Utility of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Systemic Immune Inflammation Index as Prognostic, Predictive Biomarkers in Patients with Metastatic Renal Cell Carcinoma Treated with Nivolumab and Ipilimumab

Koji Iinuma; Torai Enomoto; Kei Kawada; Shota Fujimoto; Takashi Ishida; Kimiaki Takagi; Shingo Nagai; Hiroki Ito; Makoto Kawase; Chie Nakai; Kota Kawase; Daiki Kato; Manabu Takai; Keita Nakane; Koji Kameyama; Takuya Koie

doi:10.3390/jcm10225325

Utility of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Systemic Immune Inflammation Index as Prognostic, Predictive Biomarkers in Patients with Metastatic Renal Cell Carcinoma Treated with Nivolumab and Ipilimumab

J Clin Med. 2021 Nov 16;10(22):5325. doi: 10.3390/jcm10225325.

Authors

Koji Iinuma¹, Torai Enomoto², Kei Kawada³, Shota Fujimoto⁴, Takashi Ishida⁵, Kimiaki Takagi⁶, Shingo Nagai⁷, Hiroki Ito⁷, Makoto Kawase¹, Chie Nakai¹, Kota Kawase¹, Daiki Kato¹, Manabu Takai¹, Keita Nakane¹, Koji Kameyama⁸, Takuya Koie¹

Affiliations

¹ Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan.
² Department of Urology, Matsunami General Hospital, Hashima-gun 5016062, Japan.
³ Department of Urology, Gifu Prefectural General Medical Center, Gifu 5008717, Japan.
⁴ Department of Urology, Ogaki Municipal Hospital, Ogaki 5038502, Japan.
⁵ Department of Urology, Gifu Municipal Hospital, Gifu 5008513, Japan.
⁶ Department of Urology, Daiyukai Daiichi Hospital, Ichinomiya 4918551, Japan.
⁷ Department of Urology, Toyota Memorial Hospital, Toyota 4718513, Japan.
⁸ Department of Urology, Kizawa Memorial Hospital, Minokamo 5058503, Japan.

Abstract

The aim of this study was to assess the utility of neutrophil-to-lymphocyte ratio (NLR), plate-let-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) as predictive biomarkers with oncological outcomes for metastatic renal cell carcinoma (mRCC) patients treated with nivolumab and ipilimumab (NIVO + IPI). We conducted a retrospective multicenter cohort study assessing patients with mRCC treated with NIVO + IPI at eight institutions in Japan. In this study, the follow-up period was median 14 months. The 1-year overall- and progression-free survival (PFS) rates were 89.1% and 63.1, respectively. The objective response rate (ORR) and disease control rate (DCR) were 41.9% and 81.4%, respectively. The 1-year PFS rates were 85.7% and 49.1% for NLR ≤ 2.8 and >2.8, respectively (p = 0.005), and 75.5% and 49.7% for PLR ≤ 215.6 and >215.6, respectively (p = 0.034). Regarding SII, the 1-year PFS rates were 90.0% and 54.8% when SII was ≤561.7 and >561.7, respectively (p = 0.023). Therefore, NLR, PLR, and SII levels in mRCC patients treated with NIVO + IPI may be useful in predicting oncological outcomes.

Keywords: ipilimumab; neutrophil-to-lymphocyte ratio; nivolumab; plate-let-to-lymphocyte ratio; renal cell carcinoma; systemic immune inflammation index.