Your browser doesn't support javascript.
loading
Novel Risk Scoring System for Patients with Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors.
Martini, Dylan J; Liu, Yuan; Shabto, Julie M; Carthon, Bradley C; Hitron, Emilie Elise; Russler, Greta Anne; Caulfield, Sarah; Kissick, Haydn T; Harris, Wayne B; Kucuk, Omer; Master, Viraj A; Bilen, Mehmet Asim.
Afiliación
  • Martini DJ; Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Liu Y; Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
  • Shabto JM; Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA.
  • Carthon BC; Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Hitron EE; Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
  • Russler GA; Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Caulfield S; Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
  • Kissick HT; Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Harris WB; Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
  • Kucuk O; Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Master VA; Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
  • Bilen MA; Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Oncologist ; 25(3): e484-e491, 2020 03.
Article en En | MEDLINE | ID: mdl-32162798
ABSTRACT

BACKGROUND:

The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) criteria are the gold standard for risk-stratifying patients with metastatic renal cell cancer (mRCC). We developed a novel risk scoring system for patients with mRCC treated with immune checkpoint inhibitors (ICIs).

METHODS:

We performed a retrospective analysis of 100 ICI-treated patients with mRCC at Winship Cancer Institute from 2015 to 2018. Several baseline variables were collected, including markers of inflammation, body mass index (BMI), and sites of metastatic disease, and all were considered for inclusion in our risk scoring system. Upon variable selection in multivariable model, monocyte-to-lymphocyte ratio (MLR), BMI, and number and sites of metastases at baseline were used for risk score calculation. Patients were categorized using four-level risk groups as good (risk score = 0), intermediate (risk score = 1), poor (risk score = 2), or very poor (risk score = 3-4). Cox's proportional hazard model and the Kaplan-Meier method were implemented for survival outcomes.

RESULTS:

Most patients were male (66%) with clear cell renal cell carcinoma (72%). The majority (71%) received anti-programmed cell death protein-1 monotherapy. Our risk scoring criteria had higher Uno's concordance statistics than IMDC in predicting overall survival (OS; 0.71 vs. 0.57) and progression-free survival (0.61 vs. 0.58). Setting good risk (MLR <0.93, BMI ≥24, and D_Met = 0) as the reference, the OS hazard ratios were 29.5 (95% confidence interval [CI], 3.64-238.9), 6.58 (95% CI, 0.84-51.68), and 3.75 (95% CI, 0.49-28.57) for very poor, poor, and intermediate risk groups, respectively.

CONCLUSION:

Risk scoring using MLR, BMI, and number and sites of metastases may be an effective way to predict survival in patients with mRCC receiving ICI. These results should be validated in a larger, prospective study. IMPLICATIONS FOR PRACTICE A risk scoring system was created for patients with metastatic renal cell carcinoma treated with immune checkpoint inhibitors. The results of this study have significant implications for practicing oncologists in the community and academic setting. Importantly, these results identify readily available risk factors that can be used clinically to risk-stratify patients with metastatic renal cell carcinoma who are treated with immune checkpoint inhibitors.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Carcinoma de Células Renales / Neoplasias Renales Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Oncologist Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Carcinoma de Células Renales / Neoplasias Renales Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Oncologist Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos