Neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumab

Background: There is a lack of surrogate markers to predict the outcomes of nivolumab plus ipilimumab (Nivo-Ipi) for advanced renal cell carcinoma (RCC), but neutrophil to lymphocyte ratio (NLR) and tumour burden are promising candidates. This study investigated biological and radiological surrogate...

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Main Authors: M. Oshima, S. Washino, S. Shirotake, H. Takeshita, M. Inoue, Y. Miura, A. Nakayama, S. Nagamoto, T. Nakayama, K. Izumi, M. Oyama, S. Kawakami, K. Saito, Y. Matsuoka, T. Miyagawa
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Language:English
Published: Elsevier 2025-03-01
Series:ESMO Real World Data and Digital Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949820124000845
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author M. Oshima
S. Washino
S. Shirotake
H. Takeshita
M. Inoue
Y. Miura
A. Nakayama
S. Nagamoto
T. Nakayama
K. Izumi
M. Oyama
S. Kawakami
K. Saito
Y. Matsuoka
T. Miyagawa
author_facet M. Oshima
S. Washino
S. Shirotake
H. Takeshita
M. Inoue
Y. Miura
A. Nakayama
S. Nagamoto
T. Nakayama
K. Izumi
M. Oyama
S. Kawakami
K. Saito
Y. Matsuoka
T. Miyagawa
author_sort M. Oshima
collection DOAJ
description Background: There is a lack of surrogate markers to predict the outcomes of nivolumab plus ipilimumab (Nivo-Ipi) for advanced renal cell carcinoma (RCC), but neutrophil to lymphocyte ratio (NLR) and tumour burden are promising candidates. This study investigated biological and radiological surrogate markers in advanced RCC patients receiving Nivo-Ipi. Materials and methods: Between 2018 and 2022, data were retrospectively collected for patients receiving Nivo-Ipi for previously untreated metastatic or locally advanced RCC with intermediate or poor risk across six centres. We assessed prognostic factors to stratify the outcomes of Nivo-Ipi, including tumour burden and NLR. Results: The study included 129 patients with a median age of 67 years (71% men). Both NLR and tumour burden were negatively associated with tumour response; they were also independently associated with unfavourable overall survival, whereas NLR was the only factor independently associated with unfavourable progression-free survival on multivariate analysis. Combined NLR and tumour burden assessment enabled stratification of the outcomes of Nivo-Ipi. Patients with NLR <3.0 or 3.0-5.9 and tumour burden <200 mm showed significantly superior treatment outcomes relative to the other patients with NLR ≥6.0 or 3.0-5.9 and tumour burden ≥200 mm (objective response rate: 54% versus 26%; complete response rate: 16% versus 0%; median overall survival: 44.3 versus 6.1 months; median progression-free survival: 17.4 versus 4.1 months). Conclusions: NLR and tumour burden were negatively associated with response to Nivo-Ipi in advanced RCC. Combined NLR and tumour burden assessment could efficiently stratify treatment outcomes and survival, potentially aiding treatment selection.
