Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma

Abstract Background The identification of biomarkers to select patients with metastatic renal cell carcinoma (mRCC) most likely to respond to combination immunotherapy (IO) is needed. We sought to investigate an association of the baseline neutrophil-to-eosinophil ratio (NER) with outcomes to nivolu...

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Autores principales:	Matthew D. Tucker, Landon C. Brown, Yu-Wei Chen, Chester Kao, Nathan Hirshman, Emily N. Kinsey, Kristin K. Ancell, Kathryn E. Beckermann, Nancy B. Davis, Renee McAlister, Kerry Schaffer, Andrew J. Armstrong, Michael R. Harrison, Daniel J. George, W. Kimryn Rathmell, Brian I. Rini, Tian Zhang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Kidney neoplasms Immunotherapy Tumor biomarkers Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/046d21ea12ea41aeaea7c6d824b8b8a6
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spelling	oai:doaj.org-article:046d21ea12ea41aeaea7c6d824b8b8a62021-11-07T12:12:49ZAssociation of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma10.1186/s40364-021-00334-42050-7771https://doaj.org/article/046d21ea12ea41aeaea7c6d824b8b8a62021-11-01T00:00:00Zhttps://doi.org/10.1186/s40364-021-00334-4https://doaj.org/toc/2050-7771Abstract Background The identification of biomarkers to select patients with metastatic renal cell carcinoma (mRCC) most likely to respond to combination immunotherapy (IO) is needed. We sought to investigate an association of the baseline neutrophil-to-eosinophil ratio (NER) with outcomes to nivolumab plus ipilimumab for patients with mRCC. Methods We performed a retrospective review of patients with clear cell mRCC treated with nivolumab plus ipilimumab from Vanderbilt-Ingram Cancer Center and Duke Cancer Institute. Patients with prior receipt of immunotherapy and those without available baseline complete blood count with differential were excluded. Patients were divided into groups by the median baseline NER and analyzed for overall survival (OS), progression free survival (PFS), and objective response rate (ORR). Patients were also divided by median baseline neutrophil-to-lymphocyte ratio (NLR) and analyzed for clinical outcome. Further analyses of patients above/below the median NER and NLR were performed in subgroups of IMDC intermediate/poor risk, IMDC favorable risk, and treatment naïve patients. Results A total of 110 patients were included: median age was 61 years and 75% were treatment naïve. The median NER (mNER) at baseline was 26.4. The ORR was 40% for patients with <mNER compared to 21.8% among patients with >mNER (OR 2.39, p = 0.04). The median PFS for patients with <mNER was significantly longer at 8.6 months (mo) compared to 3.2 mo for patients with >mNER (HR 0.50, p < 0.01). Median OS was not reached (NR) for patients with <mNER compared with 27.3 mo for patients with >mNER (HR 0.31, p < 0.01). The median NLR (mNLR) was 3.42. While patients with <mNLR showed improvement in OS (HR 0.42, p = 0.02), PFS and ORR did not differ compared with patients in the >mNLR group. Conclusions A lower baseline NER was associated with improved clinical outcomes (PFS, OS, and ORR) in patients with mRCC treated with nivolumab plus ipilimumab, and prospective validation of the baseline NER as a predictive biomarker for response to immunotherapy-based combinations in mRCC is warranted.Matthew D. TuckerLandon C. BrownYu-Wei ChenChester KaoNathan HirshmanEmily N. KinseyKristin K. AncellKathryn E. BeckermannNancy B. DavisRenee McAlisterKerry SchafferAndrew J. ArmstrongMichael R. HarrisonDaniel J. GeorgeW. Kimryn RathmellBrian I. RiniTian ZhangBMCarticleKidney neoplasmsImmunotherapyTumor biomarkersTherapeutics. PharmacologyRM1-950ENBiomarker Research, Vol 9, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Kidney neoplasms Immunotherapy Tumor biomarkers Therapeutics. Pharmacology RM1-950
spellingShingle	Kidney neoplasms Immunotherapy Tumor biomarkers Therapeutics. Pharmacology RM1-950 Matthew D. Tucker Landon C. Brown Yu-Wei Chen Chester Kao Nathan Hirshman Emily N. Kinsey Kristin K. Ancell Kathryn E. Beckermann Nancy B. Davis Renee McAlister Kerry Schaffer Andrew J. Armstrong Michael R. Harrison Daniel J. George W. Kimryn Rathmell Brian I. Rini Tian Zhang Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma
description	Abstract Background The identification of biomarkers to select patients with metastatic renal cell carcinoma (mRCC) most likely to respond to combination immunotherapy (IO) is needed. We sought to investigate an association of the baseline neutrophil-to-eosinophil ratio (NER) with outcomes to nivolumab plus ipilimumab for patients with mRCC. Methods We performed a retrospective review of patients with clear cell mRCC treated with nivolumab plus ipilimumab from Vanderbilt-Ingram Cancer Center and Duke Cancer Institute. Patients with prior receipt of immunotherapy and those without available baseline complete blood count with differential were excluded. Patients were divided into groups by the median baseline NER and analyzed for overall survival (OS), progression free survival (PFS), and objective response rate (ORR). Patients were also divided by median baseline neutrophil-to-lymphocyte ratio (NLR) and analyzed for clinical outcome. Further analyses of patients above/below the median NER and NLR were performed in subgroups of IMDC intermediate/poor risk, IMDC favorable risk, and treatment naïve patients. Results A total of 110 patients were included: median age was 61 years and 75% were treatment naïve. The median NER (mNER) at baseline was 26.4. The ORR was 40% for patients with <mNER compared to 21.8% among patients with >mNER (OR 2.39, p = 0.04). The median PFS for patients with <mNER was significantly longer at 8.6 months (mo) compared to 3.2 mo for patients with >mNER (HR 0.50, p < 0.01). Median OS was not reached (NR) for patients with <mNER compared with 27.3 mo for patients with >mNER (HR 0.31, p < 0.01). The median NLR (mNLR) was 3.42. While patients with <mNLR showed improvement in OS (HR 0.42, p = 0.02), PFS and ORR did not differ compared with patients in the >mNLR group. Conclusions A lower baseline NER was associated with improved clinical outcomes (PFS, OS, and ORR) in patients with mRCC treated with nivolumab plus ipilimumab, and prospective validation of the baseline NER as a predictive biomarker for response to immunotherapy-based combinations in mRCC is warranted.
format	article
author	Matthew D. Tucker Landon C. Brown Yu-Wei Chen Chester Kao Nathan Hirshman Emily N. Kinsey Kristin K. Ancell Kathryn E. Beckermann Nancy B. Davis Renee McAlister Kerry Schaffer Andrew J. Armstrong Michael R. Harrison Daniel J. George W. Kimryn Rathmell Brian I. Rini Tian Zhang
author_facet	Matthew D. Tucker Landon C. Brown Yu-Wei Chen Chester Kao Nathan Hirshman Emily N. Kinsey Kristin K. Ancell Kathryn E. Beckermann Nancy B. Davis Renee McAlister Kerry Schaffer Andrew J. Armstrong Michael R. Harrison Daniel J. George W. Kimryn Rathmell Brian I. Rini Tian Zhang
author_sort	Matthew D. Tucker
title	Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma
title_short	Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma
title_full	Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma
title_fullStr	Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma
title_full_unstemmed	Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma
title_sort	association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma
publisher	BMC
publishDate	2021
url	https://doaj.org/article/046d21ea12ea41aeaea7c6d824b8b8a6
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Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma

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