Eosinophils as a predictive marker of treatment-related adverse events in mRCC patients treated with first-line immune-checkpoint inhibitor combination therapy

Abstract Immune checkpoint inhibitors (ICIs) are a key component of first-line treatment for metastatic renal cell carcinoma (mRCC). However, predicting treatment-related adverse events (TRAEs) remains challenging. This study investigated the utility of eosinophil-related biomarkers as predictors of...

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Main Authors: Tatsushi Kawada, Satoshi Katayama, Takafumi Yanagisawa, Keiichiro Mori, Wataru Fukuokaya, Kazumasa Komura, Takuya Tsujino, Ryoichi Maenosono, Kiyoshi Takahara, Takuhisa Nukaya, Lan Inoki, Shingo Toyoda, Takeshi Hashimoto, Yosuke Hirasawa, Kohei Edamura, Tomoko Kobayashi, Kensuke Bekku, Shingo Nishimura, Takehiro Iwata, Takuya Sadahira, Yusuke Tominaga, Tomoaki Yamanoi, Kasumi Yoshinaga, Kazuma Tsuboi, Yasuyuki Kobayashi, Atsushi Takamoto, Kyohei Kurose, Takahiro Kimura, Haruhito Azuma, Ryoichi Shiroki, Kazutoshi Fujita, Yoshio Ohno, Motoo Araki, On behalf of JK-FOOT study group
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Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08767-9
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author Tatsushi Kawada
Satoshi Katayama
Takafumi Yanagisawa
Keiichiro Mori
Wataru Fukuokaya
Kazumasa Komura
Takuya Tsujino
Ryoichi Maenosono
Kiyoshi Takahara
Takuhisa Nukaya
Lan Inoki
Shingo Toyoda
Takeshi Hashimoto
Yosuke Hirasawa
Kohei Edamura
Tomoko Kobayashi
Kensuke Bekku
Shingo Nishimura
Takehiro Iwata
Takuya Sadahira
Yusuke Tominaga
Tomoaki Yamanoi
Kasumi Yoshinaga
Kazuma Tsuboi
Yasuyuki Kobayashi
Atsushi Takamoto
Kyohei Kurose
Takahiro Kimura
Haruhito Azuma
Ryoichi Shiroki
Kazutoshi Fujita
Yoshio Ohno
Motoo Araki
On behalf of JK-FOOT study group
author_facet Tatsushi Kawada
Satoshi Katayama
Takafumi Yanagisawa
Keiichiro Mori
Wataru Fukuokaya
Kazumasa Komura
Takuya Tsujino
Ryoichi Maenosono
Kiyoshi Takahara
Takuhisa Nukaya
Lan Inoki
Shingo Toyoda
Takeshi Hashimoto
Yosuke Hirasawa
Kohei Edamura
Tomoko Kobayashi
Kensuke Bekku
Shingo Nishimura
Takehiro Iwata
Takuya Sadahira
Yusuke Tominaga
Tomoaki Yamanoi
Kasumi Yoshinaga
Kazuma Tsuboi
Yasuyuki Kobayashi
Atsushi Takamoto
Kyohei Kurose
Takahiro Kimura
Haruhito Azuma
Ryoichi Shiroki
Kazutoshi Fujita
Yoshio Ohno
Motoo Araki
On behalf of JK-FOOT study group
author_sort Tatsushi Kawada
collection DOAJ
description Abstract Immune checkpoint inhibitors (ICIs) are a key component of first-line treatment for metastatic renal cell carcinoma (mRCC). However, predicting treatment-related adverse events (TRAEs) remains challenging. This study investigated the utility of eosinophil-related biomarkers as predictors of Common Terminology Criteria for Adverse Events grade ≥ 3 TRAEs in mRCC patients undergoing ICI combination therapy. In this retrospective analysis across 21 hospitals in Japan, we examined 180 patients treated with ICI/ICI therapy and 216 patients treated with ICI/tyrosine kinase inhibitor (TKI) therapy. Grade ≥ 3 TRAEs occurred in 39.4% and 31.9% of patients in the ICI/ICI and ICI/TKI groups, respectively. An elevated eosinophil proportion of ≥ 2.0% (odds ratio [OR]: 2.36; 95% CI [confidence interval] 1.23–4.54, p = 0.01) and a low neutrophil/eosinophil ratio (NER) of ≤ 40.0 (OR: 2.78, 95% CI 1.39–5.53, p = 0.004) were significant predictors of severe TRAEs in the ICI/ICI group. However, no significant associations were found in the ICI/TKI group. These findings may help identify patients who suffer from grade ≥ 3 TRAEs and help determine individualized treatment strategies in patients with mRCC.
