Metastatic renal cell carcinoma (mRCC) encompasses a heterogeneous group of neoplasms with distinct clinical behavior and prognoses. As a result of the increasing number of therapeutic options in the metastatic setting, it is crucial to improve prognostic stratification ability. We aimed to evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and combination platelet count and neutrophil lymphocyte ratio (COP-NLR) in patients with mRCC. We evaluated a cohort of mRCC patients treated with first-line pazopanib or sunitinib. Levels of NLR, PLR and COP-NLR were measured prior to systemic treatment and evaluated as prognostic predictors. Primary endpoint was overall survival (OS). Data from 276 patients were included, of which 54.7% received first-line pazopanib and 45.3%, sunitinib. Memorial Sloan-Kettering Cancer Center risk classification was intermediate and poor in 50% and 42.6% of patients, respectively. High NLR (> 3.5) was associated with inferior OS (median 9.6 vs 17.8 months, P < 0.001). A high PLR (> 200) was associated with inferior OS (median 10.3 vs 17 months, P = 0.002). The median OS in the COP-NLR 1, 2 and 3 groups were 19.0 months (95% CI 15.3–26.0), 13.1 months (95% CI 9.8–17.0) and 7.4 months (95% CI 3.6–11.9), respectively (P < 0.001). In the multivariate analysis, high NLR and high COP-NLR were associated with inferior OS. Both high NLR and high COP-NLR were associated with poorer OS in our cohort of patients with mRCC treated with first-line pazopanib or sunitinib.
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Medical records and laboratory data are available and stored in institutional databases.
Conflict of Interest
Guilherme Nader Marta has received travel/accommodations grants from Bayer Schering Pharma and Roche.
Pedro Isaacsson Velho has received research funding to his institution from Bristol Myers-Squibb and honoraria/consulting fee from Roche, AstraZeneca Bristol Myers-Squibb and Pfizer.
Renata R. C. Colombo Bonadio has received travel grants from Roche.
Mirella Nardo has no conflict of interest to declare.
Sheila F. Faraj has no conflict of interest to declare.
Manoel Carlos L. de Azevedo Souza has received speakers bureau’s grants from Novartis, MSD, Bristol Myers-Squibb and Amgen and has received travel/accommodations grants from Astellas and Zodiac.
David Q. B. Muniz: has received research funding to his institution from Pfizer, travel/accommodations grants from Janssen and has received speakers bureau’s grants from Pfizer and Janssen.
Diogo Assed Bastos has received research funding to his institution from Janssen, Astellas, Pfizer and honoraria/consulting fee from Roche, Janssen, MSD.
Carlos Dzik has received consulting or advisory grants from Janssen-Cilag, Ipsen, Novartis; speakers bureau’s grants Janssen Oncology and travel/accommodations from Astellas Pharma, Janssen Oncology.
This study was approved by the institutional research center (NP 716/14).
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Nader Marta, G., Isaacsson Velho, P., Bonadio, R.R.C. et al. Prognostic Value of Systemic Inflammatory Biomarkers in Patients with Metastatic Renal Cell Carcinoma. Pathol. Oncol. Res. (2020). https://doi.org/10.1007/s12253-020-00840-0
- Renal cell carcinoma
- Neutrophil-to-lymphocyte ratio
- Platelet-to-lymphocyte ratio