{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:49:40Z","timestamp":1791982180336,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A minority of patients receiving immunotherapy for oropharyngeal head and neck squamous cell carcinoma benefit. Finding biomarkers that predict response to ICI is important for improving outcomes in these patients. In this study, we determine the relationship between pretreatment neutrophil\u2010to\u2010lymphocyte ratio (NLR) and 6\u2010month progression\u2010free survival (PFS)\/2\u2010year overall survival (OS) among patients with recurrent or metastatic (R\/M) oropharyngeal cancer on pembrolizumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a retrospective cohort study of patients with recurrent\/metastatic OPSCC who were treated with pembrolizumab between May 2016 and May 2022 at a tertiary care academic center. The primary outcome was 6\u2010month progression\u2010free survival. The secondary outcome was 2\u2010year overall survival. NLR was treated as a continuous and dichotomous variable. Disease progression was determined using radiographic criteria adopted from the Response Evaluation Criteria in Solid Tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010four patients with OPSCC were included. The median pre\u2010treatment NLR was 5.1 (IQR 3.1\u20138.3). Thirty\u2010seven (58%) patients had distant metastases at the start of ICI. When treated as a continuous variable, higher pretreatment NLR was associated with poorer 6\u2010month PFS [HR 1.14 (1.03, 1.27),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016] and 2\u2010year OS [HR 1.21 (1.09, 1.35),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001] for patients on pembrolizumab. Subgroup analyzes on patients who were p16+ versus p16\u2010 revealed that NLR was only associated with poorer survival for p16+ patients [HR 1.16 (1.00, 1.33),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046 versus HR 1.11 (0.94, 1.31),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.203, respectively].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher pretreatment NLR was associated with poorer 6\u2010month PFS and 2\u2010year OS in OPSCC patients treated with pembrolizumab. When stratified by p16 status, this association only remained significant among p16+ patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70312","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T02:03:44Z","timestamp":1778465024000},"page":"2863-2870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neutrophil\u2010To\u2010Lymphocyte Ratio and Survival in Pembrolizumab\u2010Treated Oropharyngeal Cancer"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-6125","authenticated-orcid":false,"given":"Angeline A.","family":"Truong","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savinnie","family":"Ho","sequence":"additional","affiliation":[{"name":"Department 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8121-3726","authenticated-orcid":false,"given":"Ivan H.","family":"El\u2010Sayed","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R.","family":"George","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4296-8944","authenticated-orcid":false,"given":"Chase M.","family":"Heaton","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  San Francisco California 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