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. 2025 Jul 17:18:9343-9353.
doi: 10.2147/JIR.S517816. eCollection 2025.

Prognostic Value of C-Reactive Protein-to-Lymphocyte Ratio in Combined Immunotherapy and Chemotherapy for Small Cell Lung Cancer

Shuyan Sheng  1 , Zhaozhen Wu  1 , Hua Zheng  1 , Hui Zhang  1 , Quan Zhang  1 , Zan Liu  1 , Shouzheng Wang  1 , Xi Li  1 , Jie Li  1 , Jialin Lv  1 , Ying Hu  1
Affiliations

Prognostic Value of C-Reactive Protein-to-Lymphocyte Ratio in Combined Immunotherapy and Chemotherapy for Small Cell Lung Cancer

Shuyan Sheng et al. J Inflamm Res. .

Abstract

Purpose: Inflammatory indexes are emerging as sensible prognostic factors for small cell lung cancer (SCLC). However, the prognostic value of dynamic C-reactive protein-to-lymphocyte ratio (CLR) in SCLC patients treated with chemoimmunotherapy remains unclear.

Patients and methods: This retrospective study investigated 88 SCLC patients who underwent chemoimmunotherapy between January 1st, 2020 and December 12th 2022. We examined the association between CLR and prognostic outcomes after chemoimmunotherapy. The associations between objective response rate (ORR), progression-free survival (PFS) with changes in blood indicators were also analyzed.

Results: Patients with decreased CLR had significantly higher ORR, with odds ratios of 3.91 (P<0.05) and 3.19 (P<0.05) in univariate and multivariate logistic regression analyses, respectively. Kaplan-Meier analysis showed that decreased CLR was associated with prolonged PFS (P=0.02). Additionally, a CLR higher than 2.47 after treatment was associated with poor survival in both univariate and multivariate analyses.

Conclusion: Dynamic CLR can serve as a potential biomarker for predicting the prognosis of SCLC patients treated with chemoimmunotherapy. Reduction of CLR after chemoimmunotherapy is associated with a significantly higher ORR and improved PFS.

Keywords: C-reactive protein-to-lymphocyte ratio; chemoimmunotherapy; small cell lung cancer.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Treatment response distribution by changes in (A) the decreased and increased CLR groups (69.8% vs 37.1%, P=0.002); (B) the decreased and increased NLR groups (60.6% vs 54.5%, P>0.05); (C) the decreased and increased MLR groups (70.4% vs 50.8%, P>0.05); (D) the decreased and increased PLR groups (63.0% vs 50.0%, P>0.05).
Figure 2
Figure 2
Multivariate analysis of ORR. *P<0.05 indicates statistical significance.
Figure 3
Figure 3
Kaplan-Meier progression-free survival curves according to (A) the decreased vs increased CLR groups; (B) the decreased vs increased NLR groups; (C) the decreased vs increased MLR groups; (D) the decreased vs increased PLR groups.
See this image and copyright information in PMC

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