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spelling doaj-art-486d7104a3dd4cadb0ca97ddc1fea1962025-08-20T03:14:28ZengElsevierESMO Real World Data and Digital Oncology2949-82012025-03-01710010610.1016/j.esmorw.2024.100106Neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumabM. Oshima0S. Washino1S. Shirotake2H. Takeshita3M. Inoue4Y. Miura5A. Nakayama6S. Nagamoto7T. Nakayama8K. Izumi9M. Oyama10S. Kawakami11K. Saito12Y. Matsuoka13T. Miyagawa14Department of Urology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Musashino Study Group, Saitama, JapanDepartment of Urology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Musashino Study Group, Saitama, Japan; Correspondence to: Dr Satoshi Washino, Jichi Medical University Saitama Medical Center, 1-847, Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan. Tel: +81486472111Musashino Study Group, Saitama, Japan; Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, JapanMusashino Study Group, Saitama, Japan; Department of Urology, Saitama Medical Center, Saitama Medical University, Saitama, JapanMusashino Study Group, Saitama, Japan; Department of Urology, Saitama Cancer Center, Saitama, JapanMusashino Study Group, Saitama, Japan; Department of Medical Oncology, Toranomon Hospital, Tokyo, JapanMusashino Study Group, Saitama, Japan; Department of Urology, Dokkyo Medical University Saitama Medical Center, Saitama, JapanMusashino Study Group, Saitama, Japan; Department of Urology, Saitama Medical Center, Saitama Medical University, Saitama, JapanMusashino Study Group, Saitama, Japan; Department of Urology, Saitama Medical Center, Saitama Medical University, Saitama, JapanMusashino Study Group, Saitama, Japan; Department of Urology, Dokkyo Medical University Saitama Medical Center, Saitama, JapanDepartment of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, JapanDepartment of Urology, Saitama Medical Center, Saitama Medical University, Saitama, JapanDepartment of Urology, Dokkyo Medical University Saitama Medical Center, Saitama, JapanDepartment of Urology, Saitama Cancer Center, Saitama, JapanDepartment of Urology, Jichi Medical University Saitama Medical Center, Saitama, JapanBackground: There is a lack of surrogate markers to predict the outcomes of nivolumab plus ipilimumab (Nivo-Ipi) for advanced renal cell carcinoma (RCC), but neutrophil to lymphocyte ratio (NLR) and tumour burden are promising candidates. This study investigated biological and radiological surrogate markers in advanced RCC patients receiving Nivo-Ipi. Materials and methods: Between 2018 and 2022, data were retrospectively collected for patients receiving Nivo-Ipi for previously untreated metastatic or locally advanced RCC with intermediate or poor risk across six centres. We assessed prognostic factors to stratify the outcomes of Nivo-Ipi, including tumour burden and NLR. Results: The study included 129 patients with a median age of 67 years (71% men). Both NLR and tumour burden were negatively associated with tumour response; they were also independently associated with unfavourable overall survival, whereas NLR was the only factor independently associated with unfavourable progression-free survival on multivariate analysis. Combined NLR and tumour burden assessment enabled stratification of the outcomes of Nivo-Ipi. Patients with NLR <3.0 or 3.0-5.9 and tumour burden <200 mm showed significantly superior treatment outcomes relative to the other patients with NLR ≥6.0 or 3.0-5.9 and tumour burden ≥200 mm (objective response rate: 54% versus 26%; complete response rate: 16% versus 0%; median overall survival: 44.3 versus 6.1 months; median progression-free survival: 17.4 versus 4.1 months). Conclusions: NLR and tumour burden were negatively associated with response to Nivo-Ipi in advanced RCC. Combined NLR and tumour burden assessment could efficiently stratify treatment outcomes and survival, potentially aiding treatment selection.http://www.sciencedirect.com/science/article/pii/S2949820124000845neutrophil to lymphocyte ratiotumour burdenrenal cell carcinomanivolumabipilimumab
spellingShingle M. Oshima
S. Washino
S. Shirotake
H. Takeshita
M. Inoue
Y. Miura
A. Nakayama
S. Nagamoto
T. Nakayama
K. Izumi
M. Oyama
S. Kawakami
K. Saito
Y. Matsuoka
T. Miyagawa
Neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumab
ESMO Real World Data and Digital Oncology
neutrophil to lymphocyte ratio
tumour burden
renal cell carcinoma
nivolumab
ipilimumab
title Neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumab
title_full Neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumab
title_fullStr Neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumab
title_full_unstemmed Neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumab
title_short Neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumab
title_sort neutrophil to lymphocyte ratio and tumour burden for treatment efficacy stratification in renal cell carcinoma patients receiving nivolumab plus ipilimumab
topic neutrophil to lymphocyte ratio
tumour burden
renal cell carcinoma
nivolumab
ipilimumab
url http://www.sciencedirect.com/science/article/pii/S2949820124000845
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