C-reactive protein and neutrophil-lymphocyte ratio are prognostic in metastatic clear-cell renal cell carcinoma patients treated with nivolumab.
Urol Oncol
; 39(4): 239.e17-239.e25, 2021 04.
Article
em En
| MEDLINE
| ID: mdl-33485762
ABSTRACT
OBJECTIVE:
To evaluate the impact of markers of systemic inflammation such as C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) on outcomes of metastatic clear-cell renal cell carcinoma (m-ccRCC) patients treated with nivolumab. PATIENTS ANDMETHODS:
We retrospectively evaluated m-ccRCC patients treated with nivolumab and collected known prognostic factors and survival data. We used Kaplan-Meier survival analysis and cox proportional hazards regression analysis to study prognostic factors for overall survival (OS) and progression-free survival (PFS) since start of nivolumab. Harrell's C-index was used to evaluate the models.RESULTS:
We included 113 patients. Median OS and PFS after initiation of nivolumab was 15 (interquartile range 7-28) and 4 months (interquartile range 3-11), respectively. Elevated baseline CRP was associated with worse OS (HR per 25 mg/l 1.35, 95% CI 1.16-1.52, P < 0.001) and PFS (HR per 25 mg/l 1.19, 95% CI 1.08-1.35, Pâ¯=â¯0.001), independent from the international metastatic renal cell carcinoma database consortium (IMDC) prognostic criteria, increasing the model's C-index from 0.72 to 0.77 for OS and 0.59 to 0.62 for PFS. Elevated NLR was associated with worse OS (HR 1.10, 95% CI 1.04-1.17, Pâ¯=â¯0.002) and PFS (HR 1.06, 95% CI 1.01-1.11, Pâ¯=â¯0.03) independent from the other IMDC prognostic criteria. The model's C-index decreased from 0.72 to 0.70 for OS and increased from 0.59 to 0.60 for PFS.CONCLUSIONS:
Elevated baseline CRP and NLR predict worse OS and PFS on nivolumab in m-ccRCC patients. Including baseline CRP in the IMDC prognostic model improves its discriminatory power to predict OS and PFS since start of nivolumab.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Proteína C-Reativa
/
Linfócitos
/
Carcinoma de Células Renais
/
Antineoplásicos Imunológicos
/
Nivolumabe
/
Neoplasias Renais
/
Neutrófilos
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article