Differential prognostic effect of systemic inflammation in NSCLC patients receiving immunotherapy or chemotherapy

A proinflammatory diathesis in NSCLC patients, as measured by the neutrophil to lympocyte ratio (NLR), is associated with adverse outcomes. Post-hoc analysis of the multinational phase 3 OAK trial investigated the differential impact of the pretreatment NLR on overall survival according to treatment modality (immunotherapy versus chemotherapy). The analysis found that among patients with previously treated NSCLC, low baseline neutrophil to lymphocyte ratio identified patients who derived a greater survival benefit from atezolizumab than from docetaxel. The NLR could complement PD-L1 expression in tailoring treatment in this setting.