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Pretreatment neutrophil-to-lymphocyte ratio predicts outcomes in metastatic renal cell carcinoma
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MIAMI — Lower pretreatment neutrophil-to-lymphocyte ratios appeared associated with longer PFS and OS among patients with metastatic renal cell carcinoma treated with nivolumab, according to retrospective study results presented at International Kidney Cancer Symposium.
“Neutrophil-to-lymphocyte ratio can be used as a biomarker for prognosis in patients with metastatic renal cell carcinoma,” Giselle M. Almeida Dutcher, MD, of the department of medicine at Emory University, and colleagues wrote. “Neutrophil-to-lymphocyte ratio should be further validated in larger cohorts and in prospective studies.”
Biomarkers to guide treatment decisions for patients with metastatic renal cell carcinoma are lacking. However, prior studies suggested neutrophil-to-lymphocyte ratio predicts prognosis for these patients who receive targeted therapy, according to study background.
Dutcher and colleagues assessed the association between pretreatment neutrophil-to-lymphocyte ratio and outcomes among patients with metastatic renal cell carcinoma who received the PD-1 inhibitor nivolumab (Opdivo, Bristol-Myers Squibb).
Researchers reviewed charts of 38 patients (76.3% men; 86.8% white) treated with nivolumab as standard of care from 2015 to 2016 at Winship Cancer Institute of Emory University.
Slightly more than half (52.6%) of patients had non-clear cell histology. The majority (55.3%) had ECOG performance status of 0 or 1. Thirty patients (78.9%) had undergone prior nephrectomy.
Investigators used complete blood counts collected prior to treatment to calculate neutrophil-to-lymphocyte ratio. They used log rank test to establish a cutoff value of 5.5.
Most patients (66%) had neutrophil-to-lymphocyte ratio of 5.5 or lower at baseline.
At 12 months, 69% of patients were alive and 54% remained progression free.
Multivariable analysis showed baseline neutrophil-to-lymphocyte ratio of 5.5 or less appeared associated with longer median PFS (not reached vs. 2.6 months; HR = 0.2; 95% CI, 0.07-0.64) and median OS (not reached vs. 2.7 months; HR = 0.06; 95% CI, 0.01-0.55).
Researchers reported no significant associations between survival outcomes and patient sex or tumor histology. – by Mark Leiser
For more information:
Dutcher GMA, et al. Association between pretreatment neutrophil-to-lymphocyte ratio and outcome of metastatic renal cell carcinoma treated with nivolumab. Presented at: International Kidney Cancer Symposium; Nov. 3-4, 2017; Miami.
Disclosure: The researchers report no relevant financial disclosures.