TY - JOUR
T1 - Inflammatory indices and clinical factors in metastatic renal cell carcinoma patients treated with nivolumab: the development of a novel prognostic score (Meet-URO 15 study)
AU - Rebuzzi, Sara Elena
AU - Signori, Alessio
AU - Banna, Giuseppe Luigi
AU - Maruzzo, Marco
AU - De Giorgi, Ugo
AU - Pedrazzoli, Paolo
AU - Sbrana, Andrea
AU - Zucali, Paolo Andrea
AU - Masini, Cristina
AU - Naglieri, Emanuele
AU - Procopio, Giuseppe
AU - Merler, Sara
AU - Tomasello, Laura
AU - Fratino, Lucia
AU - Baldessari, Cinzia
AU - Ricotta, Riccardo
AU - Panni, Stefano
AU - Mollica, Veronica
AU - Sorarù, Maria
AU - Santoni, Matteo
AU - Cortellini, Alessio
AU - Prati, Veronica
AU - Soto Parra, Hector Josè
AU - Stellato, Marco
AU - Atzori, Francesco
AU - Pignata, Sandro
AU - Messina, Carlo
AU - Messina, Marco
AU - Morelli, Franco
AU - Prati, Giuseppe
AU - Nolè, Franco
AU - Vignani, Francesca
AU - Cavo, Alessia
AU - Roviello, Giandomenico
AU - Pierantoni, Francesco
AU - Casadei, Chiara
AU - Bersanelli, Melissa
AU - Chiellino, Silvia
AU - Paolieri, Federico
AU - Perrino, Matteo
AU - Brunelli, Matteo
AU - Iacovelli, Roberto
AU - Porta, Camillo
AU - Buti, Sebastiano
AU - Fornarini, Giuseppe
N1 - © The Author(s), 2021.
PY - 2021/5/18
Y1 - 2021/5/18
N2 - Background: Despite the survival advantage, not all metastatic renal cell carcinoma (mRCC) patients achieve a long-term benefit from immunotherapy. Moreover, the identification of prognostic biomarkers is still an unmet clinical need.Methods: This multicenter retrospective study investigated the prognostic role of peripheral-blood inflammatory indices and clinical factors to develop a novel prognostic score in mRCC patients receiving at least second-line nivolumab. The complete blood count before the first cycle of therapy was assessed by calculating neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), and systemic inflammation response index (SIRI). Clinical factors included pre-treatment International Metastatic RCC Database Consortium (IMDC) score, line of therapy, and metastatic sites.Results: From October 2015 to November 2019, 571 mRCC patients received nivolumab as second- and further-line treatment in 69% and 31% of cases. In univariable and multivariable analyses all inflammatory indices, IMDC score, and bone metastases significantly correlated with overall survival (OS). The multivariable model with NLR, IMDC score, and bone metastases had the highest c-index (0.697) and was chosen for the developing of the score (Schneeweiss scoring system). After internal validation (bootstrap re-sampling), the final index (Meet-URO score) composed by NLR, IMDC score, and bone metastases had a c-index of 0.691. It identified five categories with distinctive OSs: group 1 (median OS - mOS = not reached), group 2 (mOS = 43.9 months), group 3 (mOS = 22.4 months), group 4 (mOS = 10.3 months), and group 5 (mOS = 3.2 months). Moreover, the Meet-URO score allowed for a fine risk-stratification across all three IMDC groups.Conclusion: The Meet-URO score allowed for the accurate stratification of pretreated mRCC patients receiving nivolumab and is easily applicable for clinical practice at no additional cost. Future steps include its external validation, the assessment of its predictivity, and its application to first-line combinations.
AB - Background: Despite the survival advantage, not all metastatic renal cell carcinoma (mRCC) patients achieve a long-term benefit from immunotherapy. Moreover, the identification of prognostic biomarkers is still an unmet clinical need.Methods: This multicenter retrospective study investigated the prognostic role of peripheral-blood inflammatory indices and clinical factors to develop a novel prognostic score in mRCC patients receiving at least second-line nivolumab. The complete blood count before the first cycle of therapy was assessed by calculating neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), and systemic inflammation response index (SIRI). Clinical factors included pre-treatment International Metastatic RCC Database Consortium (IMDC) score, line of therapy, and metastatic sites.Results: From October 2015 to November 2019, 571 mRCC patients received nivolumab as second- and further-line treatment in 69% and 31% of cases. In univariable and multivariable analyses all inflammatory indices, IMDC score, and bone metastases significantly correlated with overall survival (OS). The multivariable model with NLR, IMDC score, and bone metastases had the highest c-index (0.697) and was chosen for the developing of the score (Schneeweiss scoring system). After internal validation (bootstrap re-sampling), the final index (Meet-URO score) composed by NLR, IMDC score, and bone metastases had a c-index of 0.691. It identified five categories with distinctive OSs: group 1 (median OS - mOS = not reached), group 2 (mOS = 43.9 months), group 3 (mOS = 22.4 months), group 4 (mOS = 10.3 months), and group 5 (mOS = 3.2 months). Moreover, the Meet-URO score allowed for a fine risk-stratification across all three IMDC groups.Conclusion: The Meet-URO score allowed for the accurate stratification of pretreated mRCC patients receiving nivolumab and is easily applicable for clinical practice at no additional cost. Future steps include its external validation, the assessment of its predictivity, and its application to first-line combinations.
U2 - 10.1177/17588359211019642
DO - 10.1177/17588359211019642
M3 - Article
SN - 1758-8340
VL - 13
JO - Ther. Adv. Med. Oncol.
JF - Ther. Adv. Med. Oncol.
M1 - 17588359211019642
ER -