Prognostic value of risk stratification using blood parameters for nivolumab in Japanese patients with metastatic renal-cell carcinoma.
BACKGROUND
Nivolumab is a standard treatment for previously treated advanced renal-cell carcinoma. However, nivolumab is effective in only a limited number of patients; therefore, we evaluated the prognostic value of several biomarkers, including inflammation-based prognostic scores and changes in these scores following nivolumab treatment in Japanese patients with metastatic renal-cell carcinoma.


METHODS
We retrospectively reviewed the medical records of 65 patients with previously treated metastatic renal-cell carcinoma and who received nivolumab. Inflammation-based prognostic scores, including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, lymphocyte/monocyte ratio, and Glasgow prognostic score before and 6 weeks after the treatment were recorded. Categorical variables influencing disease-specific survival were compared using Cox proportional-hazards regression models.


RESULTS
Univariate analysis showed that Memorial Sloan-Kettering Cancer Center risk score (P = 0.0052), lactate dehydrogenase (P = 0.0266), lymphocyte/monocyte ratio (P = 0.0113), and platelet/lymphocyte ratio (P = 0.0017) had a significant effect on disease-specific survival. Multivariate analyses showed that platelet/lymphocyte ratio and lactate dehydrogenase were found to be independent prognostic factors for disease-specific survival (P = 0.0008, risk ratio (RR) = 7.95, 95% confidence interval, 2.16-51.64 and P = 0.0123, RR = 3.92, 95% confidence interval, 1.37-10.80, respectively). The combination of platelet/lymphocyte ratio and lactate dehydrogenase was the most significant prognostic biomarker in metastatic renal-cell carcinoma (P < 0.0001). Changes in lymphocyte/monocyte ratio and platelet/lymphocyte ratio in response to nivolumab were significant prognostic factors for disease-specific survival (P < 0.0001 and P = 0.0477, respectively).


CONCLUSIONS
The combination of platelet/lymphocyte ratio and lactate dehydrogenase may be a potential biomarker for estimating disease-specific survival in Japanese patients with metastatic renal-cell carcinoma treated by nivolumab.
['Yamamoto|Yoshiaki|Y|', 'Matsuyama|Hideyasu|H|', 'Matsumoto|Hiroaki|H|', 'Sakano|Shigeru|S|', 'Fuji|Nakanori|N|', 'Oba|Kazuo|K|', 'Yamamoto|Mitsutaka|M|', 'Kamiryo|Yoriaki|Y|', 'Hiragino|Takeshi|T|', 'Nagao|Kazuhiro|K|', 'Takai|Kimio|K|', 'Aoki|Akihiko|A|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000074322:Antineoplastic Agents, Immunological D015415:Biomarkers D001792:Blood Platelets D002292:Carcinoma, Renal Cell D005260:Female D006801:Humans D007249:Inflammation D007564:Japan D007680:Kidney Neoplasms D007770:L-Lactate Dehydrogenase D008214:Lymphocytes D008297:Male D008875:Middle Aged D000077594:Nivolumab D011379:Prognosis D016016:Proportional Hazards Models D012189:Retrospective Studies D018570:Risk Assessment
nivolumab renal-cell carcinoma inflammation-based prognostic score platelet/lymphocyte ratio lactate dehydrogenase