Accessible prognostic tools are needed to individualize treatment of neuroendocrine tumors (NETs). Data suggest neutrophil/lymphocyte ratios (NLRs) have prognostic value in some solid tumors, including NETs. In the randomized double-blind CLARINET study (NCT00353496; EudraCT 2005-004904-35), the somatostatin analog lanreotide autogel/depot increased progression-free survival (PFS) compared with placebo in patients with inoperable or metastatic intestinal and pancreatic NETs (grades 1-2, Ki-67 < 10%). The exploratory post-hoc analyses presented here evaluated the prognostic value of NLR in the CLARINET study cohort, in the context of and independently from treatment. Kaplan-Meier PFS plots were generated for patients with available NLR data, in subgroups based on NLR values, and 24-month survival rates were calculated. P values and hazard ratios for prognostic effects were generated using Cox models. 31216222 Baseline characteristics were balanced between lanreotide autogel/depot 120 mg (n = 100) and placebo (n = 101) arms. Irrespective of treatment, raw 24-month PFS rates were comparable across subgroups based on NLR tertiles [37.3% (low), 38.8% (middle), 38.8% (high); n = 67 per group] and NLR cutoff of 4 [38.1% (NLR ≤ 4; n = 176), 40.0% (NLR > 4; n = 25)]. Furthermore, NLRs were not prognostic in Cox models, irrespective of subgroups used. The therapeutic effect of lanreotide autogel/depot 120 mg was independent of NLRs (P > 0.1). These exploratory post-hoc analyses in patients with advanced intestinal and pancreatic NETs contrast with previous data suggesting NLR has prognostic potential in NETs. This may reflect the inclusion of patients with lower-grade tumors or use of higher NLR cutoff values in the current analysis.

Department of Endocrinology Friedrich Alexander University Erlangen Nuernberg Erlangen Germany

Department of Gastroenterology Pancreatology Beaujon Hospital Clichy France

Department of Medical Oncology Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology Barcelona Spain

Department of Oncology 1st Faculty of Medicine and General Teaching Hospital Prague Czech Republic

Department of Oncology University Hospital Vienna Austria

Department of Radiology University of Varmia and Masuria Olsztyn Poland

Edinburgh Cancer Centre Western General Hospital Edinburgh UK

Gastroenterology and Neuroendocrine Tumours Royal Free Hospital London UK

Hematology Oncology and Radiation Oncology University of Texas Health Science Center at Tyler Tyler Texas USA

Hepato Gastroenterology and Digestive Cancerology Robert Debré Hospital Reims France

Medical Affairs Ipsen Boulogne Billancourt France

Medicine Hematology and Medical Oncology Icahn School of Medicine at Mount Sinai New York New York USA

Medizinische Klinik m S Hepatologie und Gastroenterologie Charité University Medicine Berlin Berlin Germany

Oncology Institute Leumit Health Services Jerusalem Israel

Pathological Anatomy Fondazione Policlinico Universitario A Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy

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