Elevated platelet-to-lymphocyte corresponds with poor outcome in patients with advanced cancer receiving anti-PD-1 therapy

Objectives: The purpose of this retrospective analysis was to investigate the prognostic value of PLR for PD-1 inhibitors. Methods: Patients were divided into different subgroups according to PLR. Univariate survival analysis and a multivariate Cox proportional hazards regression model were used to assess the association between PLR and overall survival (OS) or progression-free survival (PFS). Results: The optimal cut-off value of baseline PLR was 164. Among the total 85 patients, 34 patients presented with PLR >= 164, and 51 presented with PLR < 164, respectively. The median OS for the high PLR group was 7.0 months (95% CI: 4.1-9.9 months), and it was not reached for the low PLR group (P < 0.001). The median PFS was 3.0 months (95% CI: 1.9-4.1 months) vs. 9.8 months (95% CI: 6.1-13.5 months) for the high and low PLR groups, respectively (P < 0.001). In multivariate analysis, a PLR > 164 and body mass index (BMI) > 24.0 were independently associated with OS (hazard ratio [HR]: 3.549, 95% confidence interval [CI]: 1.901-6.625, P < 0.001 and HR: 0.496, 95% CI: 0.260-0.945, P = 0.033), meanwhile PLR was also significantly associated with inferior PFS (HR: 2.567, 95% CI: 1.551-4.249, P < 0.001). Disease control rate for high and low PLR group was 38.2% and 74.5%, respectively, and it was also correlated with elevated PLR (P = 0.001). Conclusion: This retrospective analysis indicates that PLR could be used as a biomarker to stratify patients who will have a better response to anti-PD-1 agents.