Figure 4. A very high neutrophil-to-lymphocyte (NLR) – over 10 – seems to forecast an even worse prognosis in patients undergoing immunotherapy, with sudden deaths in the weeks immediately following therapy. Indeed, patients with NLR higher than 10 had a median overall survival of 3.8 months. In these patients, we postulated a detrimental effect of immunotherapy. The prediction of prognosis could help identify patients who are likely to benefit more from chemo-immunotherapy rather than immunotherapy only: indeed, chemotherapy could be effective in killing myeloidderived suppressor cells and therefore, hinder their immunosuppressive role.