Association Between Pretreatment Neutrophil-to-Lymphocyte Ratio and Outcome of Patients With Metastatic Renal-Cell Carcinoma Treated With Nivolumab
| Autor: | Wayne Harris, Omer Kucuk, Bradley C. Carthon, Haydn T. Kissick, Giselle Dutcher, Yuan Liu, Mehmet Asim Bilen, Viraj A. Master, Deepak Ravindranathan |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Neutrophils Urology Gastroenterology Article 03 medical and health sciences Antineoplastic Agents Immunological 0302 clinical medicine Renal cell carcinoma Internal medicine Carcinoma Humans Medicine Lymphocyte Count Prospective Studies Neutrophil to lymphocyte ratio Carcinoma Renal Cell Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Proportional hazards model fungi Hazard ratio Complete blood count Middle Aged Prognosis medicine.disease Survival Analysis Kidney Neoplasms Progression-Free Survival Nivolumab Treatment Outcome 030104 developmental biology Oncology 030220 oncology & carcinogenesis Female business Kidney cancer |
| Zdroj: | Clinical Genitourinary Cancer. 16:e563-e575 |
| ISSN: | 1558-7673 |
| Popis: | BACKGROUND: Biomarkers to guide treatment in metastatic renal cell carcinoma (mRCC) are lacking. We aimed to investigate the association between pretreatment neutrophil-to-lymphocyte ratio (NLR) and outcome of patients with mRCC receiving nivolumab. METHODS: Through retrospective chart review, we identified 38 patients with mRCC treated with standard of care nivolumab between 2015 – 2016 at Winship Cancer Institute of Emory University. NLR was determined from complete blood count collected prior to starting treatment and imaging was performed to assess progression. The NLR cutoff value of 5.5 was determined by log rank test, and the univariate association with overall survival (OS) or progress free survival (PFS) was assessed by Cox proportional hazard model and Kaplan-Meier method. RESULTS: The 38 patients had a median age of 68.5 years. The PFS and OS for all patients at 12 months was 54% and 69%, respectively. The median PFS was 2.6 months in the high NLR group but not reached in the low NLR group. Low NLR was strongly associated with increased PFS with hazard ratio of 0.20 (95%CI 0.07–0.64; p=0.006). The median OS was 2.7 months in the high NLR group but not reached in the low NLR group. Low NLR was significantly associated with a prolonged OS with hazard ratio of 0.06 (95% CI 0.01–0.55; p=0.012). CONCLUSION: Pre-treatment NLR less than 5.5 is associated with superior PFS and OS. NLR is a biomarker that can inform prognosis for patients with mRCC and should be further validated in larger cohorts and in prospective studies. |
| Databáze: | OpenAIRE |
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