Frontiers in Oncology (Sep 2022)
The prognostic value of baseline and early variations of peripheral blood inflammatory ratios and their cellular components in patients with metastatic renal cell carcinoma treated with nivolumab: The Δ-Meet-URO analysis
- Sara Elena Rebuzzi,
- Sara Elena Rebuzzi,
- Alessio Signori,
- Marco Stellato,
- Daniele Santini,
- Marco Maruzzo,
- Ugo De Giorgi,
- Paolo Pedrazzoli,
- Paolo Pedrazzoli,
- Luca Galli,
- Paolo Andrea Zucali,
- Paolo Andrea Zucali,
- Emanuela Fantinel,
- Claudia Carella,
- Giuseppe Procopio,
- Michele Milella,
- Francesco Boccardo,
- Lucia Fratino,
- Roberto Sabbatini,
- Riccardo Ricotta,
- Stefano Panni,
- Francesco Massari,
- Francesco Massari,
- Mariella Sorarù,
- Matteo Santoni,
- Alessio Cortellini,
- Alessio Cortellini,
- Veronica Prati,
- Hector Josè Soto Parra,
- Francesco Atzori,
- Marilena Di Napoli,
- Orazio Caffo,
- Marco Messina,
- Franco Morelli,
- Giuseppe Prati,
- Franco Nolè,
- Francesca Vignani,
- Alessia Cavo,
- Giandomenico Roviello,
- Miguel Angel Llaja Obispo,
- Camillo Porta,
- Camillo Porta,
- Sebastiano Buti,
- Sebastiano Buti,
- Giuseppe Fornarini,
- Giuseppe Luigi Banna
Affiliations
- Sara Elena Rebuzzi
- Medical Oncology Unit, Ospedale San Paolo, Savona, Italy
- Sara Elena Rebuzzi
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Genova, Italy
- Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genova, Genova, Italy
- Marco Stellato
- SS Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- Daniele Santini
- Department of Medical Oncology, Università Campus Bio-Medico of Roma, Rome, Italy
- Marco Maruzzo
- Oncology Unit 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
- Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
- Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
- Paolo Pedrazzoli
- Medical Oncology Unit, IRCCS Policlinico San Matteo, Pavia, Italy
- Luca Galli
- 0Medical Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
- Paolo Andrea Zucali
- 1Department of Biomedical Sciences, Humanitas University, Milano, Italy
- Paolo Andrea Zucali
- 2Department of Oncology, IRCCS, Humanitas Clinical and Research Center, Milano, Italy
- Emanuela Fantinel
- 3Department of Oncology, Azienda Ospedaliera Universitaria Integrata di Verona, University of Verona, Verona, Italy
- Claudia Carella
- 4Division of Medical Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
- Giuseppe Procopio
- SS Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- Michele Milella
- 3Department of Oncology, Azienda Ospedaliera Universitaria Integrata di Verona, University of Verona, Verona, Italy
- Francesco Boccardo
- 5Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino of Genova, Genova, Italy
- Lucia Fratino
- 6Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Aviano, Italy
- Roberto Sabbatini
- 7Medical Oncology Unit, Department of Oncology and Hemathology, University Hospital of Modena, Modena, Italy
- Riccardo Ricotta
- 8Oncology Unit, IRCCS MultiMedica, Milan, Italy
- Stefano Panni
- 9Medical Oncology Unit, ASSTl– Istituti Ospitalieri Cremona Hospital, Cremona, Italy
- Francesco Massari
- 0Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Francesco Massari
- 1Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
- Mariella Sorarù
- 2U. O. Oncologia, Ospedale di Camposampiero, Padova, Italy
- Matteo Santoni
- 3Oncology Unit, Macerata Hospital, Macerata, Italy
- Alessio Cortellini
- 4Department of Surgery and Cancer, Imperial College London, Faculty of Medicine, Hammersmith Hospital, London, United Kingdom
- Alessio Cortellini
- 5Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Veronica Prati
- 6Department of Medical Oncology, Ospedale Michele e Pietro Ferrero, Verduno, Italy
- Hector Josè Soto Parra
- 7Department of Oncology, Medical Oncology, University Hospital Policlinico-San Marco, Catania, Italy
- Francesco Atzori
- 8Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
- Marilena Di Napoli
- 9Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
- Orazio Caffo
- 0Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
- Marco Messina
- 1UOC Oncologia Medica, Istituto Fondazione G. Giglio, Cefalù, Italy
- Franco Morelli
- 2Oncology Department, Gemelli Molise, Campobasso, Italy
- Giuseppe Prati
- 3Department of Oncology and Advanced Technologies AUSL - IRCCS, Reggio Emilia, Italy
- Franco Nolè
- 4Medical Oncology Division of Urogenital and Head and Neck Tumors, IEO, European Institute of Oncology IRCCS, Milano, Italy
- Francesca Vignani
- 5Division of Medical Oncology, Ordine Mauriziano Hospital, Torino, Italy
- Alessia Cavo
- 6Oncology Unit, Villa Scassi Hospital, Genova, Italy
- Giandomenico Roviello
- 7Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Firenze, Firenze, Italy
- Miguel Angel Llaja Obispo
- 8Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Camillo Porta
- 9Interdisciplinary Department of Medicine, University of Bari “A. Moro”, Bari, Italy
- Camillo Porta
- 0Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy
- Sebastiano Buti
- 1Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Sebastiano Buti
- 2Department of Medicine and Surgery, University of Parma, Parma, Italy
- Giuseppe Fornarini
- 8Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Giuseppe Luigi Banna
- 3Department of Oncology, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
- DOI
- https://doi.org/10.3389/fonc.2022.955501
- Journal volume & issue
-
Vol. 12
Abstract
BackgroundTreatment choice for metastatic renal cell carcinoma (mRCC) patients is still based on baseline clinical and laboratory factors.MethodsBy a pre-specified analysis of the Meet-URO 15 multicentric retrospective study enrolling 571 pretreated mRCC patients receiving nivolumab, baseline and early dynamic variations (Δ) of neutrophil, lymphocyte, and platelet absolute cell counts (ACC) and their inflammatory ratios (IR) were evaluated alongside their association with the best disease response and overall (OS) and progression-free survival (PFS). Multivariable analyses on OS and PFS between baseline and Δ ACC and IR values were investigated with receiving operating curves-based cut-offs.ResultsThe analysis included 422 mRCC patients. Neutrophil-to-lymphocyte ratio (NLR) increased over time due to consistent neutrophil increase (p < 0.001). Higher baseline platelets (p = 0.044) and lower lymphocytes (p = 0.018), increasing neutrophil Δ (p for time-group interaction <0.001), higher baseline IR values (NLR: p = 0.012, SII: p = 0.003, PLR: p = 0.003), increasing NLR and systemic immune-inflammatory index (SII) (i.e., NLR x platelets) Δ (p for interaction time-group = 0.0053 and 0.0435, respectively) were associated with disease progression. OS and PFS were significantly shorter in patients with baseline lower lymphocytes (p < 0.001 for both) and higher platelets (p = 0.004 and p < 0.001, respectively) alongside early neutrophils Δ (p = 0.046 and p = 0.033, respectively). Early neutrophils and NLR Δ were independent prognostic factors for both OS (p = 0.014 and p = 0.011, respectively) and PFS (p = 0.023 and p = 0.001, respectively), alongside baseline NLR (p < 0.001 for both) and other known prognostic variables.ConclusionsEarly neutrophils and NLR Δ may represent new dynamic prognostic factors with clinical utility for on-treatment decisions.
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