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Radiological Response and Neutrophil-to-Lymphocyte Ratio as Predictive Factors for Progression-Free and Overall Survival in Metastatic Renal Cell Carcinoma Patients Treated with Sunitinib

  • Jakub KucharzEmail author
  • Paulina Dumnicka
  • Agnieszka Giza
  • Urszula Demkow
  • Beata Kusnierz–Cabala
  • Tomasz Demkow
  • Pawel Wiechno
Chapter
Part of the Advances in Experimental Medicine and Biology book series

Abstract

Renal cell carcinoma (RCC) represents 2–3% of all malignancies. Most RCC-related deaths are caused by metastases of the disease. Studies suggest that inflammation-related parameters are of prognostic significance in metastatic renal cell carcinoma (mRCC) patients. Neutrophilia and thrombocytosis are markers of systemic inflammation that accompanies cancer, while lymphopenia is related to dysfunctions of the immune system. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) thus seem particularly interesting from a clinical perspective. The goal of this study was to determine if the response to therapy, consisting of reductions in radiologically assessed tumor burden and in inflammation-related parameters after 12 weeks of treatment with sunitinib, has a predictive value for outcome. One hundred thirty-one mRCC patients treated with the first-line sunitinib were evaluated. Inflammation-related parameters and radiologic response were correlated with treatment outcomes, progression-free, and overall survival. We found that the longest median progression-free survival of 37 months (Q1; Q3–15; not reached) and overall survival of 40 months (Q1; Q3–26; not reached) were achieved by patients who had either partial or complete response according to RECIST 1.1 and NLR lower than 1.64. In conclusion, the study confirmed that both objective response and lower grade of inflammation during treatment are predictive of better outcomes in mRCC patients treated with sunitinib.

Keywords

Cancer Metastases Neutrophil-to-lymphocyte ratio Radiological response Renal cell carcinoma Sunitinib Survival 

Notes

Conflicts of Interest

JK has received research grant from Novartis and travel grants and speakers’ honoraria from Pfizer, Bayer, Novartis, BMS, and IPSEN. PW has received speakers’ honoraria and travel grants from Pfizer, Bayer, Novartis, and IPSEN. The other authors declare no conflicts of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology (permission 38/2018).

Informed Consent

For this retrospective type of study, formal consent from individual patients was not required.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jakub Kucharz
    • 1
    Email author
  • Paulina Dumnicka
    • 2
  • Agnieszka Giza
    • 3
  • Urszula Demkow
    • 4
  • Beata Kusnierz–Cabala
    • 5
  • Tomasz Demkow
    • 1
  • Pawel Wiechno
    • 1
  1. 1.Department of UrooncologyMaria Sklodowska-Curie Memorial Cancer Center and Institute of OncologyWarsawPoland
  2. 2.Department of Medical DiagnosticsJagiellonian University Medical CollegeCracowPoland
  3. 3.Department of HematologyJagiellonian University Medical CollegeCracowPoland
  4. 4.Department of Laboratory Diagnostics and Clinical Immunology of Developmental AgeWarsaw Medical UniversityWarsawPoland
  5. 5.Department of Diagnostics, Chair of Clinical BiochemistryJagiellonian University Medical CollegeCracowPoland

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