BACKGROUND: The REAL-2 trial demonstrated that @entity416 and @entity901 were effective alternatives to @entity1487 and @entity900 , respectively, when used in triplet chemotherapy regimens for previously untreated oesophago- @entity356 . The aim of the current analysis was to evaluate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in the REAL-2 cohort. MATERIAL AND METHODS: A post hoc exploratory analysis was carried out on REAL-2 @entity1 with the available absolute neutrophil count and absolute lymphocyte count. A high NLR was defined using a cut-off value of >3.0. The NLR was then correlated with clinical outcomes including @entity1349 ( @entity1349 ), progression-free survival (PFS) and objective response rate. Survival curves were generated using the Kaplan-Meier method and comparison between groups was carried out using Cox regression. RESULTS: Data were available in 908 of the 1002 REAL-2 @entity1 . Of these, 516 (56.8%) were deemed to have a high NLR. In univariate analysis, high NLR was associated with a hazard ratio (HR) for @entity1349 of 1.73 (1.50-2.00), P < 0.001, compared with low NLR, equating to median @entity1349 values of 9.1 [95% confidence interval (CI) 8.0-9.6] and 12.7 months (95% CI 10.8-14.4), respectively. The NLR remained highly significant for @entity1349 (P < 0.001) in a multivariate model including performance status, age, disease extent, presence of liver metastases and presence of peritoneal metastases. For PFS, high NLR was associated with an HR of 1.63 (1.41-1.87), P < 0.001, compared with low NLR in univariate analysis. No significant interaction was found between NLR status and treatment arm, 13% of all @entity1 with low NLR achieving survival beyond 24 months compared with only 6% of @entity1 with high NLR (P < 0.001). CONCLUSION: Our results confirm that high NLR status had a significant negative prognostic effect in the REAL-2 trial population. Based on the multivariate analysis, this effect was independent of other known prognostic factors.

Prognostic value of neutrophil-to-lymphocyte ratio in XXXX : exploratory analysis of the REAL-2 trial.

@entity901 :: ('MESH:C030110', 'Chemical') :: ['oxaliplatin'] @entity1 :: ('9606', 'Species') :: ['participants', 'patients'] @entity416 :: ('MESH:C110904', 'Chemical') :: ['capecitabine'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival'] @entity356 :: ('MESH:D013274', 'Disease') :: ['gastric cancer'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['fluorouracil']
@entity356 :: (MESH:D013274,Disease) :: ['advanced oesophago-gastric cancer']
