Neutrophil-to-Lymphocyte Ratio May Identify Melanoma Patients Likely To Benefit From Ipilimumab Interview with:
Chiara Martinoli, PhD
Medical Oncology of Melanoma
European Institute of Oncology
Milan, Italy

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Martinoli: The recent advent of new immunomodulatory drugs and targeted therapies is changing the therapeutic algorithm for metastatic melanoma patients. Immunomodulation with the anti-CTLA-4 antibody ipilimumab improves survival but is not devoid of potential risks. There is an urgent need for biomarkers to identify patients best suited to receive this therapy, in order to maximize treatment benefit and spare toxicities.

In this study, by analyzing pre-therapy hematological parameters of a large group of metastatic melanoma patients treated with ipilimumab, we showed that neutrophil-to-lymphocyte ratio is strongly and independently associated to patient outcome. Patients with a low baseline neutrophil-to-lymphocyte ratio had a double-reduced risk of disease progression and a two-to-four-fold reduced risk of death, regardless of age, sex and LDH.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Martinoli: We suggest that the pre-therapy neutrophil-to-lymphocyte ratio might help the identification of patients that are more likely to benefit from ipilimumab.

The identification of patients who are more likely or unlikely to benefit from a therapy in advance of its initiation would allow to optimize disease-management strategies, by giving patients the treatment they are best suited to receive, sparing them from un-necessary drug-related toxicities, and improving their quality of life.

Moreover, the neutrophil-to-lymphocyte ratio would represent a convenient objective marker, as it is derived from routine diagnostic procedures, it is does not require additional expenditure, it is easily and promptly computable.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Martinoli: We would strongly encourage prospective studies with adequately powered sample size and clinical trials to validate these findings for patients receiving ipilimumab or other immunotherapies.


Br J Cancer. 2015 Jun 9;112(12):1904-10. doi: 10.1038/bjc.2015.180. Epub 2015 May 26.

Baseline neutrophil-to-lymphocyte ratio is associated with outcome of ipilimumab-treated metastatic melanoma patients.

Ferrucci PF1, Gandini S2, Battaglia A1, Alfieri S1, Di Giacomo AM3, Giannarelli D4, Cappellini GC5, De Galitiis F5, Marchetti P6, Amato G3, Lazzeri A3, Pala L1, Cocorocchio E1, Martinoli C1.


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Chiara Martinoli, PhD, Medical Oncology of Melanoma, European Institute of Oncology, & Milan, Italy (2015). Neutrophil-to-Lymphocyte Ratio May Identify Melanoma Patients Likely To Benefit From Ipilimumab