Baseline Glucose-to-Lymphocyte Ratio Predicts Nivolumab Outcomes in Advanced Non-Small Cell Lung Cancer - A Multicenter Retrospective Study

Q: What was the main biomarker evaluated in this study?

The study evaluated the baseline glucose-to-lymphocyte ratio (GLR), calculated from fasting glucose and absolute lymphocyte counts.

Q: How did the GLR relate to survival outcomes for patients on nivolumab?

Patients with GLR <70.76 had significantly longer overall survival and progression-free survival than those with GLR ≥70.76.

Q: What factors were found to independently predict prognosis?

High GLR and poor ECOG performance status independently predicted worse overall survival in multivariate analysis.

Sep 22, 2026

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Biomarkers to guide immunotherapy in non-small cell lung cancer (NSCLC) remain limited. This multicenter retrospective study evaluated whether the baseline glucose-to-lymphocyte ratio (GLR), reflecting combined metabolic and immune status, predicts outcomes in patients treated with nivolumab. Among 837 advanced or metastatic NSCLC patients across 21 Turkish oncology centers, baseline GLR cut-off analysis associated GLR <70.76 with longer overall and progression-free survival, and multivariate models linked high GLR to worse prognosis.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background

Methods

Results

Conclusion

TYPE Original Research PUBLISHED 12 February 2026 DOI 10.3389/fimmu.2026.1714533 OPEN ACCESS EDITED BY Yee Peng Phoon, Cleveland Clinic, United States REVIEWED BY Md Ataur Rahman, Wayne State University, United States Neda Dadgar, Allegheny Health Network, United States *CORRESPONDENCE Mustafa Ersoy [mustafa.ersoy@ksbu.edu.tr](mustafa.ersoy@ksbu.edu.tr) RECEIVED 27 September 2025 REVISED 22 January 2026 ACCEPTED 26 January 2026 PUBLISHED 12 February 2026 CITATION Ersoy M, Kefeli U, Cabuk D, Bayram E, Bayir D, Bozkurt O, Ürün M, Coar R, Sakalar T, Mutlu E, Cengiz M, Sahin E, Sancı P, Yıldız C, Kolemen E, Cengiz A, Agdas G, Kocaaslan E, Turkoglu E, Yıldırım S, Mermeit B, Karakayalı A, Arvas H, Mutlu M, Biter S, Yeil C¸inkir Hand Yücel MH (2026) Baseline glucoseto-lymphocyte ratio predicts nivolumab outcomes in advanced non-small cell lung cancer: a multicenter retrospective study. Front. Immunol. 17:1714533 . doi: 10.3389/fimmu.2026.1714533 COPYRIGHT © 2026 Ersoy, Kefeli, Cabuk, Bayram, Bayir, Bozkurt, Ürün, Coar, Sakalar, Mutlu, Cengiz, Sahin, Sancı, Yıldız, Kolemen, Cengiz, Agdas, Kocaaslan, Turkoglu, Yıldırım, Mermeit, Karakayalı, Arvas, Mutlu, Biter, Yeil C¸inkir and Yücel. 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) and the copyright owner(s) 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. Baseline glucose-to-lymphocyte ratio predicts nivolumaboutcomes in advanced non-small cell lung cancer: a multicenter retrospective study Mustafa Ersoy 1*, Umut Kefeli 2, Devrim Cabuk 2, Ertugrul Bayram 3, Duygu Bayir 4, Oktay Bozkurt 5, Muslih Ürün 6, Ramazan Coar 7, Teoman Sakalar 8, Emel Mutlu 9, Muhammet Cengiz 5, Elif Sahin 10, Pervin Sancı10, Canan Yıld ız7, Erdem Kolemen 2, Ayse Cengiz 5, Gozde Agdas 11, Erkam Kocaaslan 12, Ezgi Turkoglu 13, Sedat Yıld ırım13, Berrak Mermeit 14, Anil Karakayal ı 10, Hayati Arvas 15, Mehmet Mutlu 3, Sedat Biter 3, Havva Yeil C¸inkir 16 and Mehmet H. Yücel 17 1 Department of Internal Medicine, Division of Medical Oncology, Kutahya Health Sciences University, Kutahya, Türkiye, 2 Kocaeli Universitesi Tip Fakultesi, Izmit, Türkiye, 3Cukurova Universitesi Tip Fakultesi, Adana, Türkiye, 4 Eskisehir Osmangazi Universitesi Tip Fakultesi, Eskiehir, Türkiye, 5 Erciyes Universitesi Tip Fakultesi, Kayseri, Türkiye, 6Van Yuzuncu Yil Universitesi, Van, Türkiye, 7Afyon Kocatepe Universitesi Tip Fakultesi, Afyonkarahisar, Türkiye, 8Türkiye Cumhuriyeti (TC) Saglik Bakanligi Kahramanmaras Necip Fazil Sehir Hastanesi, Dulkadiro˘glu, Türkiye, 9Türkiye Cumhuriyeti (TC) Saglik Bakanligi Corum Erol Olcok Egitim ve Arastirma Hastanesi, C¸orum, Türkiye, 10Türkiye Cumhuriyeti (TC) Saglik Bakanligi Kocaeli Sehir Hastanesi, Izmit, Türkiye, 11Van Egitim ve Arastirma Hastanesi, Van, Türkiye, 12Türkiye Cumhuriyeti (TC) Saglik Bakanligi Pendik Egitim ve Arastirma Hastanesi, Pendik, Türkiye, 13 Kartal Dr Lutﬁ Kirdar Sehir Hastanesi, Istanbul, Türkiye, 14Van Yuzuncu Yil Universitesi Tip Fakultesi, Van, Türkiye, 15 Dicle Universitesi Tip Fakultesi, Diyarbakır, Türkiye, 16Gaziantep Universitesi Tip Fakultesi, Gaziantep, Türkiye, 17 Department of Internal Medicine, Division of Medical Oncology, Istanbul Medipol Universitesi Tip Fakultesi, Beykoz, Türkiye Background: Biomarkers guiding immunotherapy in non-small cell lung cancer (NSCLC) are limited. The glucose-to-lymphocyte ratio (GLR), integrating metabolic and immune status, has shown prognostic value in several cancers but has not been systematically evaluated in patients receiving PD-1 blockade. Methods: We retrospectively analyzed 837 patients with advanced or metastatic NSCLC treated with nivoluma

FAQs

What was the main biomarker evaluated in this study?

The study evaluated the baseline glucose-to-lymphocyte ratio (GLR), calculated from fasting glucose and absolute lymphocyte counts.

How did the GLR relate to survival outcomes for patients on nivolumab?

Patients with GLR <70.76 had significantly longer overall survival and progression-free survival than those with GLR ≥70.76.

What factors were found to independently predict prognosis?

High GLR and poor ECOG performance status independently predicted worse overall survival in multivariate analysis.

Sep 22, 2026

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