Umbrella Review Demonstrates Predictive Value of NLR for Immunotherapy Outcomes in HCC

While neutrophil-to-lymphocyte ratios (NLR) are often used as a predictor of immunotherapy outcomes, validation of the ratio’s reliability is still subject to debate.

A comprehensive umbrella review by Haoyu Wang, MD, and colleagues analyzed 30 meta-analyses to determine the association between pretreatment NLR and immunotherapy outcomes.

Meta-analyses were collected from electronic databases, including PubMed, Scopus, and Cochrane. Quality assessment and evidence grading were performed using classification criteria such as AMSTAR and GRADE, along with PRISMA and PRIOR guidelines.

A total of 13 systematic reviews were included. Out of 30 meta-analyses, 24 (80%) associations were noted to have statistical significance. Associations between pretreatment NLR and the prognosis of renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC) exhibited highly suggestive evidence grading.

An elevated pretreatment NLR is linked to poor immunotherapy outcomes in patients with RCC or HCC. While NLR shows potential as a biomarker to identify clinical outcomes, further research and validation are needed.