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- Title
The lymphocyte-to-monocyte ratio as a significant inflammatory marker associated with survival of patients with metastatic renal cell carcinoma treated using nivolumab plus ipilimumab therapy.
- Authors
Numakura, Kazuyuki; Sekine, Yuya; Osawa, Takahiro; Naito, Sei; Tokairin, Ojiro; Muto, Yumina; Sobu, Ryuta; Kobayashi, Mizuki; Sasagawa, Hajime; Yamamoto, Ryohei; Nara, Taketoshi; Saito, Mitsuru; Narita, Shintaro; Akashi, Hideo; Tsuchiya, Norihiko; Shinohara, Nobuo; Habuchi, Tomonori
- Abstract
Background: Nivolumab plus ipilimumab (NIVO + IPI) is the first-line treatment for patients with metastatic renal cell carcinoma (mRCC). While approximately 40% of patients treated with NIVO + IPI achieve a durable response, 20% develop primary resistance with severe consequences. Therefore, there is a clinical need for criteria to select patients suitable for NIVO + IPI therapy to optimize its therapeutic efficacy. Accordingly, our aim was to evaluate the association between candidate biomarkers measured before treatment initiation and survival. Methods: This was a multi-institutional, retrospective, cohort study of 183 patients with mRCC treated with systematic therapies between August 2015 and July 2023. Of these, 112 received NIVO + IPI as first-line therapy: mean age, 68 years; men, 83.0% (n = 93), and clear cell histology, 80.4% (n = 90). Univariable and multivariable analyses were used to evaluate associations between biomarkers and survival. Results: On univariate analysis, high C-reactive protein and systemic index, a high neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio, and a low lymphocyte-to-monocyte ratio (LMR) were associated with shorter overall survival (OS). On multivariable analysis, a LMR ≤ 3 was retained as an independent factor associated to shorter OS with the highest accuracy (C-index, 0.656; hazard ratio, 7.042; 95% confidence interval, 2.0–25.0; p = 0.002). Conclusion: A low LMR may identify patients who would be candidate for NIVO + IPI therapy for mRCC.
- Subjects
MONOCYTE lymphocyte ratio; RENAL cell carcinoma; OVERALL survival; PLATELET lymphocyte ratio; NIVOLUMAB; NEUTROPHIL lymphocyte ratio
- Publication
International Journal of Clinical Oncology, 2024, Vol 29, Issue 7, p1019
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-024-02538-8