Ki-67 with neutrophil-to-lymphocyte and CD4-positive/CD8-positive ratios predicts early response in non-small cell lung cancer

This study evaluated the combined predictive value of tumor Ki-67 expression status, peripheral blood neutrophil-to-lymphocyte ratio (NLR), and the CD4-positive/CD8-positive T-cell ratio for short-term response assessment in patients with non-small cell lung cancer receiving PD-1/PD-L1 inhibitor therapy. We retrospectively analyzed 102 consecutive patients treated at Binhaiwan Central Hospital between January 2021 and October 2023 who completed two treatment cycles. Responses were assessed using Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1: 13 patients achieved complete response, 26 partial response, 54 stable disease, and 9 progressive disease. For analysis, we defined response as complete response plus partial response and non-response as stable disease plus progressive disease. Univariable screening identified candidate predictors associated with response status, which were entered into multivariable logistic regression adjusted for age, Eastern Cooperative Oncology Group performance status, and smoking history, identifying Ki-67 status, NLR, and the CD4-positive/CD8-positive ratio as independent predictors of short-term response classification. Receiver operating characteristic analysis supported improved discrimination for the combined biomarker model compared with single markers, highlighting a practical, minimally invasive approach for early response stratification in this clinical setting.