The association of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival and overall survival of patients treated with sunitinib for metastatic renal cell carcinoma.
The association of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival and overall survival of patients treated with sunitinib for metastatic renal cell carcinoma.
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DOI：
10.1016/j.ejca.2011.09.001
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发表时间：
2012-01
影响因子：
8.4
通讯作者：
Carducci, Michael A.
中科院分区：
文献类型：
--
作者：
Keizman, Daniel;Ish-Shalom, Maya;Huang, Peng;Eisenberger, Mario A.;Pili, Roberto;Hammers, Hans;Carducci, Michael A.
舒尼替尼是转移性肾细胞癌（mRCC）的标准治疗方法。中性粒细胞与淋巴细胞比率（NLR）是一种全身性炎症的指标，与几种癌症类型的预后有关。研究治疗前中性粒细胞/淋巴细胞比值与舒尼替尼治疗mRCC患者的缓解率、无进展生存期（PFS）和总生存期（OS）的关系。我们回顾性研究了一个未选择的mRCC患者队列，他们接受舒尼替尼治疗。采用Logistic回归模型对应答率进行分析。采用Cox回归模型确定与PFS和OS相关的危险因素。在调整混杂协变量后，我们调查了治疗前NLR与这些临床结果的关系。采用截尾数据的回归树方法寻找最佳NLR截断值。2004年至2011年间，133名mRCC患者接受了舒尼替尼治疗。109例纳入NLR分析，其中排除了没有治疗前NLR数据或已知与血细胞计数变化相关的合并症/近期治疗的患者。与PFS相关的因素有低NLR≥3 （HR = 0.285, p < 0.001）、既往肾切除术（HR = 0.38, p = 0.035）、舒尼替尼剂量减少/治疗中断（HR = 0.6, p = 0.014）和使用抗紧张素系统抑制剂（HR = 0.537, p = 0.008）。低NLR≥3与OS相关（HR = 0.3, p = 0.043）。在接受舒尼替尼治疗的mRCC患者中，治疗前NLR可能与PFS和OS相关。这应该进行前瞻性的研究，如果在临床实践和临床试验中得到验证和应用。
Sunitinib is a standard treatment for metastatic renal cell carcinoma (mRCC). The neutrophil to lymphocyte ratio (NLR), an index of systemic inflammation, is associated with outcome in several cancer types. To study the association of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival (PFS) and overall survival (OS) of patients treated with sunitinib for mRCC. We retrospectively studied an unselected cohort of patients with mRCC, who were treated with sunitinib. Logistic regression model was used to analyse response rate. Cox regression models were fitted to identify risk factors associated with PFS and OS. We investigated how pre-treatment NLR is associated with these clinical outcomes after adjusting for confounding covariates. Regression tree for censored data method was used to find the best NLR cut-off value. Between 2004 and 2011, 133 patients with mRCC were treated with sunitinib. One hundred and nine were included in the NLR analysis, from which were excluded patients without available data on pre-treatment NLR or with comorbidities/recent treatments known to be associated with a change of blood counts. Factors associated with PFS were low NLR ≥ 3 (HR = 0.285, p < 0.001), past nephrectomy (HR = 0.38, p = 0.035), sunitinib dose reduction/treatment interruption (HR = 0.6, p = 0.014), and the use of antiotensin system inhibitors (HR = 0.537, p = 0.008). Low NLR ≥ 3 was associated with OS (HR = 0.3, p = 0.043). In patients with mRCC treated with sunitinib, pre-treatment NLR may be associated with PFS and OS. This should be investigated prospectively, and if validated applied in clinical practice and clinical trials.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
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通讯作者：
Pisani, P
影响因子：
8.4
作者：
Keizman, Daniel;Huang, Peng;Eisenberger, Mario A.;Pili, Roberto;Kim, Jenny J.;Antonarakis, Emmanuel S.;Hammers, Hans;Carducci, Michael A.
通讯作者：
Carducci, Michael A.