ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1633034
This article is part of the Research TopicExploring the Intersection of Cancer Metabolism, Metastasis and ImmunotherapyView all 9 articles
The Predictive Value of the Neutrophil/Eosinophil Ratio in Cancer Patients Undergoing Immune Checkpoint Inhibition: A Meta-Analysis and a Validation Cohort in Hepatocellular Carcinoma
Provisionally accepted
- Wuhan Third Hospital, Wuhan, China
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Objective: This study was conducted to determine the prognostic relevance of neutrophil/eosinophil ratio (NER) in cancer patients receiving immune checkpoint inhibition therapy.Methods: A comprehensive search of the literature was carried out across PubMed, EMBASE, and the Cochrane Library to identify relevant studies published before May 2025. Key clinical endpoints included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). Additionally, a retrospective cohort analysis involving 67 hepatocellular carcinoma (HCC) patients who received ICIs at our center was undertaken to evaluate the prognostic significance of NER with respect to OS and PFS.Results: This meta-analysis incorporated 12 studies comprising a total of 1,716 patients.Higher baseline NER was consistently associated with poorer clinical outcomes, including shorter OS (HR = 1.82, 95% CI: 1.57-2.11, p < 0.001) and PFS (HR = 1.62, 95% CI: 1.34-2.97, p < 0.001), as well as lower ORR (HR = 0.50, 95% CI: 0.37-0.68, p < 0.001) and DCR (OR = 0.44, 95% CI: 0.31-0.61, p < 0.001). Complementing these findings, analysis of a retrospective cohort from our institution involving HCC patients revealed that individuals with higher NER experienced significantly worse OS (p = 0.006) and PFS (p = 0.033) when compared to those with lower NER levels.Conclusion: These findings underscore the prognostic significance of pretreatment NER in cancer patients receiving ICI therapy. Integrating NER into standard clinical evaluation may enhance risk stratification and contribute to the personalization of treatment strategies.
Keywords: immune checkpoint inhibitors, Neutrophil-to-eosinophil ratio, prognosis, Cancer, Hepatocellular Carcinoma
Received: 22 May 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Xu, Liu, Han, He and Cao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yang Xu, Wuhan Third Hospital, Wuhan, China
Huimin Han, Wuhan Third Hospital, Wuhan, China
Zhen He, Wuhan Third Hospital, Wuhan, China
Wei Cao, Wuhan Third Hospital, Wuhan, China
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