TY - JOUR
T1 - Prognostic significance of host immune status in patients with late relapsing renal cell carcinoma treated with targeted therapy
AU - Santoni, Matteo
AU - Buti, Sebastiano
AU - Conti, Alessandro
AU - Porta, Camillo
AU - Procopio, Giuseppe
AU - Sternberg, Cora N.
AU - Bracarda, Sergio
AU - Basso, Umberto
AU - De Giorgi, Ugo
AU - Rizzo, Mimma
AU - Derosa, Lisa
AU - Ortega, Cinzia
AU - Massari, Francesco
AU - Milella, Michele
AU - Bersanelli, Melissa
AU - Cerbone, Linda
AU - Muzzonigro, Giovanni
AU - Burattini, Luciano
AU - Montironi, Rodolfo
AU - Santini, Daniele
AU - Cascinu, Stefano
PY - 2015/12/1
Y1 - 2015/12/1
N2 - We aimed to assess the prognostic role of pretreatment neutrophilia, lymphocytopenia, and neutrophil to lymphocyte ratio (NLR) in patients treated with vascular endothelial growth factor-tyrosine kinase inhibitors (VEGFR-TKIs) for late relapsing (>5 years) metastatic renal cell carcinoma (mRCC). Data were collected from 13 Italian centers involved in the treatment of metastatic RCC. Late relapse was defined as >5 years after initial radical nephrectomy. One hundred fifty-one patients were included in this analysis. Among them, MSKCC risk score was favorable in 68 %, intermediate in 29 %, and poor in 3 %. Fifty-six patients (37 %) had NLR ≥3 at the start of VEGFR-TKI therapy (group A), while 95 had lower NLR (63 %, group B). The median overall survival (OS) was 28.8 months in group A and 68.7 months (95 % confidence interval (CI) 45.3–NA) in group B (p <0.001). The median progression-free survival (PFS) was 15.8 months in group A and 25.1 months in group B (p = 0.03). At multivariate analysis, MSKCC risk group and NLR were independent prognostic factors for both OS and PFS. Pretreatment NLR is an independent prognostic factor for patients with late relapsing mRCC treated with first-line VEGFR-TKIs. A better characterization of baseline immunological impairment may optimize the management of this RCC subpopulation.
AB - We aimed to assess the prognostic role of pretreatment neutrophilia, lymphocytopenia, and neutrophil to lymphocyte ratio (NLR) in patients treated with vascular endothelial growth factor-tyrosine kinase inhibitors (VEGFR-TKIs) for late relapsing (>5 years) metastatic renal cell carcinoma (mRCC). Data were collected from 13 Italian centers involved in the treatment of metastatic RCC. Late relapse was defined as >5 years after initial radical nephrectomy. One hundred fifty-one patients were included in this analysis. Among them, MSKCC risk score was favorable in 68 %, intermediate in 29 %, and poor in 3 %. Fifty-six patients (37 %) had NLR ≥3 at the start of VEGFR-TKI therapy (group A), while 95 had lower NLR (63 %, group B). The median overall survival (OS) was 28.8 months in group A and 68.7 months (95 % confidence interval (CI) 45.3–NA) in group B (p <0.001). The median progression-free survival (PFS) was 15.8 months in group A and 25.1 months in group B (p = 0.03). At multivariate analysis, MSKCC risk group and NLR were independent prognostic factors for both OS and PFS. Pretreatment NLR is an independent prognostic factor for patients with late relapsing mRCC treated with first-line VEGFR-TKIs. A better characterization of baseline immunological impairment may optimize the management of this RCC subpopulation.
KW - Late recurrence
KW - Neutrophil to lymphocyte ratio
KW - Prognosis
KW - Renal cell carcinoma
KW - Tyrosine kinase inhibitors
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U2 - 10.1007/s11523-014-0356-3
DO - 10.1007/s11523-014-0356-3
M3 - Article
AN - SCOPUS:84949097702
VL - 10
SP - 517
EP - 522
JO - Targeted Oncology
JF - Targeted Oncology
SN - 1776-2596
IS - 4
ER -