Systemic Immune-Inflammation Index in Patients Treated With First-Line Immune Combinations for Metastatic Renal Cell Carcinoma: Insights From the ARON-1 Study
(2024) Clinical Genitourinary Cancer — Vol. 22, n° 2, p. 305-314 (2024)
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- Authors
Monteiro, Fernando 
Massari, Francesco
- Abstract
- The treatment of metastatic renal cell carcinoma has evolved on last years. Nowadays immune-combinations are the standard treatment in first-line setting. There is no prognostic biomarker for metastatic renal cell carci-noma in the systemic immunotherapy treatment era. Systemic Immune-Inflammation Index is a cheap and readily available prognostic tool to be used in daily clinical practice. Background: Systemic treatment with immune combinations is the gold standard for metastatic renal cell carcinoma (mRCC) worldwide. The systemic immune-inflammation index (SII) is a prognostic marker for several types of malignant neoplasms, including mRCC, in the era of tyrosine kinase inhibitor (TKI) treatment. Data regarding the prognostic value of the SII in patients with mRCC treated with immunotherapy are scarce and controversial. Methods: We retrospectively collected the data of patients with mRCC from 56 centers in 18 countries. SII (Platelet × Neutrophil/Lymphocyte count) was calculated prior to the first systemic treatment and cutoff was defined by a survival receiver operating characteristic (ROC) analysis. The primary objective of our retrospective study was to assess the outcomes of patients treated with first-line immunotherapy. Results: Data from 1034 mRCC patients was collected and included in this analysis. The SII cutoff value was 1265. After a follow-up of 26.7 months, and the overall survival (OS) and progression-free survival (PFS) were 39.8 and 15.7 months, respectively. According to SII (low vs. high), patients with low-SII had longer OS (55.7 vs. 22.2 months, P < .001), better PFS (20.8 vs. 8.5 months , P < .001), and higher overall response rate (52 vs. 37%, P = .033). Conclusion: A high SII is associated with poor oncological outcomes in patients with mRCC. SII could be an easily accessible prognostic indicator for use in clinical practice.
- Affiliations
LACOG, Porto Alegre, RS, Brazil Latin American Cooperative Oncology Group Charles University, Pilsen, Czech Republic Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia Medical Oncology University of Kentucky, Lexington, KY Markey Cancer Center University Hospital Hradec Kralove, Hradec Kralove, Czechia Department of Clinical Oncology and Radiotherapy Maria Sklodowska-Curie National Research Institute of Oncology Warsaw, Warsaw, Poland Department of Uro-oncology University Hospital Bonn (UKB), 53127 Bonn, Germany Department of Urology MD Anderson Cancer Center Madrid, Madrid, Spain Department of Medical Oncology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico Hematology and Oncology Department University Hospital Ramón y Cajal, Madrid, Spain Department of Medical Oncology Medical University of Innsbruck, Innsbruck, Austria Department of Urology Charles University and Thomayer University Hospital, Prague, Czech Republic Department of Oncology, First Faculty of Medicine Centre Hospitalier de Jolimont, Haine Saint Paul, Belgium Department of Medical Oncology Tawam Hospital, Al Ain, United Arab Emirates Medical Oncology National and Kapodistrian University of Athens, School of Medicine, Athens, Greece 2nd Propaedeutic Department of Internal Medicine, ATTIKON University Hospital Army Hospital Research and Referral, New Delhi, India Department of Medical Oncology Champalimaud Clinical Center, Lisbon, Portugal Urologic Oncology University of Bari "Aldo Moro", Bari, Italy Department of Biomedical Sciences and Human Oncology LACOG, Porto Alegre, RS, Brazil; PUCRS School of Medicine, Porto Alegre, RS, Brazil Latin American Cooperative Oncology Group Macerata Hospital, Macerata, Italy Oncology Unit Brasilia, DF, Brazil Hospital Sirio Libanês Porto Alegre, RS, Brazil PUCRS School of Medicine Charles University, Pilsen, Czech Republic Biomedical Center, Faculty of Medicine in Pilsen
Citations
Monteiro, F., Fiala, O., Massari, F., Myint, Z., Kopecky, J., Kucharz, J., Büttner, T., Grande, E., Bourlon, M., Molina-Cerrillo, J., Pichler, R., Buchler, T., Seront, E., Ansari, J., Bamias, A., Bhuva, D., Vau, N., Porta, C., Fay, A., & Santoni, M. (2024). Systemic Immune-Inflammation Index in Patients Treated With First-Line Immune Combinations for Metastatic Renal Cell Carcinoma: Insights From the ARON-1 Study. Clinical Genitourinary Cancer, 22(2), 305-314. https://doi.org/10.1016/j.clgc.2023.11.013 (Original work published 2024)