Serum IgA as a Prognostic Beacon: Anticipating Systemic Therapy Efficacy in Metastatic Clear Cell Renal Cell Carcinoma.

Immunotherapy-tyrosine kinase inhibitor (IO-TKI) therapy has revolutionized the treatment landscape for metastatic clear cell renal cell carcinoma (mccRCC); however, the absence of effective biomarkers poses a challenge in predicting the efficacy of these regimens. This study aims to explore the predictive and prognostic value of serum immunoglobulin A (IgA) in mccRCC patients undergoing IO-TKI therapy.

Ninety-six mccRCC patients treated with IO-TKI therapy from 2019 to 2023 were enrolled and serum IgA levels were assessed at the pretreatment baseline and after 3 months of treatment.

Notably, baseline levels of IgA showed no correlation with the objective response rate. However, patients achieving complete or partial responses exhibited a remarkable decrease in IgA levels, while those with stable or progressive disease displayed an increase in IgA levels after 3 months of treatment. Furthermore, the dynamic alteration in IgA levels after 3 months of treatment demonstrated predictive value for both progression-free survival (PFS) and overall survival (OS). The time-dependent receiver operating characteristic curves exhibited outstanding performance in predicting PFS (AUC 0.793) and OS (AUC 0.738).

Taken together, this study demonstrates that dynamic alteration of serum IgA after 3 months of treatment was significantly correlated with prognosis and therapeutic efficacy in mccRCC patients.

Annals of surgical oncology. 2024 May 20 [Epub ahead of print]

Hong-Lei Cui, Jie Wu, Gan Du, You-Yan Guan, Hong-Zhe Shi, Ai-Ping Zhou, Jian-Zhong Shou

Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Chinese Academy of Medical Sciences, Peking Union Medical College Cancer Hospital, Beijing, China., Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. ., Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Chinese Academy of Medical Sciences, Peking Union Medical College Cancer Hospital, Beijing, China. .