Frontiers in Immunology (Jul 2024)
Sodium levels and immunotherapy efficacy in mRCC patients with bone metastases: sub analysis of Meet-Uro 15 study
- Martina Catalano,
- Sara Elena Rebuzzi,
- Sara Elena Rebuzzi,
- Marco Maruzzo,
- Ugo De Giorgi,
- Sebastiano Buti,
- Sebastiano Buti,
- Luca Galli,
- Giuseppe Fornarini,
- Paolo Andrea Zucali,
- Paolo Andrea Zucali,
- Melanie Claps,
- Silvia Chiellino,
- Ilaria Zampiva,
- Stefania Pipitone,
- Riccardo Ricotta,
- Mariella Sorarù,
- Veronica Mollica,
- Marianna Tudini,
- Lucia Fratino,
- Veronica Prati,
- Orazio Caffo,
- Francesco Atzori,
- Franco Morelli,
- Giuseppe Prati,
- Franco Nolè,
- Francesca Vignani,
- Alessia Cavo,
- Marilena Di Napoli,
- Andrea Malgeri,
- Emanuele Naglieri,
- Alessio Signori,
- Giuseppe Luigi Banna,
- Pasquale Rescigno,
- Linda Cerbone,
- Lorenzo Antonuzzo,
- Lorenzo Antonuzzo,
- Giandomenico Roviello
Affiliations
- Martina Catalano
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Firenze, Firenze, Italy
- 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 Genoa, Genoa, Italy
- Marco Maruzzo
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto (IOV) - Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy
- Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
- Sebastiano Buti
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Luca Galli
- Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
- Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino of Genova, Genova, Italy
- Paolo Andrea Zucali
- 0Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Paolo Andrea Zucali
- 1Department of Oncology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Melanie Claps
- 2SS Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- Silvia Chiellino
- 3Medical Oncology Unit, IRCCS Policlinico San Matteo, Pavia, Italy
- Ilaria Zampiva
- 4Section of Innovation Biomedicine-Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Verona, Italy
- Stefania Pipitone
- 5Medical Oncology Unit, Department of Oncology and Hemathology, University Hospital of Modena, Modena, Italy
- Riccardo Ricotta
- 6Oncology Unit, IRCCS MultiMedica, Sesto san Giovanni, Milan, Italy
- Mariella Sorarù
- 7UOC Oncologia, AULSS 6 Euganea, Ospedale di Camposampiero, Padova, Italy
- Veronica Mollica
- 8Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Marianna Tudini
- 9Medical Oncology, St. Salvatore Hospital, L’Aquila, Italy
- Lucia Fratino
- 0Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Aviano, Italy
- Veronica Prati
- 1Oncology Unit, Michele e Pietro Ferrero Hospital, Azienda Sanitaria Locale (ASL) CN 2, Verduno, Italy
- Orazio Caffo
- 2Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy
- Francesco Atzori
- 3SSD Oncologia Medica, Azienda Sanitaria Locale (ASL) Sulcis, Cagliari, Italy
- Franco Morelli
- 4Medical Oncology Department, Casa Sollievo Della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
- Giuseppe Prati
- 5Department of Oncology and Advanced Technologies AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy
- Franco Nolè
- 6Medical Oncology Division of Urogenital & Head & Neck Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Francesca Vignani
- 7Division of Medical Oncology, Mauriziano Hospital, Turin, Piemont, Italy
- Alessia Cavo
- 8Oncology Unit, Villa Scassi Hospital, Genova, Italy
- Marilena Di Napoli
- 9Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
- Andrea Malgeri
- 0Department of Medical Oncology, Fondazione Policlinico Campus Bio-Medico, Roma, Italy
- Emanuele Naglieri
- 1Division of Medical Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
- Alessio Signori
- 2Department of Health Sciences, Section of Biostatistics, University of Genova, Genoa, Italy
- Giuseppe Luigi Banna
- 3Faculty of Science and Health, School of Pharmacy and Biomedical Sciences, Portsmouth Hospitals University NHS Trust, University of Portsmouth, Portsmouth, United Kingdom
- Pasquale Rescigno
- 4Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
- Linda Cerbone
- 5Department of Medical Oncology, San Camillo Forlanini Hospital, Rome, Italy
- Lorenzo Antonuzzo
- 6Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
- Lorenzo Antonuzzo
- 7Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Giandomenico Roviello
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Firenze, Firenze, Italy
- DOI
- https://doi.org/10.3389/fimmu.2024.1361010
- Journal volume & issue
-
Vol. 15
Abstract
BackgroundImmune-checkpoint inhibitors (ICIs) have significantly improved metastatic renal cell carcinoma (mRCC) prognosis, although their efficacy in patients with bone metastases (BMs) remains poorly understood. We investigated the prognostic role of natremia in pretreated RCC patients with BMs receiving immunotherapy.Materials and methodsThis retrospective multicenter study included RCC patients with BMs receiving nivolumab as second-line therapy or beyond. Inclusion criteria involved baseline sodium levels (pre-ICI) and sodium levels after 4 weeks of nivolumab initiation (post-ICI). The population was divided into two groups based on the median value, and response rates, progression-free survival (PFS), and overall survival (OS) were assessed.ResultsAmong 120 eligible patients, those with pre-treatment sodium levels ≥140 mEq/L showed longer OS (18.7 vs. 12.0 months, p=0.04). Pre-treatment sodium levels ≥140 mEq/L were associated with better OS compared to levels <140 mE/L (18.7 vs. 12.0, p=0.04). Post-treatment sodium levels ≥140 mEq/L were associated with improved PFS (9.6 vs. 3.2 months) and OS (25.1 vs. 8.8 months) (p=0.05 and p<0.01, respectively). Patients with consistent sodium levels ≥140 mEq/L at both time points exhibited the best outcomes compared to those with lower values (PFS 11.5 vs. 3.3 months and OS 42.2 vs. 9.0 months, respectively, p<0.01). Disease control rate was significantly higher in the latter group (p<0.01). Multivariate analysis confirmed the prognostic significance of sodium levels.ConclusionElevated sodium levels (≥140 mEq/L) pre- and post-ICI treatment correlate with better survival outcomes in mRCC patients with BMs. This finding suggests sodium level assessment as a potential prognostic factor in these patients and warrants further investigation, particularly in combination immunotherapy settings.
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