A high neutrophil to lymphocyte ratio prior to BRAF inhibitor treatment is a predictor of poor progression-free survival in patients with metastatic melanoma

• Published in: EJD. European journal of dermatology 2018-01, Vol.28 (1), p.38-43
• Main Authors: Finon, Antoine, Zaragoza, Julia, Maillard, Hervé, Beneton, Nathalie, Bens, Guido, Samimi, Mahtab, Caille, Agnès, Machet, Laurent
• Format: Article
• Language: English
• Subjects: Clinical Report; Dermatology; Life Sciences; Medicine; Medicine & Public Health
• ISSN: 1952-4013; 1167-1122; 1952-4013
• DOI: 10.1684/ejd.2017.3167

Background Some studies have shown that a high neutrophil/lymphocyte ratio (NLR) ≥4 before initiating ipilimumab treatment is an independent prognostic indicator of poor survival in patients with metastatic melanoma (MM). Objectives To determine whether the NLR before starting BRAF inhibitor (BRAFi) treatment in patients with (MM) is associated with progression-free survival (PFS). Materials & methods This retrospective study included 49 patients consecutively receiving BRAFi for MM between July 2012 and December 2014. Cox proportional hazards regression was used to analyse the relationship between NLR and other factors, such as lactate dehydrogenase (LDH), performance status, BRAFi as firstor second-line therapy, and corticosteroid intake with PFS. The NLR before starting BRAFi was significantly associated with PFS based on univariate analysis and multivariate analysis adjusted for potential confounding factors, such as LDH activity, ulceration, performance status, first-line therapy, and corticosteroid intake. A high NLR (continuous variable) was associated with short PFS (HR: 1.35; 95% CI: 1.07-1.70; p = 0.01), and NLR ≥4 was associated with shorter PFS (HR: 3.24; 95% CI: 1.30-8.12; p = 0.01). Corticosteroid intake was not associated with short PFS based on multivariate analysis. Conclusion An NLR > 4, before starting BRAFi treatment, is an independent prognostic indicator of poor progression-free survival.