Elevated Neutrophil-to-Lymphocyte Ratio Predicts Survival in Patients with Advanced Gastric Cancer Treated with Trastuzumab Combination Chemotherapy

Background/Aim: This study investigated the clinical prognostic relevance of the neutrophil-to-lymphocyte ratio (NLR) in patients with human epidermal receptor 2 (HER2)-positive metastatic advanced gastric cancer (AGC) treated with combination chemotherapy including trastuzumab. Patients and Methods: This is a retrospective analysis of 73 patients diagnosed with metastatic AGC who were treated with trastuzumab combination chemotherapy. NLR was calculated as the neutrophil count divided by the lymphocyte count. A cutoff value of 3 was selected, which classified patients into two categories, low (<= 3.0) or high (>3.0). Results: In the univariate analysis, the high-NLR patients showed a significantly shorter progression free survival (PFS) and overall survival (OS) than the low-NLR patients (PFS, p=0.012, OS, p=0.047). In the multivariate analysis, the high NLR was independently associated with a shorter PFS (p=0.015) and OS (p=0.040). Conclusion: This study found that a high NLR was associated with a shorter PFS and OS in patients with HER2-positive gastric cancer treated with trastuzumab.