Systemic Immune-Inflammation Index in Patients Treated With First-Line Immune Combinations for Metastatic Renal Cell Carcinoma: Insights From the ARON-1 Study.

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 cut-off 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 cut-off 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).

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.

Clinical genitourinary cancer. 2023 Nov 24 [Epub ahead of print]

Fernando Sabino Marques Monteiro, Ondřej Fiala, Francesco Massari, Zin W Myint, Jindrich Kopecky, Jakub Kucharz, Thomas Büttner, Enrique Grande, Maria Teresa Bourlon, Javier Molina-Cerrillo, Renate Pichler, Tomas Buchler, Emmanuel Seront, Jawaher Ansari, Aristotelis Bamias, Dipen Bhuva, Nuno Vau, Camillo Porta, Andre Poisl Fay, Matteo Santoni

Latin American Cooperative Oncology Group - LACOG, Porto Alegre, RS, Brazil; Hospital Sirio Libanês, Brasilia, DF, Brazil; PUCRS School of Medicine, Porto Alegre, RS, Brazil. Electronic address: ., Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital, Charles University, Pilsen, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic., Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia., Markey Cancer Center, University of Kentucky, Lexington, KY., Department of Clinical Oncology and Radiotherapy, University Hospital Hradec Kralove, Hradec Kralove, Czechia., Department of Uro-oncology, Maria Sklodowska-Curie National Research Institute of Oncology Warsaw, Warsaw, Poland., Department of Urology, University Hospital Bonn (UKB), 53127 Bonn, Germany., Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain., Hematology and Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Department of Medical Oncology, University Hospital Ramón y Cajal, Madrid, Spain., Department of Urology, Medical University of Innsbruck, Innsbruck, Austria., Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic., Department of Medical Oncology, Centre Hospitalier de Jolimont, Haine Saint Paul, Belgium., Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates., 2nd Propaedeutic Department of Internal Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece., Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India., Urologic Oncology, Champalimaud Clinical Center, Lisbon, Portugal., Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy., Latin American Cooperative Oncology Group - LACOG, Porto Alegre, RS, Brazil; PUCRS School of Medicine, Porto Alegre, RS, Brazil., Oncology Unit, Macerata Hospital, Macerata, Italy.