Abstract P75: THE NEGATIVE IMPACT OF DELAYED INTER-CYCLE CHEMOTHERAPY ADMINISTRATION ON NEUTROPHIL-TO-LYMPHOCYTE RATIO IN CERVICAL CANCER PATIENTS

Abstract Background: Delayed initiation of chemotherapy increases the incidence of mortality in patients with cancer. Currently, more than half of cervical cancer patients experience an inter-cycle delay. However, there is no adequate evidence regarding the effect of inter-cycle delay in chemotherapy. Neutrophil-to-lymphocyte ratio, as a strong prognostic factor for overall survival, is a crucial alternative marker to monitor. This research analyzed the impact of inter-cycle delayed chemotherapy on increasing the ratio of neutrophil-to-lymphocyte. Methods: A retrospective, observational, cohort study was conducted at a tertiary teaching hospital in East Java, Indonesia. Cervical cancer patients who completed six cycles of chemotherapy in December 2021-2022 and had an inter-cycle delay with a minimum of 7 days from one cycle were included. Neutrophils and lymphocytes were collected before chemotherapy administration and then categorized into groups under or over the cut-off value. A surge and the probability of exceeding a cut-off value of the neutrophil-to-lymphocyte ratio were assessed. The Mann-Whitney U and Spearman tests were analyzed. Results: A total of 77 patients were observed in this study. The cycle when patients had an inter-cycle delay significantly increased the neutrophil-to-lymphocyte ratio (p=0.000; Z=-5.975). Patients with high delayed accumulation days had a positive correlation with the rise in the neutrophil-to-lymphocyte ratio between two cycles (p=0.000; r=0.326). The patients with 15 and 30 inter-cycle delayed days had raised an event neutrophil-to-lymphocyte ratio over the cutoff (p=0.044 vs p=0.027), respectively. Conclusion: Inter-cycle delays represent a remarkable upsurge in the neutrophil-to-lymphocyte ratio. Pharmacists and the entire healthcare team should educate the patient on minimizing inter-cycle delays to achieve a desirable therapy outcome. Citation Format: Dinda M N Ratri, Wynne T Elvira, Wenny P Nilamsari, Amitasari Damayanti. THE NEGATIVE IMPACT OF DELAYED INTER-CYCLE CHEMOTHERAPY ADMINISTRATION ON NEUTROPHIL-TO-LYMPHOCYTE RATIO IN CERVICAL CANCER PATIENTS [abstract]. In: Proceedings of Frontiers in Cancer Science 2025; 2025 Nov 5-7; Singapore. Philadelphia (PA): AACR; Cancer Res 2026;86(13_Suppl):Abstract nr P75.