Prognostic value of risk stratification using blood parameters for nivolumab in Japanese patients with metastatic renal-cell carcinoma.

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.

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.

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).

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.

Japanese journal of clinical oncology. 2019 Nov 22 [Epub ahead of print]

Yoshiaki Yamamoto, Hideyasu Matsuyama, Hiroaki Matsumoto, Shigeru Sakano, Nakanori Fuji, Kazuo Oba, Mitsutaka Yamamoto, Yoriaki Kamiryo, Takeshi Hiragino, Kazuhiro Nagao, Kimio Takai, Akihiko Aoki

Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi., Department of Urology, Kokura Memorial Hospital, Kitakyusyu, Fukuoka., Department of Urology and Nephrology, Tokuyama Central Hospital, Shunan, Yamaguchi., Department of Urology, Saiseikai Yamaguchi General Hospital, Yamaguchi, Yamaguchi., Department of Urology, Yamaguchi Grand Medical Center, Hofu, Yamaguchi., Department of Urology, Shimonoseki Saisekai Toyoura Hospital, Shimonoseki, Yamaguchi., Department of Urology, Nagato General Hospital, Nagato, Yamaguchi., Department of Urology, Shuto General Hospital, Yanai, Yamaguchi., Department of Urology, Saiseikai Shimonoseki General Hospital, Shimonoseki, Yamaguchi., Department of Urology, Masuda Red Cross Hospital, Masuda, Shimane, Japan.