Karantanos T, et al. - Given the association of neutrophil-to-lymphocyte (ANC/ALC) ratio with worse prognosis in patients with NSCLC on immunotherapies, researchers determined the correlation of the peripheral blood counts with the overall survival (OS) and overall time on treatment. Further, they assessed the effect of the previous radiation on peripheral blood counts and clinical outcomes. They performed a retrospective evaluation of 22 patients with advanced NSCLC treated with nivolumab at Boston Medical Center from January 2014 to September 2016 and identified a positive correlation of ALC at baseline and at 6 weeks on treatment with the overall survival. Thereby suggesting ALC be a predictive marker. The previous radiation was noted to be linked with higher ANC and lower ALC during treatment suggesting practicing caution in applying the combination of radiation therapy with immunotherapy. Peripheral blood counts can be utilized to stratify patients for this approach.