Derived neutrophil lymphocyte ratio may predict benefit from @entity900 in the advanced XXXX : the @entity1125 -02 and @entity4377 studies.

@entity1 @entity5 @entity900 @entity4377 @entity14113 @entity136 @entity1125 @entity1349
BACKGROUND: The superiority of @entity900 and @entity136 (CisGem) chemotherapy over @entity136 ( @entity14113 ) alone in @entity1 with @entity1125 ( @entity1125 ) has been demonstrated in two randomised trials; ABC02 and the Biliary Tract (BT) 22 study. We used a combined dataset from these two trials to investigate the derived neutrophil-to-lymphocyte ratio (dNLR), which is thought to be a prognostic factor associated with clinical outcomes in several solid @entity5 , including @entity1125 . METHODS: White blood cell (WBC) and absolute neutrophil count (ANC) were available for 379 of 410 @entity1 from @entity1125 -02 and all 83 @entity1 in @entity4377 . The dNLR was calculated as ANC/(WBC-ANC), as previously specified. We examined the association between dNLR and @entity1349 ( @entity1349 ) and progression-free survival (PFS), as well as comparing the treatment effect in two @entity1 groups defined by their dNLR level. A high dNLR was defined as >= 3.0, which was approximately the upper tertile value. RESULTS: A total of 462 individual @entity1 records were analysed, 328 with baseline dNLR <3 and 134 with dNLR >= 3. There were 443 deaths in the cohort, and all surviving @entity1 had a dNLR <3. There was strong evidence that dNLR was closely associated with both @entity1349 [hazard ratio (HR), 1.62; 95% confidence interval (CI) 1.32-2.01] and PFS (HR, 1.40; 95% CI 1.13-1.72). There was limited evidence (P = 0.10) of a differential effect of CisGem on @entity1349 between the two dNLR groups, but this was clearest in the @entity1125 -02 dataset (P = 0.06). There was good evidence (P = 0.008) of an association between low baseline dNLR and long-term survival on a CisGem regimen. There was also good evidence of an association between ECOG performance status (split at 0 and 1 versus 2) on both @entity1349 (P < 0.001) and PFS (P = 0.01), but no evidence of a differential treatment effect, with both groups receiving benefit from the addition of @entity900 . CONCLUSIONS: These data confirm that high dNLR is associated with worse @entity1349 and PFS, and suggests it may also be predictive of benefit for the addition of @entity900 to @entity136 in European @entity1 with @entity1125 . Incorporating dNLR into the clinical context may better inform prognosis and chemotherapy decisions in @entity1125 @entity1 .
