Karaboyun, Kubilay2024-10-292024-10-2920232667-663Xhttps://doi.org/10.4328/ACAM.21947https://hdl.handle.net/20.500.11776/14811Aim: Non-small cell lung cancer (NSCLC) is a significant cause of cancer-related morbidity and mortality worldwide. In recent years, immunotherapies such as Nivolumab have revolutionized treatment strategies, demonstrating enhanced survival and response profiles compared to traditional platinum-based therapies. This study elucidated the prognostic significance of pretreatment hematological parameters, including Neutrophil-Lymphocyte Ratio (NLR), Systemic Immune-Inflammation Index (SII), and Prognostic Nutritional Index (PNI), in NSCLC patients undergoing Nivolumab treatment. Material and Methods: This retrospective study included patients treated with Nivolumab for pathologically proven advanced NSCLC between January 2019 and March 2021. Hemogram parameters and clinicopathological and clinicopathological factors before Nivolumab treatment were recorded from the hospital's electronic data record system. Survival analysis was conducted using the Kaplan-Meier method and the Log-Rank test was utilized for comparison. Multivariate analysis of factors affecting survival was performed with the Cox proportional-hazards model. Results: Ninety-two patients were included in this study. The median OS and PFS for all patients included in the analysis were 14.5 months and 11.1 months, respectively. The ideal cut-off value dividing NLR into 2 for overall survival time was calculated as 1.89 (AUC: 0.694, p=0.002) using Roc-Curve. In univariate analysis, ECOG performance score (p<0.001), leukocytes (p < 0.029), high neutrophil (p < 0.018) as well as NLR (p <0.018) were found to be associated with worse overall survival. Multivariate Cox regression model demonstrated that ECOG (HR=3.54, 95% CI, 1.46-8.60, p =0.005) and NLR (HR=1.52, CI 1.16 - 2.01, p=.003) were significant predictors factors for survival. Discussion: These results underline the critical role of inflammation and immune response in tumor progression and therapeutic outcomes. The identified markers offer a practical means of predicting patient responses to Nivolumab therapy, aiding in personalized treatment decisions. As NSCLC treatment paradigms shift towards immunotherapy, these easily accessible parameters could aid clinicians in selecting optimal therapeutic strategies for individual patients, ultimately contributing to improved clinical management and outcomes.en10.4328/ACAM.21947info:eu-repo/semantics/openAccessLung CancerNivolumabOverall SurvivalProgression-Free SurvivalNLRArticle14361365N/AWOS:001087343700032