Absolute lymphocyte count is an independent predictor of survival in patients with metastatic renal cell carcinoma treated with nivolumab
Absolute lymphocyte count is an independent predictor of survival in patients with metastatic renal cell carcinoma treated with nivolumab
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DOI：
10.1093/jjco/hyab157
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发表时间：
2021-10-05
影响因子：
2.4
通讯作者：
Igawa, Tsukasa
中科院分区：
文献类型：
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作者：
Ueda, Kosuke;Suekane, Shigetaka;Igawa, Tsukasa
目的程序性细胞死亡-1抗体治疗改善了转移性肾癌患者的无进展生存期和总生存期。然而，关于可以预测免疫检查点抑制剂疗效的生物标志物的研究有限。我们研究了外周炎症生物标志物对转移性肾癌患者接受尼伏路单抗治疗的临床结果的影响。方法对2016年11月至2021年2月收治的38例转移性肾癌患者在接受至少一种分子靶向治疗后再接受尼伏单抗治疗的资料进行回顾性分析。结果淋巴细胞绝对值低的患者中位无进展生存期和总生存期明显短于中性粒细胞/淋巴细胞比率低的患者(P=0.0344)。多因素分析显示，淋巴细胞绝对计数是影响无进展生存率(危险比=2.332，95%可信区间=1.012~5.375，P=0.0468)和总生存率(危险比=4.153，95%可信区间=1.108~15.570，P=0.0347)的独立因素。治疗后1个月淋巴细胞绝对计数增加是无进展生存期(危险比=0.419，95%可信区间=0.189~0.926，P=0.0317)和总生存期(危险比=0.285，95%可信区间=0.091~0.890，P=0.0308)的积极预测因素。结论转移性肾癌患者在接受尼伏路单抗治疗前，外周血淋巴细胞绝对计数可作为不良反应的预测指标。另外，nivolumab治疗1个月后淋巴细胞绝对计数的增加可以预测nivolumab的疗效，而nivolumab治疗前的外周淋巴细胞绝对计数是转移性肾癌患者生存的独立预测因素。启动后淋巴细胞绝对计数的增加可以预测尼伏卢单抗的疗效。
Objective Programmed cell death-1 antibody therapy has demonstrated improved progression-free survival and overall survival in patients with metastatic renal cell carcinoma. However, there are limited studies on biomarkers that can predict the efficacy of immune checkpoint inhibitors. We examined the influence of peripheral inflammatory biomarkers on the clinical outcomes of patients with metastatic renal cell carcinoma treated with nivolumab. Methods Data of 38 patients with metastatic renal cell carcinoma, who were treated with nivolumab monotherapy after receiving at least one molecular targeted therapy from November 2016 to February 2021, were retrospectively reviewed and analyzed. Results Median progression-free survival and overall survival were significantly shorter in patients with low absolute lymphocyte count (= 3.0) versus those with low neutrophil-lymphocyte ratio (P = 0.0344). Multivariate analysis showed that absolute lymphocyte count was an independent factor for progression-free survival (hazard ratio = 2.332, 95% confidence interval = 1.012-5.375, P = 0.0468) and overall survival (hazard ratio = 4.153, 95% confidence interval = 1.108-15.570, P = 0.0347). Increased absolute lymphocyte count, 1 month after nivolumab initiation, was a positive predictive factor for progression-free survival (hazard ratio = 0.419, 95% confidence interval = 0.189-0.926, P = 0.0317) and overall survival (hazard ratio = 0.285, 95% confidence interval = 0.091-0.890, P = 0.0308). Conclusion Our study indicates that peripheral absolute lymphocyte count, before nivolumab initiation, is a predictor of poor response in metastatic renal cell carcinoma. Additionally, increased absolute lymphocyte count, 1 month post-nivolumab initiation, can be a predictor of the effects of nivolumab.Peripheral absolute lymphocyte count, before nivolumab initiation, is an independent predictor of survival in metastatic renal cell carcinoma. Increased absolute lymphocyte count after initiation can be a predictor of nivolumab efficacy.