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spelling doaj-art-e0091f8387b04643a4e5b552337ac88e2025-08-20T03:05:18ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-08767-9Eosinophils as a predictive marker of treatment-related adverse events in mRCC patients treated with first-line immune-checkpoint inhibitor combination therapyTatsushi Kawada0Satoshi Katayama1Takafumi Yanagisawa2Keiichiro Mori3Wataru Fukuokaya4Kazumasa Komura5Takuya Tsujino6Ryoichi Maenosono7Kiyoshi Takahara8Takuhisa Nukaya9Lan Inoki10Shingo Toyoda11Takeshi Hashimoto12Yosuke Hirasawa13Kohei Edamura14Tomoko Kobayashi15Kensuke Bekku16Shingo Nishimura17Takehiro Iwata18Takuya Sadahira19Yusuke Tominaga20Tomoaki Yamanoi21Kasumi Yoshinaga22Kazuma Tsuboi23Yasuyuki Kobayashi24Atsushi Takamoto25Kyohei Kurose26Takahiro Kimura27Haruhito Azuma28Ryoichi Shiroki29Kazutoshi Fujita30Yoshio Ohno31Motoo Araki32On behalf of JK-FOOT study groupDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, The Jikei University School of MedicineDepartment of Urology, The Jikei University School of MedicineDepartment of Urology, The Jikei University School of MedicineDepartment of Urology, Osaka Medical and Pharmaceutical UniversityDepartment of Urology, Osaka Medical and Pharmaceutical UniversityDepartment of Urology, Osaka Medical and Pharmaceutical UniversityDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Kindai University Faculty of MedicineDepartment of Urology, Kindai University Faculty of MedicineDepartment of Urology, Tokyo Medical UniversityDepartment of Urology, Tokyo Medical UniversityDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Urology, The Jikei University School of MedicineDepartment of Urology, Osaka Medical and Pharmaceutical UniversityDepartment of Urology, Fujita Health University School of MedicineDepartment of Urology, Kindai University Faculty of MedicineDepartment of Urology, Tokyo Medical UniversityDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAbstract Immune checkpoint inhibitors (ICIs) are a key component of first-line treatment for metastatic renal cell carcinoma (mRCC). However, predicting treatment-related adverse events (TRAEs) remains challenging. This study investigated the utility of eosinophil-related biomarkers as predictors of Common Terminology Criteria for Adverse Events grade ≥ 3 TRAEs in mRCC patients undergoing ICI combination therapy. In this retrospective analysis across 21 hospitals in Japan, we examined 180 patients treated with ICI/ICI therapy and 216 patients treated with ICI/tyrosine kinase inhibitor (TKI) therapy. Grade ≥ 3 TRAEs occurred in 39.4% and 31.9% of patients in the ICI/ICI and ICI/TKI groups, respectively. An elevated eosinophil proportion of ≥ 2.0% (odds ratio [OR]: 2.36; 95% CI [confidence interval] 1.23–4.54, p = 0.01) and a low neutrophil/eosinophil ratio (NER) of ≤ 40.0 (OR: 2.78, 95% CI 1.39–5.53, p = 0.004) were significant predictors of severe TRAEs in the ICI/ICI group. However, no significant associations were found in the ICI/TKI group. These findings may help identify patients who suffer from grade ≥ 3 TRAEs and help determine individualized treatment strategies in patients with mRCC.https://doi.org/10.1038/s41598-025-08767-9Renal cell carcinomaImmune checkpoint inhibitorICIEosinophilImmune-related adverse eventTreatment-related adverse event
spellingShingle Tatsushi Kawada
Satoshi Katayama
Takafumi Yanagisawa
Keiichiro Mori
Wataru Fukuokaya
Kazumasa Komura
Takuya Tsujino
Ryoichi Maenosono
Kiyoshi Takahara
Takuhisa Nukaya
Lan Inoki
Shingo Toyoda
Takeshi Hashimoto
Yosuke Hirasawa
Kohei Edamura
Tomoko Kobayashi
Kensuke Bekku
Shingo Nishimura
Takehiro Iwata
Takuya Sadahira
Yusuke Tominaga
Tomoaki Yamanoi
Kasumi Yoshinaga
Kazuma Tsuboi
Yasuyuki Kobayashi
Atsushi Takamoto
Kyohei Kurose
Takahiro Kimura
Haruhito Azuma
Ryoichi Shiroki
Kazutoshi Fujita
Yoshio Ohno
Motoo Araki
On behalf of JK-FOOT study group
Eosinophils as a predictive marker of treatment-related adverse events in mRCC patients treated with first-line immune-checkpoint inhibitor combination therapy
Scientific Reports
Renal cell carcinoma
Immune checkpoint inhibitor
ICI
Eosinophil
Immune-related adverse event
Treatment-related adverse event
title Eosinophils as a predictive marker of treatment-related adverse events in mRCC patients treated with first-line immune-checkpoint inhibitor combination therapy
title_full Eosinophils as a predictive marker of treatment-related adverse events in mRCC patients treated with first-line immune-checkpoint inhibitor combination therapy
title_fullStr Eosinophils as a predictive marker of treatment-related adverse events in mRCC patients treated with first-line immune-checkpoint inhibitor combination therapy
title_full_unstemmed Eosinophils as a predictive marker of treatment-related adverse events in mRCC patients treated with first-line immune-checkpoint inhibitor combination therapy
title_short Eosinophils as a predictive marker of treatment-related adverse events in mRCC patients treated with first-line immune-checkpoint inhibitor combination therapy
title_sort eosinophils as a predictive marker of treatment related adverse events in mrcc patients treated with first line immune checkpoint inhibitor combination therapy
topic Renal cell carcinoma
Immune checkpoint inhibitor
ICI
Eosinophil
Immune-related adverse event
Treatment-related adverse event
url https://doi.org/10.1038/s41598-025-08767-9
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