib failure". Oncology Letters 18, no. 3 (2019): 3373-3380. https://doi.org/10.3892/ol.2019.10622